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Presenteeism and Quiet Quitting. What’s the connection?

Presenteeism describes being at work but being unproductive due to stress, overwhelm and/or illness.

Harvard Business Review has estimated presenteeism costs the U.S. economy upwards of $150 billion a year

Quiet quitting is the ‘latest’ phrase to describe what many have done for decades – which is doing the bare minimum to get by.

And this too is costing the economy. opb.org in their article discussing quiet quitting write:

Gallup recently did a survey about quiet quitting, counting workers who report being neither engaged nor “actively disengaged” at work. They found that these quiet quitters make up at least half of the U.S. workforce.

 Presenteeism and quiet quitting are similar when you boil them down – someone is at work but doing the bare minimum. And that phrase, doing the bare minimum needs to be qualified for presenteeism:

This could be due to a fatigue-related impairment, or a downward spiral of functionality from mild to more serious levels of depression, hence the performance anxiety associated with presenteeism

Quiet quitting has taken off on social media, especially Tick Tok and there are many discussing what it is:

“We’re acting our wage”

“We have no hope of ever buying our own home – so why work hard for nothing?”

“We are working jobs that do not care about us as people”

 This Tik Tok is a great explanation of the quiet part – on both parts – the employee and employer, and suggests, as we will all know deep down, that it is up to the managers, including HR, to not only understand this trend but address it.

@managermethod #quietquitting #worktok #hrtiktok #pov #worklife #workstress #corporate #hrtok #whattosay ♬ original sound – Manager Method

Once the bean counters start to analyse quiet quitting, it will probably cause similar levels of costs as presenteeism.

Add to the above, there is also disagreement when it comes to working from home – where managers don’t believe their employees are productive:

What’s going on, and what do they both have in common?

 Unmet needs, unrealistic expectations, and the idea that the worker must go above and beyond, be more than, and not have any work-life balance to be, what?

A good cog in the wheel

To not be discarded.

In one instance the worker fears are being weaponised due to illness. No, you can’t take time out to be a human being as you must be a cog, and we will fire you if you do not fulfil the role of a cog.

On the other, they are there because they need the salary, they know they are replaceable and will find something else if needed.

Indifference and fear – two emotions that will harm not only the people experiencing them but also the business they’re employed in.

Living a life of fear and living an unfulfilled life at work.

Unmet needs and unrealistic expectations are the bottom lines here.

Unmet needs in the workplace, well, let’s face it, they are legion.

The office worker, employed from 9-5 (depending upon where you live), yet expected to routinely stay late, answer emails in the evening and to a degree, be on call over the weekend.

It’s as if the employee needs to behave like a business owner.

This is entirely unfair, yet it plays into the busy paradigm, of being a martyr for your work when you know your work will replace you within an unfeeling heartbeat.

So why should you care? Why should you go the extra mile just because Napoleon Hill says you should when it gains you nothing but pain? You miss out on the things that truly bring you joy.

So, business needs to start walking the talk and seeing their employees as just as valuable as the customer.

It needs to look after them.

Bonuses only work to a degree, as noted in peoplevalue.net

Businesses if they want to keep an employee, one that will go the extra mile, then it’s a quid pro quo that’s required.

And that starts with recognition for sure, but also ergonomics, wellbeing, and an environment where it’s conducive to be yourself so you can produce your best work, where you feel valued, seen and cared for.

This means investing in diversity, equality, and inclusion. Investing in accessibility, and wellbeing, and yes we are going to mention DSE regulations ( linked to our essential guide)  because there you have it business owners, a handbook that shows you the way.

Display screen regulations, all the way up to and including ISO 30071.1 give you the foundation for looking after your people that spend their days in an office and/or in front of a screen all day.

And it’s so simple.

It’s all about reasonable adjustment for the individual, the same way as when you get in a car and check the seat and mirrors are set in a way that’s perfect for you.

Display Screen Optimisation is a perfect example of this.  By ensuring safety and wellbeing when working with a display screen, making the reasonable adjustments as laid out in the regulations, including individualising the adjustments, so helping their performance and productivity.

To explain in more depth how our  Display Screen Optimiser (DSO)  aids wellbeing, we suggest you understand colour therapy that underpins the science behind the DSO tech and then dive further into how the Display Screen Optimiser software works.

The Display Screen Equipment regulations ask you to look at your employee as human, not a cog, so they stay your people, they want to stay your people, they give their best work and presenteeism and quiet quitting are totally absent and alien to them.

And our DSO can help you do just that.

Presenteeism and quiet quitting, are different, but the same.

What are you going to do about it?

Scanning versus reading. Is there a difference?

(Yes, and why we prefer scanning over reading may surprise you.)

Scanning; we all do it, especially when scrolling through social media or skimming through a post. We visually bounce from word to word to understand the ‘gist’ of what’s being conveyed.

Scanning involves the internal recognition of letters and words, and it identifies patterns of text. So, it is not necessarily about comprehension (though that does happen).

It closely mimics a user’s natural reading speed for personal consumption, which is important to note. However, reading speed is reduced when the user is asked to read the entire text and then reduced further when reading aloud.

Reading aloud is a less fluid process, as vocalising words lags behind the brain predicting what’s next and modifying what’s being spoken as a result.

Looking ahead can cause incorrect predictions, leading to some stumbling over words, especially for slow readers.

Interestingly, “If you watch a person’s eyes scanning text at a normal rate, the eyes seem to be ahead of the voice when we read aloud.”

Diving deeper into the science of scanning:

Rayner and Pollatsek, two researchers from the Massachusetts Institute of Technology, spent 20 years studying how the eye moves when reading. They discovered that it fixates on what they call content words, e.g., nouns and verbs in a quick succession of stops and jumps called fixation and saccades

A saccade “is a rapid, conjugate eye movement that shifts the center of gaze from one part of the visual field to another. Saccades are used for orienting gaze towards an object of interest. Saccades may be horizontal, vertical, or oblique.”

Imotions.com describe the fixation as “Between saccades, our eyes remain still for around 200-300 ms – this known as a fixation (“still” is a bit of a relative term here – our eyes often continue to move around as a result of optokinetic nystagmus, which aids visual processing in the brain).”

image of text showing eye movement of scanning
Showing the eye focus when scanning

(Image from readingrockets.org )

Why do our eyes jump around like this?

Up-close we have a very narrow field of vision.

Try looking at both of someone’s eyes at the same time without flicking from one to the other. This narrow field makes us very sensitive to misalignment and being uncomfortable when wondering which of their eyes is looking at us.

Even when reading, our eyes move around to take in a larger view.

If you can scan quickly and easily, your eyes are not only seeing the text easily, but you are interpreting the text efficiently and with a degree of visual comfort. 

Reading, on the other hand, is comprehending the words.

If it’s silent reading, it can include creating visual images to help understand the words, and we can often ‘hear’ the word in our heads. So, for example, when you read a novel, you’ll imagine the characters in your mind; you might even imagine how their voices sound.

Reading, primarily when out loud, engages the brain and the vocal system and, to a degree, comprehension.

However, with reading out loud before reading silently, there is a difference in understanding, with a greater degree of comprehension gained from silent reading first.

Ok, so why are we telling you all this?  

When our software is choosing the individualised contrast colour background to text for your digital display screen, we are looking at set data to find the “one” most visually comfortable or accessible colour contrast for you.

One that aids in your scanning and reading.  

The correct colour contrast does this by helping sustain the synchronicity of both eyes, mitigating binocular discomfort and loss of stereoscopic vision due to eye muscle fatigue.

It’s a fatigue that presents as early-onset blurred or double vision.

Different coloured backgounds for the same texts
black text with different coloured backgrounds

Here’s (very simply) how it works:

There are two primary types of photoreceptors in the human retina – rods and cones.

Rods are responsible for vision at low light levels (scotopic vision). They do not mediate colour vision and have a low spatial acuity.

Rods don’t help with colour vision, which is why at night, we see everything in grayscale. The human eye has over 100 million rod cells. Cones require a lot more light and they are used to see colour.”

Cones are active at higher light levels (photopic vision), are capable of colour vision and are responsible for high spatial acuity.

The correct colour contrast background aids in your scanning and reading by engaging the colour “cones” in the eyes, as opposed to the monochrome rods.

It’s about your individual photopic sensitivity.  

Photopic sensitivity refers to visual sensitivity under conditions of bright light, where radiant energy stimulates the cones  – the retinal photoreceptors responsible for colour perception.

The cones, with their high acuity, are better placed to deal with text but are not invoked by black on white text.

Black text on a bright white computer screen only turns up the volume of any discomfort or fatigue.

Bringing in the colour contrast background brings the cones to the party and help you read and scan much more easily.

Now to your screens:

 The visual system (eyesight) is effectively disabled by “Glare”. Think of how you screw up your eyes and want to look away at bright headlights in the dark.

If there is also photophobic flickering light, or very high contrast and/or very low contrast that causes discomfort, prompting visual stress with avoidance strategies such as looking away, natural “adaptations” due to eyestrain will appear.

They must, as your body is trying to defend itself.

The warning signals of this will be loud and clear – pain, headaches, blurry or worse double vision, dizziness, migraine, even nausea and vomiting.

These signals should not be ignored.  

 Every individual and display screen for that matter is different, so it is simply a question of matching the screen colour contrast settings/calibration to the user operators most comfortable, expressed by RGB background screen colour values or HEX number.

By analysing the eye systems responses, we look for any evidence of eye muscle fatigue. We measure screen to brain sets of functions and timescales – namely the focus and refocus of the eye muscles and look at any deficits in speed when scanning.

We’ve found the simplest way to do this is to use a block of no-sense text. This prevents the individual’s natural capacity “for predicting what comes next”, to allow repeat scanning of the same subject matter without becoming familiar with its content.

“With the DSO scanning challenge, we are looking at specific data points, and we are looking at the speed of scanning, as this simply points towards gains in accessibility, comfort and ease”.

 The gains in accessibility to text on-screen, increase comprehensibility, increase the comfort within your visual system for longer and reduces the risk of early-onset eyestrain, mitigating vision system deterioration.

Until our brains are chipped to interface with our computers directly to the screen, users will still need to use their eyes to read.

Until that day, users contend with screen brightness, glare, colour contrasts, and moving images, all of which can overexcite the visual system and cause fatigue, which leads to all the symptoms of screen fatigue/computer vision syndrome.

We aim to calm the visual system more than aid in dyslexia/comprehension by bringing on board the cones to help the eyes to focus and refocus, not leaving the poor rods to do all the heavy lifting.

That it helps in these areas too is a bonus.

In optometry terms, we aim to increase binocular stability, as we all know looking at a screen for too long causes binocular instability, essentially visual fatigue.

(Anecdotally, we notice an average 20% gain in accessibility/reduction in eyestrain and risk of screen fatigue / CVS by using the DSO, which is being investigated further in our clinical trials.)

What about biometrics?

We currently use AI to drive the DSO, and soon we will be adding biometrics screening and voice recognition to next-generation packages of Score My Screen.

Display Screen Equipment Regulations. Quick-Reference Guide

 If you take anything away from this quick reference guide – let it be these words:

                                  “So far as reasonably practicable.”

Have them etched in your mind because this is what is being asked of you.

DSE regulations have a “reasonably practicable” regulatory solution for most visual repetitive stress injuries.

The evolution

evolution from ape to pc ( image from dreamstime.com)

The regulations for Display Screen Equipment have been evolving for decades.

 As you read through this document, you’ll see how they’ve evolved to encompass all aspects of working with DSE, from the chair to the mental health of the operative.


black and white image of digital devices in 1974
Digital Devices in 1974

They began back in 1974 with the Health & Safety at Work Act legislation still current to this day.

The aim of the Health and Safety at Work Act is so that we all know and understand what health and safety measures are needed in our workplaces, where we can find the information for them, and that they have been implemented so far as is reasonably practicable.’

This phrase is not a get out of free jail card – this is a – you need to look and see what needs implementing, and do it as far as is reasonably practicable.

Please note we have provided examples of checklists for each regulation where possible.  

Example of 1974 Health and Safety checklist>>>  https://www.londonofficespace.com/healthsafetychecklist.html


Personal Digital Assistant 1992
PDA 1992
  • Starting in earnest in 1992 as the digital age begins to take off –

We have The Health and Safety (Display Screen Equipment) Regulations 1992

This regulation is the benchmark for evaluating the workplace for any health and safety risks for display screen users – BUT – as this was the start of the digital age, they didn’t focus too much on the screen – it was more about the office environment and the ergonomics.

The emphasis was on assessing and evaluating the workplace.

The main points are:

  • Analysis and requirement of workstation

·      Daily work routine – a bit Shakespearian in writing, but here’s a sample – 4.  Every employer shall so plan the activities of users at work in his undertaking that their daily work on display screen equipment is periodically interrupted by such breaks or changes of activity as reduce their workload at that equipment.

·      If you work with DSE, you are entitled to regular eye tests and equipment needed to ensure your vision is cared for.

·      The checklist for this regulation >>> https://www.hse.gov.uk/pubns/ck1.htm


The imac 1998
iMac computer 1998

Six years later and new realisations are emerging. Tech is becoming better; digital is more and more in our daily lives, the office chair and desk are regulated – so now we have the

1998 PUWER Act ( created initially in 1992, updated in 1998, with minor updates in 2021 to reflect that the UK is no longer part of the EU)

These regs move from the workplace environment – office desk and chair etc. to the equipment – asking the questions:

>>>>>>>>> is it suitable, how is it used, and have they been trained? <<<<<<<<<<

From the regulations themselves:

“The use of work equipment is also very widely interpreted and ‘…means any activity involving work equipment and includes starting, stopping, programming, setting, transporting, repairing, modifying, maintaining, servicing and cleaning”.

The 1998 PUWER requires risks to people’s health and safety from equipment they use at work to be prevented or controlled. … safe for use, maintained in a safe condition; “used only by people who have received adequate information, instruction, and training”.

This act is trying to prevent injuries and mishaps.

A brief overview:

  • Selection and conformity of work equipment
  • Maintenance and inspection of work equipment.
  • Training and competence.

An example of a PUWER checklist >>> https://datascope.io/en/template/manufacturing/work-equipment-assessment-puwer?id=167581


digital tech in 2007
iPhone 2007

Nine years later, we are into the new millennium, and being faithful tech people, we are looking at DATA, and the impacts that working with DSE have on our bodies.

HSE RR561 2007 landmark Study  – Think: Presenteeism, carrying-on regardless of visual stress, MSD’s and repetitive physical stress injuries MSK’s/

The opening paragraph tells us most of what we need to know about this study:

A variety of ill ­health symptoms have been associated with work with Display Screen Equipment (DSE), including musculoskeletal disorders, mental stress, and visual fatigue.

The survey found high prevalences in DSE users of self­ reported symptoms, eg.

headaches (52%),

eye discomfort (58%), and

neck pain (47%);

other symptoms such as back (37%)

and shoulder (39%)  pain were also frequently reported.

>>>>>>. Most of those reporting symptoms did not take any time off work. <<<<<<<<<<

All symptoms were more common among respondents who had indications of stress, anxiety and/or depression.

It’s important to note that this is 15 years after the introduction of DSE regs in 1992, and they quite rightly point out:

“However, there are substantial uncertainties, not least over the extent to which the provisions of the legislation have been fully implemented, and it cannot be safely concluded that the legislation has had no effect.”

Has there been an update to this?

Not that we have been able to find, but then we have just been living through 2020/2021, so we are sure there will be an update due to screen fatigue and zoom fatigue now being endemic.


tech in 2016
Digital technology in 2016

WHO ICD 10 Version 2016

Why would we include a list of eye problems in a regulatory quick reference guide?

Especially when this particular ICD-10 list of eye diseases is the basis for identifying the severity of illness in the USA and used by eye hospitals for billing purposes (depending on specific conditions covered by insurance or not).

We’ve included it as a pause, a time to reflect, and ask the question:

How long before this list is used in the UK? Particularly if a DSE operator recognises that their eyesight has deteriorated because their employer has not been implementing the DSE regs?


Digital devices 2017
Digital devices 2017

This year saw the release of a DSE  Safety Alert  as it was noted “ There is evidence of non-compliance in the area of Display Screen Equipment (DSE) assessment as required by current legislation. The purpose of this Safety Alert is to highlight the importance of ensuring all workstations are assessed.”


2018 and tech is everywhere
Digital Life 2018

So, by now, we realise that sitting in a chair all day, staring at a screen, is not great for the body, mind or soul, there is a vast list of injuries used by the USA insurance companies, a safety alert has been raised by Health and Safety England, so we need to start looking at limits.

Not easy with working from home becoming more popular, but we become tired, and when fatigued, we make mistakes, which can be costly.

2018 ISO 45001 “Work Exposure Limits.”

ISO 45001 is the world’s international standard for occupational health and safety.

It was issued to protect employees and visitors from work-related accidents and diseases.

As a result, ISO 45001 is concerned with mitigating any factors that are harmful or that pose a danger to workers’ physical and/or mental wellbeing.

We’ve moved from assessing risks to doing our best to prevent them.

The main points from this regulation – taken  from the BSI website:

  • Increase organisational resilience through proactive risk prevention, innovation and continual improvement
  • Strengthening of legal and regulatory compliance whilst reducing business losses
  • Demonstrates brand responsibility by committing to safe, healthy and sustainable work
  • One global occupational health and safety system for all businesses of all sizes.

An example of the ISO 45001 checklist >>> https://www.qmsuk.com/iso-standards/iso-45001/iso-45001-audit-checklist

Also, in 2018 we have the arrival of WCAG 2.1

Web Content Accessibility Guidelines (WCAG) 2.1 covers a wide range of recommendations for making Web content more accessible.

The website states:

“Following these guidelines ensures content is more accessible to a wider range of people with disabilities, including accommodations for blindness and low vision, deafness and hearing loss, limited movement, speech disabilities, photosensitivity, and combinations of these, and some accommodation for learning disabilities and cognitive limitations.”

They also clearly state:

Following these guidelines will also often make Web content more usable to users in general.

Bullet points:

  • Ensuring non-text is available in text
  • Assistive technology
  • Human language

An example of the WCAG 2.1 checklist >>>>https://webaim.org/standards/wcag/checklist


Top mobile phones 2019
Mobile phone in 2019

Welcomes ISO 30071.1, which takes WCAG a step further, is the evolution of British Standard 8878 and focuses more on user experience and the more personalised approach, emphasising accessibility.

This ISO applies to all types of organisations. It applies to the breadth of ICT systems (Information and Communications Technology) within an organisation, including, but not limited to: information systems; intranet systems; websites; mobile and wearable applications; social media; and Internet of Things (IoT) systems.

Giving requirements and recommendations for organisations such as:

  • Ensuring accessibility is considered in their policies or strategy by creating an organisational ICT accessibility policy.
  • Embedding the consideration of accessibility decisions through the entire process of developing, procuring, installing, operating and maintaining ICT systems, and documenting these choices.
  • Communicating the ICT system’s accessibility decisions to its users at launch through creating and publishing its “Accessibility Statement”.


Digital Devices 2021
Digital devices in charging dock ( image Esquire.com)

ISO 45003Finally, we arrive at the mental health aspects of DSE regulations.

Remember how the 2007 Data showed people carrying on regardless of illness, injury and poor mental health? Well, this set of regulations attempts to redress this.

Occupational health and safety management Psychological health and safety at work – Guidelines for managing psychosocial risks guide psychological health and safety risks within an occupational health and safety management system.

This ISO addresses the many areas that can impact a worker’s psychological health, including ineffective communication, excessive pressure ( our note: not taking a lunch break, poor lighting, working late – staring at a screen that has not been calibrated for the user – i.e. straight out of the box – for over 9 hours a day), poor leadership and organisational culture.

And here is where we want to take another pause and think more about Exposure Control.

We usually consider exposure control is required for chemicals or toxic substances. Still, here we are referring to exposure to visual health stressors – and yes – high on the list is the display screen, including the hours and hours we all spend looking at one – be that pc – phone or TV.

Overexposure to DSE presents as dry-eye syndrome and binocular visual disturbances (WHO ICD-10), debilitating myopic and asthenopic (eye stress) disease. This often presents as deficits in spatial awareness and blurred, or worse double vision, impairing learning and educational/work performance.

Tying this all together.

You should now see the evolution from thinking about the desk and the chair to the actual human experience working with DSE in the chair.

We know that the office environment needs to be optimal, and risks mitigated.

We know that frequent breaks are required, overexposure leads to physical and mental harm, and we know we need to take care of our most valuable asset – the employee.

And you can do that by personalising their DSE.

The DSO creates the optimal, personal coloured background for the DSE user, mitigating the harms of overexposure and the disease associated with that, reducing stress, and having them shows compliance with the DSE regulations in that reasonably practical way.

Looking after your employees’ wellbeing isn’t a chore; it’s a privilege, and if you do it well, everybody and the company flourishes.

Congratulations if you made it this far!

You probably now know more than most regarding DSE regulations

A brief note about colour contrast validation.

Poor colour contrast has a cascade effect that few people are aware of.

This is what happens:

  • The colour contrast affects your eyes.
  • Which affects the stamina of your visual systems and brain.
  • Which negatively affects your capacity to sustain concentration levels.
  • Which in turn, affects your levels of cognitive fatigue, efficiency and productivity.

Processing (understanding) visual information uses energy. For example, if you work harder to process visual information because certain colour combinations cause you pain or discomfort, you use up more energy, become fatigued and therefore less efficient and productive.

  • You are also prone to increased error rates and making simple mistakes.
  • Poor Colour contrast is also visually uncomfortable. It affects the eye-muscle stamina in sustaining binocular/stereoscopic vision close up, and can contribute to early-onset eye strain.

What is colour contrast?

The term refers to the tone, contrast colours, brightness of the background and amount of text and images on a webpage or website, (now regulated by WCAG).

The most basic colour contrast (out of the box setting), is black text on a bright white background. This is considered very high contrast and should be avoided.

But more and more, people are noticing that colours and colour contrast can either enhance or detract from our well-being due to the amount of visual stress it causes.

Bright colours can grab our attention, but they can also cause pain.

Finding the correct colour contrast can enhance access to text.

And if you are a DSE operator, you want your eyes to work well, you want to be alert, you want to avoid pain, and you want to be as productive as you can be.

If you are in HR, you want these for your staff.

This is why the DSO should be on your DSE

regulation and wellbeing checklist:

  • Does everyone know where the health and safety manuals are? ✅
  • Chair, pc and table and office lighting assessed? ✅
  • Necessary training has been given/undertaken? ✅
  • Have work exposure limits been set? ✅
  • PC has had personalised adjustments for the individual user? ✅
  • DSO installed on company computers? ✅
  • Employee is aware of psychological and wellbeing services? ✅

Download our DSE Regulations Reference Guide here

Digital Accessibility

Hooray – the time has come the Walrus said for many things and eye-strain (Asthenopia) Computer Vision Syndrome or Screen Fatigue as a disability which has, for far to long, been dismissed as temporary yet, as an everyday uncomfortable even painful impairment to performance and productivity in the majority of DSE workers contributes 20% or 30 days to the total 57.2 days lost productivity in the UK. Maybe now, whilst recognised as a Global Pandemic elsewhere we can do something to raise awareness in the UK by revisiting the 2007 HSE Better Display Screen RR561 that subjectively reported 58% of user operators experienced symptoms