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NIOSH Suggests Considerations for Alternative Keyboard Use

NIOSH Update:

Contact: Fred Blosser (202) 260-8519
January 12, 1998

“Alternative Keyboards,” a new publication from the National Institute for Occupational Safety and Health (NIOSH), offers information for video display terminal (VDT) users who are considering non-traditional or alternative VDT keyboards for the workplace.

The easy-to-read publication describes different types of alternative keyboards, such as split keyboards, concave and convex designs, tented keyboards, keyboards whose slope can be adjusted, and designs with built-in palm or wrist rests.

“There is no conclusive evidence as to whether alternative keyboards can reduce the risk of musculoskeletal disorders such as carpal tunnel syndrome,” noted NIOSH Director Linda Rosenstock, M.D., M.P.H. “But various types of alternative keyboards are widely used, and little information is available to help organizations and individuals make decisions about selection and application. The new NIOSH publication provides basic, practical information as research continues.”

Alternative keyboards can help keep wrists straight, avoiding postures that are thought to cause musculoskeletal problems. However, few studies have examined actual performance on alternative keyboards to evaluate whether they are more beneficial than conventional designs in preventing discomfort, fatigue, and strain. Also, NIOSH cautions that a computer keyboard is only one element of the workplace that can influence comfort and health. Therefore,all features of the work environment, not just the keyboard, should be examined when evaluating ways to enhance user comfort and avoid potential musculoskeletal problems. Suggestions for selecting a keyboard appear on the following page.

NIOSH is the Federal agency responsible for conducting research and making recommendations for the prevention of work-related disease and injury. The Institute is part of the Centers for Disease Control and Prevention

Copies of “Alternative Keyboards,” NIOSH (DHHS) Publication No. 97-148, are available by calling the NIOSH toll-free information number, 1-800-35-NIOSH (1-800-356-4674). For further information on alternative keyboard research and other ergonomics research, call the toll-free number or visit NIOSH on the World Wide Web at

If alternative keyboards are to be used in the workplace, the following suggestions may be helpful in making purchasing decisions:

  • Determine if the keyboard is compatible with existing hardware and software, and whether it can accommodate other input devices such as mice and trackballs.
  • Assess how the keyboard will fit with the workstation. Some alternative keyboards, particularly those with a tented design, must be placed on surfaces that are lower than those required for standard keyboards to achieve proper working posture.
  • Evaluate whether the keyboard will affect the user’s performance. Does the design make it difficult for the user to see the keys? Does the job require a numeric keypad or specialized keys that may not appear on an alternative keyboard?
  • Allow users to try a keyboard on a trial basis before buying it.
  • Because one type of keyboard will not be appropriate for all users or tasks, allow users to try different kinds before deciding which to buy, and allow them to retain a conventional keyboard if they wish.
  • It may take a few days for a user to become accustomed to an alternative keyboard, and frustration may occur if productivity is affected during this learning phase.
  • It can be helpful to involve a specialist who knows about and is experienced in office ergonomics, and also to involve a health professional if a computer user has discomfort or musculoskeletal symptoms.
  • Integrate a new alternative keyboard carefully into the work process, ensuring that users are trained in correct use.
  • Each workplace should have a comprehensive ergonomics program to protect all workers.

(From “Alternative Keyboards,” NIOSH (DHHS) Publication 97-148)