WORKERS OF HONG Kong unite - you have nothing to lose but your back pain. That's the clarion call of the Chiropractic Doctors' Association, which says the spines of the city's workforce are being oppressed by businesses with poorly designed offices and that the government is failing to protect them. Seven out of 10 Hong Kong office workers suffer from stiff necks, backs and shoulders - all symptoms of spinal problems - according to a survey by the association, and one in four young Hong Kong people suffers back problems usually associated with geriatric patients overseas. At the root of the city's epidemic of back pain, according to association chairman, Vincent Chan Wan-ho, is a crippling combination of long working hours, unhealthy lifestyles and a widespread failure by employers to provide ergonomically designed work stations. All of that was supposed to start changing in July last year when the Occupational Safety and Health (Display Screen Equipment) Regulation came into effect - forcing employers to make sure their staff are seated directly in front of their computers, with monitors at eye level, reducing the risk of spinal injuries. It's had little effect, according to Chan, who says the regulation is widely ignored because enforcement isn't strict enough Not a single fine or penalty has been imposed in the first year of the regulation - although the Labour Department says it has organised 660 educational talks and issued 139 warning letters and improvement orders. Now, in the interests of the deteriorating spinal health of Hong Kong, it's time to get tough, says Chan. 'I think they need to be more aggressive about [the regulations],' he says. 'They should make an example of large companies where a lot of staff are working on computers to get the message across. When you look around offices in Hong Kong, you often see the work station isn't set up well. They're cramped. The computer is set to one side. The office environment isn't ergonomically friendly. Employers should take a large responsibility for this. 'Employers aren't motivated to change the working environment because doing so costs money, so it has to be forced on them by the government,' Chan says. In the meantime, workers can take matters into their own hands by making sure their work stations are properly set up and that they get sufficient screen breaks. 'Hong Kong workers are very passive,' Chan says. 'But they should try to modify their conditions. If their monitor is too low, they should put something under it to make it higher. Take frequent breaks. Take a break from your screen every half hour. Keep your back against the back of the chair.' It's difficult to overstate the scale of Hong Kong's spinal problems. Teenagers who spend hours crouched over video games are reported to be suffering from conditions normally associated with the elderly. Most patients visiting the city's 50 registered practising chiropractors are office workers aged 45 and under. 'We see in some cases people of 18 or 19 with back spurs (calcification of the soft joint tissues under constant pressure) and degeneration of the neck,' says Chan. This is usually unheard of in people of such a young age. Back spurs are usually associated with old age. 'The typical patient in Hong Kong is a lot younger than you'd expect in Canada or the US,' he says. 'There, they have a lot of geriatric patients. Here, you see a lot of officer workers. Probably about 70 to 80 per cent of patients are aged 25 to 45. Typically, they have back or lower back problems. 'The reason is that Hong Kong people spend a lot of time in the office. Jobs tend to be stressful. They're in a fixed position for a long time. In Canada and the US, people of that age get it from other sources, from outdoor activities such as fishing and mowing the lawn. In Hong Kong, people get it from sitting in the office.' Hong Kong's notoriously unhealthy lifestyles are a major contributing factor. 'It's not just being in the office,' says Chan. 'We ask our patients to have a balanced lifestyle. It's hard to do that if you're working 12 or 13 hours and you don't have time for swimming and the gym or other types of exercise. It's a real problem. And because the population density is so great, there aren't many recreation facilities. 'People need to introduce some routine into their daily office work. Every half an hour they should be stretching out their lower back a little bit. They should also be introducing physical exercise to their daily routine. If they travel to the office by bus, they should try getting off one stop early and walking the rest of the way to work. Swimming is good exercise for spinal conditions because the spine isn't under vertical pressure. It puts the back under less stress than walking or jogging.' The good news for back-pain sufferers is that, if the condition is treated at an early stage, there's no reason it shouldn't be completely cured. If untreated, however, it can develop into a life-long condition. Chan says Hong Kong's best hope for stronger backbones is to deal more rigorously with companies that show scant regard for employees' spinal health. 'I think if they had the right working environment coupled with a good lifestyle almost all my patients wouldn't be patients any longer and I'd be out of work,' he says. A Labour Department spokseman disputes any suggestion it hasn't done enough to enforce the new regulations on work stations. 'We have conducted targeted inspections of high-risk workplaces, such as those where employees perform long periods of data processing work,' he says. A total of 130 warning letters and nine improvement notices have been issued after inspections on 310 premises since the regulation came into effect.