## 1 Introduction  
In the rapidly evolving landscape of the digital age, the use of video display terminals (VDTs) has become ubiquitous in various occupational settings. The work digitalization challenge seems enormous and of fundamental importance: a substantial aspect of the potential development of Italian and other European companies will depend on it [1]. Digital resources may undoubtedly enhance efficiency and productivity, but despite this, they also pose potential health risks to users, whose health risk assessment by ergonomists, prevention technicians and occupational physicians is necessary [1, 2]. According to the Italian law that regulates health and safety in occupational environments [2], a VDT user's health is considered potentially at risk if the operator uses the VDT for at least 20 h a week, considering pauses for physiological recovery. The conventional health risks to be considered include vision and eye load (dry eye disease or computer vision syndrome), posture and physical or mental fatigue, biomechanical overload of the musculoskeletal apparatus due to the working position and postural adaptations (wrists, neck and lumposacral tract) and indoor air quality [3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16]. The effect of a good organization that minimizes these impacts on the overall health of the worker needs to be better characterized.  
The schedule of work tasks and the attribution of roles in a firm are crucial factors for the maintenance of psychosocial health among employees [3]. In this regard, a main factor that affects the risk to office workers is the number of active worker-VDT interactions [17]. Good daily work routine planning can help workers take on the right amount of stress, so they are neither demoted nor overwhelmed [4].  
Currently, the evaluation of a workstation is carried out through specific ergonomic checklists [5] related to the setting of the tools in use (mouse, keyboard, display, chair and ambient lighting). In addition to these factors, individual susceptibility factors also play a role; furthermore, individual ways of interacting with the VDT, which show wide interindividual variability, may lead to differences in individual risk profiles. In our previous study [17], we validated the prototype of an electronic system that is able to objectively assess active operator-VDT interactions by collecting electrical impulses generated by the activation of a mouse, keyboard and camera to determine attentive eye-screen fixation. Through this system, it was therefore possible to analyze different work tasks and outline user-VDT interaction profiles.  
Computer vision syndrome (CVS) is a potential health outcome in which patients display a wide array of symptoms related to vision, which has been associated with, among other factors, prolonged computer use. CVS affects 75% to 90% of computer users, with a global prevalence that is estimated at approximately 60 million people [18; 19; 20; 21; 22; 23; 24].  
Common symptoms (strain, blurred vision, eye dryness, ocular redness and headache) are directly linked to dry eye disease, in which a vicious cycle results in reduced blink rates, incomplete blinks and, consequently, tear film instability. This process can become self-perpetuating and worsen over years of exposure, strongly affecting the quality of life of workers and, as some scientific works have suggested, possibly correlating with mental health disorders such as depression, depending on symptom severity [25; 26; 27; 28; 29; 30; 31; 32]. The present study aimed to shed light on the challenges faced by occupational health physicians in accurately assessing the risks of VDT-associated tasks. By testing an innovative nonwearable acquisition system, we sought to provide an objective assessment of the intentional operation of input peripherals and active display screen fixation among office workers, thereby identifying objective measures of parameters that should be used in the future for more effective risk assessment and management.