The relationship between upper extremity musculoskeletal disorders and occupational factors among workers using video display terminals (VDTs) in the newspaper industry was assessed in a cross sectional survey of 973 randomly selected subjects from four departments at a large metropolitan newspaper. Questionnaires addressed issues of symptoms, work tasks, psychosocial factors, and work organization. Of the participants, 41% reported significant occupationally related symptoms of the neck, shoulder, elbow, and hand/wrist in the past year. The most frequent symptoms involved the neck (26%), followed by hand/wrist (22%), shoulder (17%), and elbow (10%). Women were at higher risk for neck, shoulder, and hand/wrist symptoms than men. The length of employment was found to be the only significant occupational history risk factor in the association with shoulder symptoms. An important predictor for neck and hand/wrist symptoms was number of hours spent under a deadline. Among psychosocial work environment characteristics, a significantly higher prevalence of neck symptoms was observed for workers who reported a greater amount of work variability. Employees who perceived a lack of supervisory support seemed to have a higher prevalence of hand/wrist disorders. Workers who reported increased job pressure and lack of participation were found to have a higher incidence of shoulder symptoms. A dose dependent association was observed between the number of hours spent at VDTs and the prevalence of hand/wrist disorders. The authors conclude that the occurrence and high prevalence of occupationally related musculoskeletal disorders among newspaper employees is related to greater hours of VDT use, time pressure, and increased workload.