Tehran University of Medical Sciences International Journal of Occupational Hygiene 2008-5109 17 2 2025 12 09 88 95 Payam Khanlari Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Tayebeh Lorestani Department of Ergonomics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Kazhal Jalilian Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Leila Amiri Ergonomics Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Elahe Amouzadeh Department of Ergonomics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran 2025 02 13 2025 04 27 Background: Reading and studying on digital devices—such as personal computers, laptops, and mobile phones—has become integral to daily life. The shift from paper to electronic formats has raised concerns about the impact of digital devices on human performance and health. The current study aimed to compare the effects of paper and electronic devices on perceived fatigue, workload, usability, and comprehension. Methods: Thirty-six participants (58.3% female) read general passages on three devices in 2021: a laptop, a mobile phone, and paper. After each trial, participants answered ten comprehension questions to assess their understanding. Additionally, fatigue, mental workload, and usability were evaluated using a visual analog scale, NASA-TLX, and the System Usability Scale (SUS). Results: The results showed that 69.4% of participants preferred reading on paper over screens. The average scores for fatigue (22.64) and workload (40.47) were lower for paper. The usability score for paper was higher (88.44) than for the mobile phone (68.17) and laptop (68.44). While comprehension scores were higher for paper (4.36) than for laptop (4.19) and mobile phone (4.22), the difference was not statistically significant. Conclusion: Despite the widespread use of electronic devices for reading, paper was rated significantly higher in terms of usability and cognitive workload, although it showed no statistically significant advantage in comprehension. https://ijoh.tums.ac.ir/index.php/ijoh/article/view/673 https://ijoh.tums.ac.ir/index.php/ijoh/article/download/673/864