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Jack [email protected]
@JackDennerlein
October 2019
Sedentary Work & the Paradox of Occupational
Physical Activity
http://www.northeastern.edu/ergonomics/
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There is a public health paradox in ergonomics — we seek to design work that fits a large population and reduces physical loading on muscles, bones and tissues. Yet, we know that physical activity is important to reduce chronic illnesses like diabetes and heart disease
Can we design work and workstations that allow for more opportunities to exercise? Does standing at a computer workstation improve health outcomes as well as performance? Or does it introduce other health problems associated with sustained standing? Future research needs to ask these important questions
Dennerlein The Paradox of the Perfect Chair: Is all that sitting really killing us. The New York Times Room for Debate, 2010 April 23. http://roomfordebate.blogs.nytimes.com/2010/04/23/is-all-that-sitting-really-killing-us/
2010
TOTAL SITTING TIME IS NOT GOOD
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5Rempel (2017)
EVIDENCE ABOUT SITTING AT WORK
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The annual rate of Coronary Heart Disease for Drivers 2.7 per 1,000Conductors 1.9 per 1,000
Morris, J.N., Heady, J.A., Raffle, P.A.B., Roberts, C.G., and Parks, J.W., 1953. Coronary heart disease and physical activity of work. Lancet 265, 1053-1057.
1953
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Church, Tudor-Locke, Katzmarzyk et al. . Trends over 5 decades in U.S. occupation-related physical activity and their associations with obesity. PLoS One. 2011;6(5): http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0019657
2011
Efforts to reduce sedentary time at work
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Pronk Prev Chronic Dis. Oct 2012;9:E154. PMID: 23057991
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Intervention group (n=23) Control group (n=10)
2012
• Introduction of the WorkFit sit-to-stand devices among a group of highly active, fit, normal weight, apparently healthy, mostly female employees with relatively sedentary work tasks:– Increased non-sitting time by more than an
hour per day– Reduced Pain in
» upper back, neck and shoulder pain
– Improved mood states– Increased face-to-face time during work
Pronk Prev Chronic Dis. Oct 2012;9:E154. PMID: 23057991
• Participants felt the WorkFit devices made them feel:– More comfortable (87%)– More energized (76%)– Healthier (75%)– More focused (71%) – More productive (66%)– Happier (62%)– Less stressed (33%)
Removal of the devices after four weeks eliminated most improvements generated due to the intervention, in many cases to below baseline levels
• There is insufficient evidence to make firm conclusions regarding the effects of installing height-adjustable workstations on sedentary behaviour and associated health outcomes in office workers.
12Tew et al., Occup Med (Lond). 2015 Jul;65(5):357-66
2015
13https://www.ncbi.nlm.nih.gov/pubmed/29677023 J Occup Environ Med. 2018 Jul;60(7):e319-e320.
2018
• Energy Expenditure for standing versus sitting• = 0.15 (0.12 – 0.17) kcal/min (46 studies with 1,184 participants)• = 9 kcal for every hour spent standing instead of sitting• = 54 kcal if people stood for 6 hours per day (instead of sitting)
14Saeidifard et al. Eur J Prev Cardiol. 2018 Mar;25(5):522-538. Slide from Peter Smith, IWH
2018
What is 54 kcal?
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2018
Slide from Peter Smith, IWH
Adding dynamic workstations increasing PA at work
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Adding dynamic workstations
Impact on Productivity• Appears to impact
– fine motor control tasks – thinks requiring the mouse (<10% completion time)
• Does not impact– selective attention – processing speed or – reading comprehension
Impact on Health• Appears to improve
– Health of obese workers– Hip circumferences– lipid and metabolic profiles
• Challenges in implementations– Space and resource– Noise, – Shoes– Risk of injury
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John et al. J Phys Act Health. 2009 Sep;6(5):617-24.John et al. J Phys Act Health. 2011 Nov;8(8):1034-43.Huysmans et al, Ergonomics in Design 2015 4-8
IS SITTING AT WORK BAD FOR YOU?I asked my students this question.
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The annual rate of Cardiac Heart Disease for Drivers 2.7 per 1,000, Conductors 1.9 per 1,000
Morris, J.N., Heady, J.A., Raffle, P.A.B., Roberts, C.G., and Parks, J.W., 1953. Coronary heart disease and physical activity of work. Lancet 265, 1053-1057.
1953
Tavia Allen PT/s, Meghan McPhee PT/s,
Kayla Wegener B.S., PT/s
The Impact of Occupational Sitting on
Health Outcomes: Where do we stand?
A Scoping Study
http://www.northeastern.edu/ergonomics/
2018
Does occupational sitting have a negative impact on health outcomes?
Scoping review of the literature• Identify relevant papers• Extract Data• Reviewed results• Synthesized findings from relevant
studies.
Criteria• Measured exposure of occupational
sitting• Measures a health outcome• Examines an association• Published after 2005 • Published in English
Does occupational sitting have a negative impact on health outcomes?
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Does occupational sitting have a negative impact on health outcomes?
• 14 papers encompass upwards of
• 130,000 participants from • 20 different countries from a
variety of industries
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24Rempel and Krause (2018)
IS STANDING AT WORK THAT GOOD FOR YOU?
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Dennerlein The Paradox of the Perfect Chair: Is all that sitting really killing us. The New York Times Room for Debate, 2010 April 23. http://roomfordebate.blogs.nytimes.com/2010/04/23/is-all-that-sitting-really-killing-us/Duchame J. Six Tips for Using Standing Desks Correctly, Boston Magazine http://www.bostonmagazine.com/health/blog/2016/05/10/standing-desks/
If sitting [at work] is the new “smoking”, we have to remember that standing is an old “smoking”
Can we design work and workstations that allow for more opportunities to exercise? Does standing at a computer workstation improve health outcomes as well as performance? Or does it introduce other health problems associated with sustained standing? Future research needs to ask these important questions
2010
Standing at work is not good.• Increases low back pain• Increase risk of CVD
• Standing Increases Carotid Athersclerosis– 4-year Change of Carotid Intima
Media Thickness (IMT), adjusted for Age, Technical, Physical and Psychosocial Job Factors, Income, Biological and Behavioral Factors: Men with IHD
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Krause et al. Standing at work and progression of caro7d atherosclerosis. SJWEH 2000; 26(3): 227-236 https://www.ncbi.nlm.nih.gov/pubmed/10901115https://en.wikipedia.org/wiki/Intima-media_thickness
2000
Standing at work is similar to smoking• Increases low back pain• Increase risk of CVD
• Standing Increases Carotid Athersclerosis– 4-year Change of Carotid Intima
Media Thickness (IMT), adjusted for Age, Technical, Physical and Psychosocial Job Factors, Income, Biological and Behavioral Factors: Men with IHD – smoking is an independent, yet has similar effect
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Krause et al. Standing at work and progression of caro7d atherosclerosis. SJWEH 2000; 26(3): 227-236 https://www.ncbi.nlm.nih.gov/pubmed/10901115https://en.wikipedia.org/wiki/Intima-media_thickness
2000
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Hazard ratios for occupational exposures and incident heart diseaseover a 12-Year Period in Ontario, Canada. (N = 7,320)
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ref ref
Adjusted for all covariates Additional adjustment for HB and BMI
Smith et al, Am J Epidemiol. 2018 Jan 1;187(1):27-33
2018
OCCUPATIONAL PHYSICAL ACTIVITY IN GENERAL
Modern day farmer to wife who works in public health research: “Why do you have to go the gym? You could simply work in the fields with me and not go to the gym”
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The health paradox of occupational physical activity
31Holtermann et al., Br J Sports Med. 2012 Mar;46(4):291-5.
2012
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2019
http://dx.doi.org/10.1136/bjsports‐2017‐097965
OKAY, SO WHAT CAN WE DO?
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They give me freedom similar to the way commuting by bicycle frees me from sitting in my car stuck in rush hour traffic. I can stand up and I can move more frequently while still interacting with my computer and conducting the business of the day
Sit-Stand Workstations:Benefits other than cardiovascular
BEST PRACTICES
Use sit-stand workstations• Combined with training, they
provide adjustability• Changing between sitting and
standing increases postural variability
• They give workers control over their workstations
• Reduce discomfort
Increase breaks from sitting• Breaks increase productivity• Increase postural variability• Reduce discomfort• Opportunity for small bouts of
physical activity
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Jack [email protected]
@JackDennerlein
September 2019
Sedentary Work: Evidence and Approaches for
Combating Sedentary Work
http://www.northeastern.edu/ergonomics/
