Published on April 28, 2020
Introduction
Sit-stand workstations gain in popularity is likely attributed to the phrase “sitting is the new smoking.” This phrase has become popular due to media outlets sharing the misconception that the negative health outcomes of sitting far outweighs that of smoking. This belief has become the primary driver of a sit-stand ergonomics program and overlooks how the workplace can be designed to facilitate movement. The popularity of sit-stands has led to employees making a switch from excessive sitting to excessive standing. Is it possible that sit-stands are not beneficial to an ergonomics program?
First, the equipment itself is not dangerous. It is the misuse of the equipment and the misconceptions that follow that leads to negative health outcomes. Let’s look at a couple of the misconceptions that you may have heard.
- Standing reduces pain and discomfort associated with sitting
- More calories are burned standing than sitting
Misconceptions vs. Reality: Standing Reduces Discomfort
While some studies have shown the benefits of sit-stands in reducing discomfort, other studies have begun to sing a different tune. Though standing may decrease discomfort in the back and shoulders, prolonged standing with little to no movement is a cause of concern. According to a research article published by David Antle, excessive standing has been shown to increase negative health outcomes of the lower limbs. A 2015 Human Factors and Ergonomics article looked at a study conducted by Maria Gabriela Garcia in which her research found evidence for sustained muscle fatigue after following two (2) age groups of participants over a 5-hour workday. Despite taking breaks and having a 30-minute lunch, both age groups experienced similar long-term fatigue due to sustained standing. In another study conducted by Husemann et. al. 2009, the researchers found that implementing sit-stand desks showed positive effects in terms of physical well-being, comfort and mood. However, there was small, but not statistically significant, trend towards a decline in efficiency during standing tasks. A professor at Cornell University, Alan Hedge stated that prolonged standing “can compress the spine and lead to lower back problems over time.” He then goes on to state that prolonged standing can contribute to an individual’s risk of “carotid arteries, varicose veins, deep vein thrombosis and other cardiovascular problems.” In an article title “Is sitting really the new smoking?” Mark Benden, PhD, CPE of Texas A&M shows us cause and effect between prolonged sitting and cardiovascular health issues. He states that obesity does not directly kill but can contribute to heart disease, stroke, type 2 diabetes, etc. He compares it to how smoking does not directly kill, but it leads to lung cancer due to carcinogens. Also, it is important to understand that there are several other factors that contribute to the rise of obesity in the United States. These factors include, but not limited to, genetics, epigenetics, diet and the amount of exercise.
Misconceptions vs Reality: Energy Expenditure
The shift in thought can also be applied to the utilization of sit-stands as a means to burn more calories and thus lose weight. Though everyone agrees that sedentary behavior, poor lifestyle choices, and high energy consumption results in negative and chronic health outcomes, the amount of energy that one expends while standing is minimal. A systematic review conducted Saeidifard et. al. 2017 has determined that the energy difference between the two postures is minimal. This difference is likely due to the muscles being at work when transitioning from either posture. Saeidifard et. al. 2017 has also demonstrated that an individual can burn roughly 54 kcal daily by standing for 6 hours per day. This amount of energy expenditure equates to around 2.2 kg (5.5 lbs.) in a year. This idea is also echoed in Dr. David Rempel position paper in which he states that the overall metabolism between sitting and standing is identical, and the small difference only equates to an extra “60 kcal extra metabolism per day, or a half a bottle of beer.” Creasy et. al. 2016 followed participants performing several activities and measured their energy expenditure. The researchers found an insignificant increase in the number of calories burned. The participants burned 2 additional calories standing versus sitting.
Solutions
The use of sit-stands in the workplace as a means to relieve discomfort or to lose weight does not equate to an effective ergonomics program nor does it improve the safety and health of the worker. It is important to note that the focus should not be to switch from prolonged sitting to prolonged standing. An effective office ergonomics program should focus on providing employees with a workplace that facilitates movement throughout the workday. The question now is how can this be done?
The simple answer is to facilitate movement through the redesign of the work environment. This redesign should look to break up static and prolonged posture. One way is to alternate between a sitting and standing posture by adjusting your sit-standing desk. Another way is to find ways to move away from your desk. This can be printing to a printer that is further away or talking face-to-face to your colleagues or manager. The counter to a prolonged and sustained posture, according to Dr. Benden, is physical activity.
Another solution is to ensure that your company’s workplace ergonomics program is designed according to the guiding principles found in ANSI/HFES 100-2007. The specifications set forth by ANSI/HFES 100-2007 is designed to accommodate for diverse abilities, physical sizes, attributes and expertise levels. It is important to educate the end user on the recommendations and range of specification on the various workstation adjustments to reduce and prevent ergonomic-related risk factors. ANSI/HFES 100-2007 also encourages that your company’s workplace ergonomics program incorporates “frequent movement and postural changes to achieve and maintain comfort and productivity.”
Your budget may allow your ergonomics program to purchase sit-stand desk for everyone. However, it is important to educate and train employees on how to use their new equipment. It is also important to reinforce the consequences of sustained and prolonged posture and how it contributes to musculoskeletal discomfort and other negative health factors. Darcie Jaremey, MSc, CPE goes on to discuss how to implement a sit-stand schedule. It is important to find a schedule that works for you. In the article, Jaremey points out that many individuals prefer either the 1:1, 2:1 and the 3:1 method over the 7:1 method. Table 1 – Sit-Stand Schedule. Jaremey also states that whichever method the individual chooses should not contribute to ergonomic risks. Jaremey has compared it to a stoplight analogy where green is the lowest for ergonomic risk, yellow is moderate for ergonomic risk and red is highest ergonomic risk.
Your budget may not allow your ergonomics program to purchase sit-stand desk for everyone. However, you may consider providing sit-stands on the basis of medical necessity. It is important to have a system in place that triages the request for a sit-stand. Does your ergonomics program educate and demonstrate the adjustability of your chair and workspace? Is your ergonomics program designed with ANSI/HFES 100-2007 in mind? Does your ergonomics program encourage employees to move throughout the day? If these questions can be answered positively and the employee still experiences discomfort or pain, then a sit-stand may be medically needed. The employee should speak with their medical provider and to obtain in written diagnosis of their need for a sit-stand desk.
In conclusion, the design of your ergonomics program is important. It may include sit-stand desks for everyone or for those that medically need it. It is important to remember to educate and encourage employees to move and to avoid static and prolonged postures.
