People

Standing up in the workplace: that’s risky too

We’ve been told that sitting is the new smoking, but medical research suggests that standing up all day at work is hardly a healthy alternative

Sedentary existence is killing us slowly, and not just through the very obvious impacts such as obesity (Schmid et al., 2015). Many people think of a sedentary lifestyle as spending the weekend lying on the settee watching television, when in fact even people who may consider themselves active are spending clinically significant amounts of time sitting down at work.

The answer could be more movement and variation

Research in this area often presents sitting and standing as two extremes on a continuum: sit for too long and health risks increase, so stand more to avoid them. This has led to a great deal of interest in standing desks and an increase in the provision of standing and adjustable desks. However, although by some measures standing appears to be better than sitting, it comes with its own health problems (Tuchsen, 2005). The answer may not be more standing, but more movement and variation between sitting and standing (Biddhu et al., 2015).

In recent years, the health benefits of standing workstations have seen much interest in both the media and in research; popular media outlets such as The Economist and Wired have championed standing workstations whilst research has focused on the health risks of the modern sedentary lifestyle (Wilmot, et al., 2012).

Media advocacy of standing workstations and the potential health impacts of sedentary offices mean that businesses may be interested in the current market for standing workstations and the potential benefits that they can bring.

Misunderstanding the research

The media has characterised prolonged sitting as a significant risk factor for poor health. However, this attention and subsequent advocacy of standing workstations appears to be characterised by both a misunderstanding of research into prolonged sitting, and an ignorance of the potential health impacts that prolonged standing might have.

One particular article, frequently cited in the media, found that prolonged sitting was associated with increased risks of diabetes, cardiovascular disease, and both cardiovascular and all-cause mortality (Wilmot, et al., 2012). However, association does not indicate causation, and so this research has been incorrectly characterised as demonstrating prolonged sitting as such a risk factor.

There may still be a strong causal relationship between prolonged sitting and increased health risks – one study found a causal relationship between prolonged sitting and increased risk of dying, but concludes by emphasising that more research is needed (van der Ploeg, Chey, Korda, Banks, & Bauman, 2012).

Furthermore, this study does not advocate standing to protect against this health risk, but instead suggests that sitting for less than eight hours a day and meeting the World Health Organisation’s physical activity recommendations (150-300 minutes of exercise and strength training for at least two major muscle groups per week) provides protection against this risk.

Substituting prolonged sitting with prolonged standing is also not without its associated health risks. There is strong evidence suggesting that prolonged standing can lead to hospitalisations for varicose veins, which form as a result of the way the body’s circulation changes when standing for prolonged periods (Tüchsen, Krause, Hannerz, Burr, & Kristensen, 2000) (Tuchsen, Hannerz, Burr, & Krause, 2005).

There has also been some research linking prolonged standing to the build-up of fatty plaques in the main artery supplying the brain, but only in men with heart disease (Krause, Lynch, Kaplan, Cohen, Salonen, & Salonen, 2000). Evidently, standing is not as clear-cut an alternative to sitting as has been presented.

The science is not yet clear on sitting and standing in the workplace. Prolonged sitting appears to have some negative health impacts, but the strength of this relationship is unclear, as are the nature of the impacts. Moreover, prolonged standing is not the best alternative because it also has associated health risks. Overall, the research indicates that a combination of both would protect against potential health risks.

Sit-stand desks

Adjustable sit-stand conversion kits offer the potential to convert desks to switch between different options and need not be as expensive as specially made desks. These kits are also adjustable, but their low cost comes at the expense of available desk area and overall design quality.

A significant factor affecting the usefulness of both sit-stand desks and conversion kits is that they are designed for use with desktop computers – they have separate attachments for monitors and keyboards. This means that laptop-based offices will have a much harder time transitioning to a standing workplace.

Sit-stand desks may provide a better alternative to traditional sitting desks, but crucially, not because of just standing up: the benefit is because they let people alternate between the two. Changing posture and moving around in general appears to be the best way to avoid the health problems associated with remaining in one position for too long.

Promoting active workplace

In conclusion, standing up in the workplace is touted as a solution to the health impacts of prolonged sitting. However, the scope and severity of these health impacts is still unclear, and adopting standing workstations would be a cost-ineffective solution that disregards the health impacts of prolonged standing, as well as the issues of usability and compliance that have to be negotiated throughout implementation.

Prolonged sitting is still a potential health risk to office workers, however, and there are methods available to counteract prolonged sitting that are both responsible from an economic and practical standpoint, and also prioritise employee health.

Promoting active workspaces in a practical way

Stand-up meetings, sit-stand transient work-clusters, and stair prompt signage all respect the need to promote active workspaces in a practical and economical way. Further research is needed to elucidate the health effects of both sitting and standing, but at the moment the best advice seems to be to stay active and shift between different positions.

Bibliography of research

Below is a WORKTECH Academy bibliography of research sources in this area:

Bluedorn, A., Turban, D., & Love, M. (1999). The effects of stand-up and sit-down meeting formats on meeting outcomes. Journal of Applied Psychology, 84:277- 285.

Center for Active Design. (2013, January 14). Stair Prompt Signage. From The Center for Active Design: http://centerforactivedesign.org/stairprompt

Cornell University Human Factors and Ergonomics Research Group. (2011, April 12). Sitting and Standing at Work. From Cornell University Ergonomics Web: http://ergo.human.cornell.edu/CUESitStand.html

Gilson, N., Suppini, A., Ryde, G., Brown, H., & Brown, W. (2012). Does the use of standing   ‘hot’ desks change sedentary work time in an open plan office? Preventive Medicine, 54:65-67.

Grunseit, A., Chau, J., van der Ploeg, H., & Bauman, A. (2013). ‘Thinking on your feet’: A qualitative evaluation of sit-stand desks in an Australian workplace. BMC Public Health, 13:365.

Kahn, E., Ramsey, L., RC, B., & Heath, G. (2002). The Effectiveness of Interventions to Increase Physical Activity: A Systematic Review. American Journal of Preventive Medicine, 22:4S.

Krause, N., Lynch, J., Kaplan, G., Cohen, R., Salonen, R., & Salonen, J. (2000). Standing at work and progression of carotid atherosclerosis. Scandivanian Journal of Work, Environment and Health, 26:227-236.

Tüchsen, F., Krause, N., Hannerz, H., Burr, H., & Kristensen, T. (2000). Standing at work and varicose veins. Scandinavian Journal of Work, Environment & Health,  26:414-420.

The Economist. (2013, August 10). Standing Orders: The Perils of Sitting Down. From The Economist: http://www.economist.com/news/science-and- technology/21583239-real-science-lies-behind-fad-standing-up-work-standing-orders?frsc=dg%7Ca

Tuchsen, F., Hannerz, H., Burr, H., & Krause, N. (2005). Prolonged standing at work and hospitalisation due to varicose veins: a 12 year prospective study of the Danish population. Occupational and Environmental Medicine, 62:847-850.

van der Ploeg, H., Chey, T., Korda, R., Banks, E., & Bauman, A. (2012). Sitting Time   and All-Cause Mortality Risk in 222,497 Australian Adults. Archives of Internal Medicine, 172:494-500.

van Uffelen, J., Wong, J., Chau, J., van der Ploeg, H., Riphagen, I., Gilson, N., et al. (2010).  Occupational sitting and health risks: a systematic review. American Journal of Preventative Medicine , 39:379-388.

Wall Street Journal. (2012, February 2). No More Angling for the Best Seat; More Meetings Are Stand-Up Jobs. From The Wall Street Journal:       http://online.wsj.com/article/SB100014240529702046529045771934604725         98378.html

Wilmot, E., Edwardson, C., Achana, F., Davies, M., Gorely, T., Gray, L., et al. (2012). Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia , 55:2895-2905.

Wired. (2012, May 31). Ditch Your Office Chair For A New Standing Desk. From Wired: http://www.wired.com/gadgetlab/2012/05/ditch-your-office-chair-for-a-new- standing-desk/

World Health Organization. (2010). Global Recommendations on Physical Activity for Health. Geneva: World Health Organization Press.

Philip Ross is the founder and CEO of UnWork and Chairman of WORKTECH Academy. This article is based on an UnWork report, Standing Up in the Workplace