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Abstract

Purpose Sedentary behavior is linked to health risks, and prolonged sitting is prevalent among office workers. Adjustable workstations (AWS) promote health by allowing transitions between sitting and standing. Stand Up to Work compares workers with AWS to traditional desks (TD). The paper aims to discuss these issues. Design/methodology/approach Employees were randomly selected from one office floor to receive AWS, two identical floors maintained TD. Participants received workplace wellness and ergonomic training, completed self-administered questionnaires, and responded to repeated micropolling at baseline (T0), 3 (T1), 6 (T2), and 12 (T3) months in Atlanta, 2015-2016. Groups were compared using two-sample t -tests and nonparametric Wilcoxon tests. Findings Compared to TD ( n = 24), participants with AWS ( n = 24) reported significantly less sedentary behavior at T1 and T2 after AWS installation ( p <0.05), with a retention rate at T2 of 80 and 65 percent for the AWS and TD group, respectively. In all, 47 percent of participants with AWS reported decline in upper back, shoulder, and neck discomfort ( p =0.04); 88 percent of AWS participants reported convenience to use, 65 percent reported increased productivity, and 65 percent reported positive impact outside the workplace. Individuals with normal or underweight body mass index (BMI) reported a significantly greater decline in percent of time sitting compared to participants with overweight or obese BMI at all three time points. Originality/value AWS are beneficial in reducing sedentary behavior in and outside the workplace. Behavioral changes were sustained over time and associated with less self-reported muscle pain, more self-reported energy, and awareness of standing. When considering total worker health, employers should include options for AWS to promote reducing sedentary behavior.

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... In general, because of the naturalistic settings in which these studies took place, the overall risk of bias among individual studies was moderate (see Table 4). Despite the use of cluster randomisation techniques and allocation blinding, baseline imbalances were a high source of bias in five studies [45,59,62,63,78]. Contamination during the intervention due to spillover effects may have biased findings in six studies [63,67,68,70,71,77]. ...
... Despite the use of cluster randomisation techniques and allocation blinding, baseline imbalances were a high source of bias in five studies [45,59,62,63,78]. Contamination during the intervention due to spillover effects may have biased findings in six studies [63,67,68,70,71,77]. External validity was assessed as high risk in four studies [50,54,61,66], largely because these involved university faculty and staff educated to a high degree level, thereby limiting the application of findings to the population at large. ...
... Of the 10 interventions that showed no improvements for cardiometabolic risk markers [46, 47, 53, 58, 61-63, 69, 74, 78], six interventions significantly reduced sedentary behaviour [46,47,53,63,69,74]. The remaining four interventions [58,61,62,78] did not observe a change in sedentary behaviour. ...
Article
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Background Sedentary behaviour is a risk factor for type 2 diabetes and cardiovascular disease. Objectives The aims of this work were to systematically review the effects of workplace sedentary behaviour reduction interventions on cardiometabolic risk markers (primary aim) and identify the active behaviour change techniques (BCTs) by which these interventions work (secondary aim). Methods A systematic search of 11 databases for articles published up to 12 April 2019 yielded a total of 4255 unique titles, with 29 articles being identified for inclusion. Interventions were rated as very promising, quite promising or non-promising based on their effects on cardiometabolic risk markers compared with baseline and/or a comparison arm. Interventions were coded for BCTs used. To assess the relative effectiveness of BCTs, a promise ratio was calculated as the frequency of a BCT appearing in all promising interventions divided by its frequency of appearance in all non-promising interventions. Results A narrative synthesis included 29 published studies of varying study design and comprised of 30 interventions. Risk of bias was high for blinding and allocation concealment, moderate for random sequence generation, and low for outcome assessment. Nine interventions were very promising, 11 were quite promising, 10 were non-promising, and 10 active control groups did not experience cardiometabolic changes. Significant sedentary behaviour reductions were present in all but five studies where cardiometabolic risk markers improved. The BCTs of social comparison, problem solving, demonstration of the behaviour, goal setting (behaviour), behaviour substitution, and habit reversal, demonstrated moderate to high promise ratios. Conclusions Workplace interventions show promise for improving cardiometabolic risk markers. The BCTs with the greatest promise of cardiometabolic risk marker improvements included social comparison, those related to individual habits, and behaviour goals. Registration This systematic review was prospectively registered in PROSPERO (CRD42017072427).
... Qualitative studies on single-component sit-stand desk interventions show positive overall acceptability and feasibility [15][16][17][18]. This is also the case for dual-component interventions that pair sit-stand desks with an initial educational/training session [19][20][21] or ongoing motivational support [22]. With regards to multi-component interventions, less is known about the participant experience. ...
... Sit-stand desks have been identified as a key driver of behaviour change [14]. Indeed, sedentary time is largely replaced by standing in multi-component interventions incorporating sit-stand desks [14,[19][20][21][22]. The sit-stand desk BCTs used here, ' Adding objects to the environment' and 'Restructuring the physical environment' , frequently appear in promising interventions to reduce workplace sedentary behaviour [52] and improve cardiometabolic risk outcomes [27]. ...
Article
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Objective Sedentary workplace interventions have had success in reducing excessive sitting time in office workers, but barriers to implementation and uptake remain. This study formally assessed a theory-derived, sit-stand desk intervention using the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side-effects, Equity) criteria. Methods Thirteen adults (eight female, mean age 38 ± 10 years) from the treatment arm of a sedentary behaviour intervention participated in semi-structured interviews. Thematic codes were inductively assigned to data items followed by deductive charting using the APEASE criteria. Results The intervention was highly acceptable, practicable, safe to deploy, and helped workers reduce workplace sitting time, though individual preferences and workload mediated engagement. Affordability of sit-stand desks and Equity of access were potential barriers to uptake. Conclusions Through the lens of the APEASE criteria, this theory-derived, multi-component sit-stand desk intervention showed acceptability, practicability and effectiveness in reducing and breaking up sedentary time at work with minimal side effects. Using this approach with further tailoring and personalisation may help workers achieve greater reductions in workplace sitting, though affordability and equity should be considered further.
... Several studies assessed the added value of facilities and services such as adjustable workstations (sit-stand desks) in relation to health and wellbeing. For instance, Garland et al. (2018) conducted a quantitative study of an organisation in the USA with a group of staff getting adjustable workstations and a control group with traditional workstations. Participants received workplace wellness and ergonomic training, completed self-administered questionnaires and responded to repeated micro-polling four times over one year. ...
... A combination of qualitative research methods such as content analysis of documents, workshops and different types of interviews (Waldburger & Nielsen, 2012), and quantitative methods such as questionnaire surveys, real-time data collection using smart devices, and benchmarking of costs and benefits of different interventions may help to capture a holistic view of value adding workplace management. The former section discussed research projects using semistructured interviews (Petrulaitiene & Jylhä, 2015) and quantitative surveys (Von Felten et al., 2015;Garland et al., 2018), whereas Section 5 will present some research projects using cards with the names of different values on it, asking the respondents whether they incorporate these values in daily practice, why and how (van der Zwart et al., 2012), and the combined use of document analysis and semi-structured interviews (Beckers et al., 2015). Based on a critical review of twenty-one research papers, Jensen and van der Voordt (2015) concluded that the use of mixed research methods is most appropriate, where quantitative results provide overview and identify the most important aspects; while qualitative research identifies specific interventions that can actually add value. ...
Chapter
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This book chapter presents a theory about the added value of buildings, workplaces, facilities and services. Traditionally value is mainly associated with financial parameters. This chapter presents a more holistic approach. It explains the meaning of value and discusses different value types and value parameters. It shows that prioritized values depend on culture, time, context, and who is involved. Furthermore, it presents a Value Adding Facilities and Corporate Real Estate Management process model. This VAM model guides decision makers through the process of adding value in four steps, from identification of performance gaps, objectives for improvement and selection of appropriate interventions to its implementation and a check on whether the objectives have been attained, what value has been added to whom, and which Key Performance Indicators are most appropriate to measure the added value by FM and CREM. Next, the chapter shows how this VAM theory is or can be applied in workplace studies and practice.
... Active design impacts on human health by helping building occupants integrate regular physical activity into their daily life unconsciously [22,23]. Based on the principles of active design, it seems feasible that layout of homes and, in particular, the distance required to reach key destinations in residential buildings such as bed rooms, living rooms, kitchens, washrooms and others could affect both occupants' levels of movement and time spent sitting or lying [24,25]. For example, the Center for Active Design [26] had noted that having staircase, appealing, supportive walking routes such as lobbies and corridors and location of functions within buildings to encourage walking can promote physical activity and the health of occupants. ...
... This seems to also resonate with the goal of active design, which is to encourage physical activity at home as explained in the literature [26]. Again, this may provide support to the submission of previous authors that the distance required to reach key destinations in residential buildings such as bed rooms, living rooms, kitchen, washrooms and others could affect occupants' sedentary lifestyle [24,25]. Table 5 shows that average time spent by the residents in different home features on physical activities (sitting and standing) was significantly different (p < 0.05). ...
Article
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Sedentary lifestyle is a major cause of several non-communicable killer diseases globally. However, there is limited understanding of how the design and planning of residential buildings can help in curbing sedentary lifestyle among urban population in the developing countries. This research investigated the spatial layout of residential buildings and its influence on sedentary lifestyle of the occupants in Enugu metropolis in southeast Nigeria. A questionnaire survey of 400 residents and evaluation of the active design features of the floor plans of their residential buildings were conducted in the study area. The data were analysed using descriptive statistics, ANOVA, Duncan multiple comparison test, and thematic content analysis. The residential buildings were found to have the traditional house and western style house layouts. Although the results indicated that residents spent about 90% of the time at home on sedentary activity, those living in buildings with traditional house layout were found to spend the least time on sedentary activity compared to those in dwelling units with western style house layout pattern. The results of Duncan multiple comparison test revealed that residents in house layouts where the conveniences are separated from the sleeping place or lounge, spent significantly lower time on sedentary activity such as sitting, while the reverse was the case for light activity like standing. The findings of this research are instructive in revealing that when it comes to active design, the traditional house layout pattern appears to have advantage over the modern or western style. It is therefore recommended that to achieve residential design that promotes physical activity among occupants, architects and other professionals involved in housing development should consider the adoption of the traditional layout concept in the design of future homes in the study area and beyond.
... Indeed, non-student work environment research has found that standing desks can improve worker health and productivity. Standing desks, which can help improve posture and take pressure off the neck and lower back, were associated with reduced reported worker discomfort (Chau et al., 2015;Karakolis and Callaghan, 2014), reduced musculoskeletal pain and improved posture (Mazzotta et al., 2018), significant decreases in upper back, shoulder and neck discomfort (Garland et al., 2018) and significant decreases in lower back pain (Ognibene et al., 2016). Standing desks also were associated with reduced sleepiness and fatigue (Kowalsky et al., 2018) and increased worker productivity (Garrett et al., 2016), with one study showing that 65% of workers reported increased productivity (Garland et al., 2018). ...
... Standing desks, which can help improve posture and take pressure off the neck and lower back, were associated with reduced reported worker discomfort (Chau et al., 2015;Karakolis and Callaghan, 2014), reduced musculoskeletal pain and improved posture (Mazzotta et al., 2018), significant decreases in upper back, shoulder and neck discomfort (Garland et al., 2018) and significant decreases in lower back pain (Ognibene et al., 2016). Standing desks also were associated with reduced sleepiness and fatigue (Kowalsky et al., 2018) and increased worker productivity (Garrett et al., 2016), with one study showing that 65% of workers reported increased productivity (Garland et al., 2018). Thus, workplace health and productivity can potentially be enhanced by the use of standing desks. ...
Article
Purpose This study aims to examine the impact of college students’ health and wellness orientations on the perceived importance of health benefits for an innovative new brand of standing desk, which is hypothesized to positively affect students’ attitudes and intentions. Research in this domain for the college student market is sparse. Design/methodology/approach An online survey was conducted among business students at a large Midwestern US University, with class credit offered for completion. Of the 325 students given the opportunity to participate, 210 completed the survey. Findings Health motivation is positively related to calorie reduction importance, whereas wellness orientation is positively related to back health and cognitive enhancement. Calorie reduction and potential cognitive benefits significantly affect attitudes toward standing desks, which positively impact intentions to use, pay a school usage fee and buy the product. Research limitations/implications Different health orientation factors are associated with specific health benefits, providing greater insight into consumer attitudinal motivations for health-related products. Future research can further evaluate the generalizability of the results. Practical implications Marketers can tailor more effective communications based on underlying consumer motivations for health-related product benefits, resulting in better marketing outcomes. Social implications Obesity is a growing societal issue, which could be ameliorated by improved daily behaviors, including the use of standing desks to assist in countering sedentarism. Originality/value To the best of the authors’ knowledge, neither academic research has yet examined standing desk purchase decision factors for the college student market, nor the effects of different health orientations on perceived health benefits.
... Poor workspace design can be a source of stress in the workplace [7]. Social psychology studies have shown that a congested and crowded workspace can negatively affect an individual's job performance [34]. Research has shown that workspace congestion and discomfort are negatively associated with focus and privacy, which in turn may increase stress in the workplace [35]. ...
Article
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The lack of comfort due to workplace environment impact could trim down job performance and organizational productivity. Literature reviews indicate that ergonomic workplace environment that is strongly associated with the job performance. Employees' perceptions to be examined by the organizations to ensure the excellent job performance. Thus, 295 officers were selected using proportionate stratified random sampling with two-section questionnaire. The data were analyzed using statistical package for the social sciences (SPSS) and analysis of a moment structure (AMOS) software. The research findings show that acoustic is the most crucial factor (0.928) followed by lighting (0.898), workstation design (0.846), working hours (0.670), and chair (0.563). Ventilation is still significant to the whole environment although scored the lowest coefficient value (0.385). These findings provide valuable information to organizations in their attempts to sustain the human resources so that they are always competitive and productive in facing the challenges of the environmental change.
... Four studies were also rated as 'high' RoB due to deviations from intended interventions (data not analysed according to intention-to-treat principles 40 58 74 79 ) and missing outcome data. 76 79 83 87 An unclear risk level was typically assigned based on inadequate reporting of randomisation (k=12), concerns with missing outcome data (k=11) and/or bias in measurement of the outcome (k=9). Low risk was still permitted with lack of blinding, given the context (behavioural intervention) in which allocation is impossible to conceal from participants and is generally known to staff, and in which outcomes are collected objectively. ...
Article
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Context/purpose Observational and acute laboratory intervention research has shown that excessive sedentary time is associated adversely with cardiometabolic biomarkers. This systematic review with meta-analyses synthesises results from free living interventions targeting reductions in sedentary behaviour alone or combined with increases in physical activity. Methods Six electronic databases were searched up to August 2019 for sedentary behaviour interventions in adults lasting for ≥7 days publishing cardiometabolic biomarker outcomes covering body anthropometry, blood pressure, glucose and lipid metabolism, and inflammation (54 studies). The pooled effectiveness of intervention net of control on 15 biomarker outcomes was evaluated using random effects meta-analyses in the studies with control groups not providing other relevant interventions (33 studies; 6–25 interventions analysed). Results Interventions between 2 weeks and <6 months in non-clinical populations from North America, Europe and Australia comprised much of the evidence base. Pooled effects revealed small, significant (p<0.05) beneficial effects on weight (≈ −0.6 kg), waist circumference (≈ −0.7 cm), percentage body fat (≈ −0.3 %), systolic blood pressure (≈ −1.1 mm Hg), insulin (≈ −1.4 pM) and high-density lipoprotein cholesterol (≈ 0.04 mM). Pooled effects on the other biomarkers (p>0.05) were also small, and beneficial in direction except for fat-free mass (≈ 0.0 kg). Heterogeneity ranged widely (I ² =0.0–72.9). Conclusions Our review of interventions targeting sedentary behaviour reductions alone, or combined with increases in physical activity, found evidence of effectiveness for improving some cardiometabolic risk biomarkers to a small degree. There was insufficient evidence to evaluate inflammation or vascular function. Key limitations to the underlying evidence base include a paucity of high-quality studies, interventions lasting for ≥12 months, sensitive biomarkers and clinical study populations (eg, type 2 diabetes). PROSPERO trial registration number CRD42016041742 NOTE: Article is Open Access
Article
Purpose Despite preventive efforts from some companies to offer some sport and physical activity (SPA) to their employees, French participation rates remain very low, which limit impacts in terms of health and economic benefits. The aim of this study was to better understand the factors influencing SPA participation in the workplace. Design/methodology/approach A cross-sectional study was conducted based on an electronic questionnaire survey disseminated to 24 companies based in France that offered SPA to their employees. An independent sample t -test was conducted to explore the differences between the most common facilitating and constraining factors, in relation to “being a sporty person” self-perception, leisure-time physical activity (LTPA) level and demographic information. Predictors of SPA in the workplace were determined using a binomial logistic regression. Findings A total of 1,318 employees completed the survey, of which 60% were women, mostly highly educated and white collar. “Being a sporty person,” self-perception has been a predictor of SPA participation in the workplace. Practical implications More multicomponent work-based interventions, including incidental physical activity, might be necessary to increase participation and overcome time constraint. Originality/value Although SPA participation in the workplace is considered to promote numerous positive organizational and individual consequences, this is the first study to assess the associations between facilitating and constraining factors of SPA participation in the workplace setting and physical self-perception.
Article
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Purpose This paper aims to explore the added value of healthy workplaces for employees and organizations, in particular regarding employee satisfaction, labour productivity and facility cost. Design/methodology/approach The paper is based on a narrative review of journal papers and other sources covering the fields of building research, corporate real estate management, facilities management, environmental psychology and ergonomics. Findings The review supports the assumption of positive impacts of appropriate building characteristics on health, satisfaction and productivity. Correlations between these impacts are still underexposed. Data on cost and economic benefits of healthy workplace characteristics is limited, and mainly regard reduced sickness absence. The discussed papers indicate that investing in healthy work environments is cost-effective. Originality/value The findings contribute to a better understanding of the complex relationships between physical characteristics of the environment and health, satisfaction, productivity and costs. These insights can be used to assess work environments on these topics, and to identify appropriate interventions in value-adding management of buildings and facilities.
Article
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Time spent sitting is associated with negative health outcomes, motivating some individuals to adopt standing desk workstations. This study represents the first investigation of the effects of standing desk use on reading comprehension and creativity. In a counterbalanced, within-subjects design, 96 participants completed reading comprehension and creativity tasks while both sitting and standing. Participants self-reported their mood during the tasks and also responded to measures of expended effort and task difficulty. In addition, participants indicated whether they expected that they would perform better on work-relevant tasks while sitting or standing. Despite participants’ beliefs that they would perform worse on most tasks while standing, body position did not affect reading comprehension or creativity performance, nor did it affect perceptions of effort or difficulty. Mood was also unaffected by position, with a few exceptions: Participants exhibited greater task engagement (i.e., interest, enthusiasm, and alertness) and less comfort while standing rather than sitting. In sum, performance and psychological experience as related to task completion were nearly entirely uninfluenced by acute (~30-min) standing desk use.
Article
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PURPOSE: To evaluate, compared to usual practice, the initial and long-term effectiveness of a workplace intervention targeting reducing sitting on activity outcomes. METHODS: Office worksites (≥1km apart) from a single organization in Victoria, Australia were cluster randomized to intervention (n=7) or control (n=7). Participants were 231 desk-based office workers (5 to 39 participants per worksite) working at least 0.6 full time equivalent. The workplace-delivered intervention addressed organizational, physical environment, and individual behavioural change to reduce sitting time. Assessments occurred at baseline, three-, and 12-months, with the primary outcome participants' objectively measured (activPAL3 device) workplace sitting time (mins/8-h workday). Secondary activity outcomes were: workplace time spent standing, stepping (light, moderate-vigorous and total) and in prolonged (≥30min) sitting bouts (h/8-h workday); usual duration of workplace sitting bouts; and, overall sitting, standing and stepping time (mins/16-h day). Analysis was by linear mixed models, accounting for repeated measures and clustering and adjusting for baseline values and potential confounders. RESULTS: At baseline, on average, participants (68% women; mean±SD age = 45.6±9.4 years) sat, stood and stepped for 78.8±9.5%, 14.3±8.2%, and 6.9±2.9% of work hours respectively. Workplace sitting time was significantly reduced in the intervention group compared to the controls at three months (-99.1 [95% CI -116.3 to -81.8] min/8-h workday) and 12 months (-45.4 [-64.6 to -26.2] min/8-h workday). Significant intervention effects (all favoring intervention) were observed for standing, prolonged sitting, and usual sitting bout duration at work, as well as overall sitting and standing time, with no significant nor meaningful effects observed for stepping. CONCLUSIONS: This workplace-delivered multicomponent intervention was successful at reducing workplace and overall daily sitting time in both the short- and long- term.
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This study evaluated the effects of sit-stand desks on workers' objectively and subjectively assessed sitting, physical activity, and productivity. This quasi-experimental study involved one intervention group (n = 16) and one comparison group ( n = 15). Participants were call center employees from two job-matched teams at a large telecommunications company in Sydney, Australia (45% female, 33 ±. 11 years old). Intervention participants received a sit-stand desk, brief training, and daily e-mail reminders to stand up more frequently for the first 2. weeks post-installation. Control participants carried out their usual work duties at seated desks. Primary outcomes were workday sitting and physical activity assessed using ActivPAL or ActiGraph devices and self-report questionnaires. Productivity outcomes were company-specific objective metrics (e.g., hold time, talking time, absenteeism) and subjective measures. Measurements were taken at baseline, 1, 4, and 19. weeks post-installation. Intervention participants increased standing time after 1. week (+. 73. min/workday (95% CI: 22, 123)) and 4. weeks (+. 96. min/workday (95% CI: 41, 150)) post-intervention, while control group showed no changes. Between-group differences in standing time at one and 4. weeks were + 78 (95% CI: 9, 147) and + 95. min/workday (95% CI: 15, 174), respectively. Sitting time in the intervention group changed by -. 64 (95% CI: - 125, - 2), - 76 (95% CI: - 142, - 11), and - 100. min/workday (95% CI: - 172, -. 29) at 1, 4, and 19. weeks post-installation, respectively, while the control group showed no changes. No changes were observed in productivity outcomes from baseline to follow-up in either group. Sit-stand desks can increase standing time at work in call center workers without reducing productivity.
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An international group of experts convened to provide guidance for employers to promote the avoidance of prolonged periods of sedentary work. The set of recommendations was developed from the totality of the current evidence, including long-term epidemiological studies and interventional studies of getting workers to stand and/or move more frequently. The evidence was ranked in quality using the four levels of the American College of Sports Medicine. The derived guidance is as follows: for those occupations which are predominantly desk based, workers should aim to initially progress towards accumulating 2 h/day of standing and light activity (light walking) during working hours, eventually progressing to a total accumulation of 4 h/day (prorated to part-time hours). To achieve this, seated-based work should be regularly broken up with standing-based work, the use of sit-stand desks, or the taking of short active standing breaks. Along with other health promotion goals (improved nutrition, reducing alcohol, smoking and stress), companies should also promote among their staff that prolonged sitting, aggregated from work and in leisure time, may significantly and independently increase the risk of cardiometabolic diseases and premature mortality. It is appreciated that these recommendations should be interpreted in relation to the evidence from which they were derived, largely observational and retrospective studies, or short-term interventional studies showing acute cardiometabolic changes. While longer term intervention studies are required, the level of consistent evidence accumulated to date, and the public health context of rising chronic diseases, suggest initial guidelines are justified. We hope these guidelines stimulate future research, and that greater precision will be possible within future iterations.
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Time spent sitting in the workplace is an important contributor to overall sedentary risk. Installation of height-adjustable workstations has been proposed as a feasible approach for reducing occupational sitting time in office workers. To provide an accurate overview of the controlled trials that have evaluated the effects of height-adjustable workstation interventions on workplace sitting time in office-based workers. A comprehensive search was conducted up until March 2014 in the following databases: Medline, PsychINFO, CENTRAL, EMBASE and PEDro. To identify unpublished studies and grey literature, the reference lists of relevant official or scientific web pages were also checked. Studies assessing the effectiveness of height-adjustable workstations using a randomized or non-randomized controlled design were included. The initial search yielded a total of 8497 citations. After a thorough selection process, five studies were included with 172 participants. A formal quality assessment indicated that risk of bias was high in all studies and heterogeneity in interventions and outcomes prevented meta-analysis. Nevertheless, all studies reported that height-adjustable workstation interventions reduced occupational sitting time in office workers. There was insufficient evidence to determine effects on other relevant health outcomes (e.g. body composition, musculoskeletal symptoms, mental health). 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. Larger and longer term controlled studies are needed, which include more representative populations. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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The number of people working whilst seated at a desk keeps increasing worldwide. As sitting increases, occupational physical strain declines at the same time. This has contributed to increases in cardiovascular disease, obesity and diabetes. Therefore, reducing and breaking up the time that people spend sitting while at work is important for health. To evaluate the effects of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, OSH UPDATE, PsycINFO, Clinical trials.gov and the World Health Organization (WHO) search trial portal up to 14 February, 2014. We also searched reference lists of articles and contacted authors. We included randomised controlled trials (RCT), cluster-randomised controlled trials (cRCTs), and quasi-randomised controlled trials of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies (CBAs) with a concurrent control group. The primary outcome was time spent sitting at work per day, either self-reported or objectively measured by means of an accelerometer coupled with an inclinometer. We considered energy expenditure, duration and number of sitting episodes lasting 30 minutes or more, work productivity and adverse events as secondary outcomes. Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. We included eight studies, four RCTs, three CBAs and one cRCT, with a total of 1125 participants. The studies evaluated physical workplace changes (three studies), policy changes (one study) and information and counselling (four studies). No studies investigated the effect of treadmill desks, stepping devices, periodic breaks or standing or walking meetings. All the studies were at high risk of bias. The quality of the evidence was very low to low. Half of the studies were from Australia and the other half from Europe, with none from low- or middle-income countries. Physical workplace changesWe found very low quality evidence that sit-stand desks with or without additional counselling reduced sitting time at work per workday at one week follow-up (MD -143 minutes (95% CI -184 to -102, one study, 31 participants) and at three months' follow-up (MD - 113 minutes, 95% CI -143 to -84, two studies, 61 participants) compared to no intervention. Total sitting time during the whole day decreased also with sit-stand desks compared to no intervention (MD -78 minutes, 95% CI -125 to -30, one study, 31 participants) as did the duration of sitting episodes lasting 30 minutes or more (MD -52 minutes, 95% CI -79 to -26, two studies, 74 participants). Sit-stand desks did not have a considerable effect on work performance and had an inconsistent effect on musculoskeletal symptoms and sick leave. Policy changesWalking strategies had no considerable effect on sitting at work (MD -16 minutes, 95% CI -54 to 23, one study, 179 participants, low quality evidence). Information and counsellingGuideline-based counselling by occupational physicians reduced sitting time at work (MD -28 minutes, 95% CI -54 to -2, one study, 396 participants, low quality evidence). There was no considerable effect on reduction in total sitting time during the whole day.Mindfulness training induced a non-significant reduction in workplace sitting time (MD -2 minutes, 95% CI -22 to 18) at six months' follow-up and at 12 months' follow-up (MD -16 minutes, 95% CI -45 to 12, one study, 257 participants, low quality evidence).There was an inconsistent effect of computer prompting on sitting time at work. One study found no considerable effect on sitting at work (MD -18 minutes, 95% CI -53 to 17, 28 participants, low quality evidence) at 10 days' follow-up, while another study reported a significant reduction in sitting at work (MD -55 minutes, 95% CI -96 to -14, 34 participants, low quality evidence) at 13 weeks' follow-up. Computer prompting software also led to a non-significant increase in energy expenditure at work (MD 278 calories/workday, 95% CI 0 to 556, one study, 34 participants, low quality evidence) at 13 weeks' follow-up. At present there is very low quality evidence that sit-stand desks can reduce sitting time at work, but the effects of policy changes and information and counselling are inconsistent. There is a need for high quality cluster-randomised trials to assess the effects of different types of interventions on objectively measured sitting time. There are many ongoing trials that might change these conclusions in the near future.
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There is a growing body of research into the total amount and patterns of sitting, standing and stepping in office-based workers and few studies using objectively measured sitting and standing. Understanding these patterns may identify daily times opportune for interventions to displace sitting with activity. A sample of office-based workers (n = 164) residing in England were fitted with thigh-worn ActivPal accelerometers and devices were worn 24 hours a day for five consecutive days, always including Saturday and Sunday and during bathing and sleeping. Daily amounts and patterns of time spent sitting, standing, stepping and step counts and frequency of sit/stand transitions, recorded by the ActivPal accelerometer, were reported. Total sitting/standing time was similar on weekdays (10.6/4.1 hrs) and weekends (10.6/4.3 hrs). Total step count was also similar over weekdays (9682 ± 3872) and weekends (9518 ± 4615). The highest physical activity levels during weekdays were accrued at 0700 to 0900, 1200 to 1400, and 1700 to 1900; and during the weekend at 1000 to 1700. During the weekday the greatest amount of sitting was accrued at 0900 to 1200, 1400 to 1700, and 2000 to 2300, and on the weekend between 1800 and 2300. During the weekday the greatest amount of standing was accrued between 0700 and 1000 and 1700 and 2100, and on the weekend between 1000 and 1800. On the weekday the highest number of sit/stand transitions occurred between 0800 to 0900 and remained consistently high until 1800. On the weekend, the highest number occurred between 1000 to 1400 and 1900 to 2000. Office based-workers demonstrate high levels of sitting during both the working week and weekend. Interventions that target the working day and the evenings (weekday and weekend) to displace sitting with activity may offer most promise for reducing population levels of sedentary behaviour and increasing physical activity levels, in office-based workers residing in England.
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Few studies have examined the association between occupational sitting and body mass index (BMI). There is a particular lack of evidence among diverse populations. The objective of this study was to quantify the association between self-reported occupational sitting time and BMI by sex and race, independent of levels of occupational and leisure-time physical activity. In 2012 and 2013, participants residing in 4 Missouri metropolitan areas were interviewed via telephone. The interview included questions on sociodemographic characteristics and time spent sitting at work. Multinomial logistic regressions were used to examine the association between occupational sitting and BMI between men and women and between black and white women. Overall 1,891 participants (66.9% women, 29.5% black) provided complete data. Median daily time spent by both men and women in occupational sitting was 180 minutes (interquartile range, 30 to 360 minutes); most participants were overweight (32.3%) or obese (33.6%). After adjusting for potential confounders, we found that black women in 3 categories of sitting time (31-180 minutes, 181-360 minutes, and >360 minutes) were approximately 2.5 times as likely (P for trend, .02) to be obese as black women who reported sitting for 30 minutes or less, independent of occupational and leisure-time physical activity. This association was not seen among white women. No significant associations were found among men. Occupational sitting is associated with an increased likelihood of obesity among black women, independent of occupational and leisure-time physical activity. Areas of future research include evaluating associations among various occupations and industries, assessing the association in prospective cohorts, and exploring the feasibility of worksite interventions that target sitting.
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Background Prolonged sitting time has been identified as a health risk factor. Sit-stand workstations allow desk workers to alternate between sitting and standing throughout the working day, but not much is known about their acceptability and feasibility. Hence, the aim of this study was to qualitatively evaluate the acceptability, feasibility and perceptions of using sit-stand workstations in a group of desk-based office workers. Methods This article describes the qualitative evaluation of the randomized controlled cross-over Stand@Work pilot trial. Participants were adult employees recruited from a non-government health agency in Sydney, Australia. The intervention involved using an Ergotron Workfit S sit-stand workstation for four weeks. After the four week intervention, participants shared their perceptions and experiences of using the sit-stand workstation in focus group interviews with 4–5 participants. Topics covered in the focus groups included patterns of workstation use, barriers and facilitators to standing while working, effects on work performance, physical impacts, and feasibility in the office. Focus group field notes and transcripts were analysed in an iterative process during and after the data collection period to identify the main concepts and themes. Results During nine 45-min focus groups, a total of 42 participants were interviewed. Participants were largely intrinsically motivated to try the sit-stand workstation, mostly because of curiosity to try something new, interest in potential health benefits, and the relevance to the participant’s own and organisation’s work. Most participants used the sit-stand workstation and three common usage patterns were identified: task-based routine, time-based routine, and no particular routine. Common barriers to sit-stand workstation use were working in an open plan office, and issues with sit-stand workstation design. Common facilitators of sit-stand workstation use were a supportive work environment conducive to standing, perceived physical health benefits, and perceived work benefits. When prompted, most participants indicated they were interested in using a sit-stand workstation in the future. Conclusions The use of a sit-stand workstation in this group of desk-based office workers was generally perceived as acceptable and feasible. Future studies are needed to explore this in different desk-based work populations and settings.
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Excessive sedentary time is detrimentally linked to obesity, type 2 diabetes, cardiovascular disease and premature mortality. Studies have been investigating the use of activity-permissive workstations to reduce sedentary time in office workers, a highly sedentary target group. This review systematically summarizes the evidence for activity-permissive workstations on sedentary time, health-risk biomarkers, work performance and feasibility indicators in office workplaces. In July 2013, a literature search identified 38 relevant peer-reviewed publications. Key findings were independently extracted by two researchers. The average intervention effect on sedentary time was calculated via meta-analysis. In total, 984 participants across 19 field-based trials and 19 laboratory investigations were included, with sample sizes ranging from n = 2 to 66 per study. Sedentary time, health-risk biomarkers and work performance indicators were reported in 13, 23 and 23 studies, respectively. The pooled effect size from the meta-analysis was −77 min of sedentary time/8-h workday (95% confidence interval = −120, −35 min). Non-significant changes were reported for most health- and work-related outcomes. Studies with acceptability measures reported predominantly positive feedback. Findings suggest that activity-permissive workstations can be effective to reduce occupational sedentary time, without compromising work performance. Larger and longer-term randomized-controlled trials are needed to understand the sustainability of the sedentary time reductions and their longer-term impacts on health- and work-related outcomes.
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Background: The impact of active workstations has been studied in several settings, and several outcomes have been investigated. However, the effects on health, work performance, quality of life, etc., have never been systematically reviewed. Objective: To evaluate the existing literature about active workstations and their possible positive health and work performance effects. Data sources: We searched the electronic databases PubMed and Web of Science (up until 28 February 2014). The search terms we used were 'active workstation', 'standing workstation', 'standing desk', 'stand up workstation', 'stand up desk', 'walking desk', 'walking workstation', 'treadmill workstation', 'treadmill desk', 'cycling workstation', 'cycling desk' and 'bike desk', in combination with 'health', 'quality of life', 'cognition', 'computer task performance', 'absenteeism', 'productivity', 'academic achievement', 'cognitive decline', and 'independent living'. In addition, we searched the reference lists of relevant published articles. Study selection: Randomized controlled trials, non-randomized controlled trials and non-randomized non-controlled trials investigating the introduction of active workstations in humans were included in this systematic review. Only original studies were included, and we did not accept studies combining the introduction of active workstations with other interventions. Outcomes concerning health, energy expenditure, cognition, quality of life and work performance were included. Results: We included 32 studies, of which five were longitudinal studies in school-aged children, 10 were longitudinal studies in adults and 17 were non-longitudinal studies in adults. Sixteen studies investigated standing desks, 15 investigated walking desks, and one investigated a cycling workstation. The general findings were decreased sitting time, increased energy expenditure, a positive effect on several health markers, no detrimental effect on work performance, no acute effect on cognitive function and no straightforward findings concerning computer task performance. Conclusion: The implementation of active workstations might contribute to improving people's health and physical activity levels. The effect of the use of these active workstations on cognition and applied work tasks, such as computer task performance, needs further investigation before conclusions can be drawn. Another aspect that needs further investigation is the implementation of the different active workstations in all age groups.
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Background Sedentary time has been found to be independently associated with poor health and mortality. Further, a greater proportion of the workforce is now employed in low activity occupations such as office work. To date, there is no research that specifically examines the contribution of sedentary work to overall sedentary exposure and thus risk. The purpose of the study was to determine the total exposure and exposure pattern for sedentary time, light activity and moderate/vigorous physical activity (MVPA) of office workers during work and non-work time. Methods 50 office workers from Perth, Australia wore an Actical (Phillips, Respironics) accelerometer during waking hours for 7 days (in 2008–2009). Participants recorded wear time, waking hours, work hours and daily activities in an activity diary. Time in activity levels (as percentage of wear time) during work and non-work time were analysed using paired t-tests and Pearson’s correlations. Results Sedentary time accounted for 81.8% of work hours (light activity 15.3% and MVPA 2.9%), which was significantly greater than sedentary time during non-work time (68.9% p < 0.001). Office workers experienced significantly more sustained sedentary time (bouts >30 minutes) and significantly less brief duration (0–10 minutes) light intensity activity during work hours compared to non-work time (p < 0.001). Further, office workers had fewer breaks in sedentary time during work hours compared to non-work time (p < 0.001). Conclusions Office work is characterised by sustained sedentary time and contributes significantly to overall sedentary exposure of office workers.
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Sedentary (sitting) behaviours are ubiquitous in modern society. We conducted a systematic review and meta-analysis to examine the association of sedentary time with diabetes, cardiovascular disease and cardiovascular and all-cause mortality. Medline, Embase and the Cochrane Library databases were searched for terms related to sedentary time and health outcomes. Cross-sectional and prospective studies were included. RR/HR and 95% CIs were extracted by two independent reviewers. Data were adjusted for baseline event rate and pooled using a random-effects model. Bayesian predictive effects and intervals were calculated to indicate the variance in outcomes that would be expected if new studies were conducted in the future. Eighteen studies (16 prospective, two cross-sectional) were included, with 794,577 participants. Fifteen of these studies were moderate to high quality. The greatest sedentary time compared with the lowest was associated with a 112% increase in the RR of diabetes (RR 2.12; 95% credible interval [CrI] 1.61, 2.78), a 147% increase in the RR of cardiovascular events (RR 2.47; 95% CI 1.44, 4.24), a 90% increase in the risk of cardiovascular mortality (HR 1.90; 95% CrI 1.36, 2.66) and a 49% increase in the risk of all-cause mortality (HR 1.49; 95% CrI 1.14, 2.03). The predictive effects and intervals were only significant for diabetes. Sedentary time is associated with an increased risk of diabetes, cardiovascular disease and cardiovascular and all-cause mortality; the strength of the association is most consistent for diabetes.
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OBJECTIVE: Recently, interest has increased in productivity loss associated with medical conditions or health behaviors that do not preclude attendance at work (e.g., migraine, smoking). Commonly, productivity loss is subjectively assessed (asking workers directly to report on the productivity impacts of their medical conditions or health behaviors) which may be problematic because certain illnesses or health behaviors are viewed as socially undesirable. We describe the initial validation of a new instrument, the Health and Work Questionnaire (HWQ) that can be used in studies of worker health and productivity. METHOD: The HWQ consists of 24 items assessing work quality, quantity, efficiency, and related factors. To minimize “social desirability” tendencies on the part of respondents, they are asked to rate their work quality, quantity, and efficiency from their supervisor's and their co-worker's perspectives as well as their own. All items have ten-point response scales. The initial questionnaire was pretested by 30 subjects. Based on subject feedback, no wording changes were deemed necessary. The HWQ was administered to 294 employees of a major US airline and was completed at baseline and at three subsequent monthly intervals. Validation included comparisons with two objective productivity measures collected by the airline: Time Lost, the average time a reservation agent is unavailable between calls; and Total Performance Points, the performance measure used for quarterly employee evaluation. RESULTS: Six subscales were identified by factor analyses: productivity, concentration/focus, supervisor relations, impatience/irritability, work satisfaction, and non-work satisfaction. Internal consistency reliability values were high for all scales (0.84–0.96), with the exception of impatience/irritability, displaying adequate reliability (0.72). All HWQ scale scores correlated significantly with the Time Lost measure; two scales correlated significantly with the performance measure. The significant correlations were all modest (0.12 to 0.22). CONCLUSIONS: With other measures, the HWQ may be a useful instrument in assessing group differences and evaluating the impact of health interventions on work-place productivity.
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Long uninterrupted sedentary periods, independent of total sedentary time, are risk factors for poor health. There is little objective data relating to workplace sedentary behaviour and adherence to current recommendations. The sitting behaviour of office workers (n = 83) was quantified objectively using body-worn accelerometers (activPAL (TM)) over a working week. Adherence to three different recommendations (maximum length of a sitting event of: 20 min; 30 min; 55 min) were assessed. Participants were seated at work for 5.3 +/- 1.0 h/d (mean +/- 1 SD), equivalent to 66 +/- 12% of the working day, accrued in 27 +/- 7events/d individual sitting events. Dependent on the recommendation applied, 5-20% of sitting events and 25-67% of time was accumulated in sitting events longer than current guidelines. No participants met the 20 or 30 min recommendations on every working day but seven (8%) participants met the 55 min recommendation. In conclusion, office workers spend a considerable period of their day sitting, accumulated in uninterrupted sitting events longer than current recommendations.
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This study explored whether musculoskeletal complaints can be reduced by the provision of ergonomics education. A cluster randomized controlled trial study was conducted in which 3 units were randomized to intervention and received training and 3 units were given a leaflet. The effect of intervention on knowledge, workstation practices, musculoskeletal complaints, sickness absence, and psychological well-being were assessed at 6 and 12 months. Although there was no increment of knowledge among workers, significant improvements in workstation practices in the use of monitor, keyboard, and chair were observed. There were significant reductions in neck and upper and lower back complaints among workers but these did not translate into fewer days lost from work. Workers' stress was found to be significantly reduced across the studies. In conclusion, office ergonomics training can be beneficial in reducing musculoskeletal risks and stress among workers.
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The true causes of the obesity epidemic are not well understood and there are few longitudinal population-based data published examining this issue. The objective of this analysis was to examine trends in occupational physical activity during the past 5 decades and explore how these trends relate to concurrent changes in body weight in the U.S. Analysis of energy expenditure for occupations in U.S. private industry since 1960 using data from the U.S. Bureau of Labor Statistics. Mean body weight was derived from the U.S. National Health and Nutrition Examination Surveys (NHANES). In the early 1960's almost half the jobs in private industry in the U.S. required at least moderate intensity physical activity whereas now less than 20% demand this level of energy expenditure. Since 1960 the estimated mean daily energy expenditure due to work related physical activity has dropped by more than 100 calories in both women and men. Energy balance model predicted weights based on change in occupation-related daily energy expenditure since 1960 for each NHANES examination period closely matched the actual change in weight for 40-50 year old men and women. For example from 1960-62 to 2003-06 we estimated that the occupation-related daily energy expenditure decreased by 142 calories in men. Given a baseline weight of 76.9 kg in 1960-02, we estimated that a 142 calories reduction would result in an increase in mean weight to 89.7 kg, which closely matched the mean NHANES weight of 91.8 kg in 2003-06. The results were similar for women. Over the last 50 years in the U.S. we estimate that daily occupation-related energy expenditure has decreased by more than 100 calories, and this reduction in energy expenditure accounts for a significant portion of the increase in mean U.S. body weights for women and men.
Article
Background: Sit-stand workstations are proposed solutions to reduce sedentary time at work. Numerous companies are using them to mitigate health concerns such as musculoskeletal discomfort. Objective: To review the literature on sit-stand workstations and low back discomfort. Method: We conducted a meta-analysis on literature published before November 17, 2016 that addressed the relationship between sit-stand workstations and musculoskeletal discomfort, focusing on the low back. Results: Twelve articles were identified and eight that presented results in means (SD) were included. Among a pain-free population, the standardized mean difference (SMD) was -0.230 for low back discomfort with use of sit-stand workstations. When applying the SMD to studies using the 10-point pain scale, the effect estimates ranged between -0.30 to -0.51. Conclusion: Sit-stand workstations may reduce low back pain among workers. Further research is needed to help quantify dosage parameters and other health outcomes. Practitioner Summary: In a sedentary population, changing posture may reduce the chance of developing low back pain. The literature lacks studies on specific populations such as those who have pre-existing low back pain and also does not adequately address the dosage of sit-stand time required to help reduce pain.
Article
Background Recent guidelines recommend accruing 2–4h of standing or light activity during the working day. Use of sit–stand desks could achieve this goal, but whether standing can meaningfully increase energy expenditure (EE) is unclear. Aims To study EE, heart rate, feelings and productivity during deskwork while sitting, standing or alternating positions. Methods We measured EE by indirect calorimetry in working adults over three randomly ordered 60-min conditions while performing deskwork: continuous sitting (SIT), 30min of each standing and sitting (STAND–SIT) and continuous standing (STAND). We also assessed heart rate, productivity and self-reported energy, fatigue and pain. Linear mixed models compared minute-by-minute EE and heart rate across conditions. Non-parametric tests compared remaining outcomes across conditions. Results The study group comprised 18 working adults. Compared with SIT, STAND–SIT engendered an additional 5.5±12.4 kcal/h (7.8% increase) and STAND engendered an additional 8.2±15.9 kcal/h (11.5% increase) (both P < 0.001). Alternating positions to achieve the recommended 4h/day of standing could result in an additional 56.9 kcal/day for an 88.9kg man and 48.3 kcal/day for a 75.5kg woman. STAND–SIT and STAND also increased heart rate over SIT by 7.5±6.8 and 13.7±8.8 bpm, respectively (both P < 0.001). We observed no meaningful differences in feelings or productivity. Conclusions Desk-based workers could increase EE without added discomfort by using a sit–stand desk. These findings inform future research on sit–stand desks as a part of workplace interventions to increase EE and potentially improve health.
Article
Purpose: To evaluate, compared to usual practice, the initial and long-term effectiveness of a workplace intervention targeting reducing sitting on activity outcomes. Methods: Office worksites (≥1km apart) from a single organization in Victoria, Australia were cluster randomized to intervention (n=7) or control (n=7). Participants were 231 desk-based office workers (5 to 39 participants per worksite) working at least 0.6 full time equivalent. The workplace-delivered intervention addressed organizational, physical environment, and individual behavioural change to reduce sitting time. Assessments occurred at baseline, three-, and 12-months, with the primary outcome participants' objectively measured (activPAL3 device) workplace sitting time (mins/8-h workday). Secondary activity outcomes were: workplace time spent standing, stepping (light, moderate-vigorous and total) and in prolonged (≥30min) sitting bouts (h/8-h workday); usual duration of workplace sitting bouts; and, overall sitting, standing and stepping time (mins/16-h day). Analysis was by linear mixed models, accounting for repeated measures and clustering and adjusting for baseline values and potential confounders. Results: At baseline, on average, participants (68% women; mean±SD age = 45.6±9.4 years) sat, stood and stepped for 78.8±9.5%, 14.3±8.2%, and 6.9±2.9% of work hours respectively. Workplace sitting time was significantly reduced in the intervention group compared to the controls at three months (-99.1 [95% CI -116.3 to -81.8] min/8-h workday) and 12 months (-45.4 [-64.6 to -26.2] min/8-h workday). Significant intervention effects (all favoring intervention) were observed for standing, prolonged sitting, and usual sitting bout duration at work, as well as overall sitting and standing time, with no significant nor meaningful effects observed for stepping. Conclusions: This workplace-delivered multicomponent intervention was successful at reducing workplace and overall daily sitting time in both the short- and long- term.
Article
Purpose: Sit-to-stand workstations are becoming common in modern offices and are increasingly being implemented in sedentary behavior interventions. The purpose of this study was to examine whether the introduction of such a workstation among office workers leads to reductions in sitting during working hours, and whether office workers compensate for any reduction in sitting at work by increasing sedentary time and decreasing physical activity (PA) outside work. Methods: Office workers (n=40; 55% female) were given a WorkFit-S, sit-to-stand workstation for 3 months. Participants completed assessments at baseline (prior to workstation installation), 1-week and 6-weeks after the introduction of the workstation, and again at 3-months (post-intervention). Posture and PA were assessed using the activPAL inclinometer and ActiGraph GT3X+ accelerometer, which participants wore for 7-days during each measurement phase. Results: Compared to baseline, the proportion of time spent sitting significantly decreased (75+/-13% versus 52+/-16 - 56+/-13%), and time spent standing and in light activity significantly increased (standing: 19+/-12% versus 32+/-12 - 37+/-15%, light PA: 14+/-4% versus 16+/-5%) during working hours at all follow-up assessments. However, compared to baseline, the proportion of time spent sitting significantly increased (60+/-11% versus 66+/-12 - 68+/-12%) and light activity significantly decreased (21+/-5% versus 19+/-5%) during non-working hours across the follow-up measurements. No differences were seen in moderate-to-vigorous activity during non-working hours throughout the study. Conclusion: The findings suggest that introducing a sit-to-stand workstation can significantly reduce sedentary time and increase light activity levels during working hours. However, these changes were compensated for by reducing activity and increasing sitting outside of working hours. An intervention of a sit-to-stand workstation should be accompanied by an intervention outside of working hours to limit behavior compensation.
Article
Introduction: Prolonged sedentary behavior is an independent risk factor for many negative health outcomes. Although many employers have begun introducing sit-stand desks as means of reducing employee's occupational sitting time, few studies have examined the impact of prolonged access to such desks on sitting/standing time or cardiometabolic outcomes. The present study compared occupational sedentary/physical activity behaviors and cardiometabolic biomarkers among employees with long-term access to traditional sitting and sit-stand desks. Methods: This study used a naturalistic, cross-sectional study design. Occupational sedentary and physical activity behaviors and cardiometabolic health outcomes were collected in a controlled laboratory between February and June 2014. Data were analyzed in September 2014. Adults working in full-time sedentary desk jobs who reported having either a sit-stand desk (n=31) or standard sitting desk (n=38) for a minimum of 6 months were recruited. Results: Employees with sit-stand desks sat less (p=0.02) and stood more at work (p=0.01) compared with employees with sitting desks. Significant inverse correlations were observed between several occupational physical activity outcomes (walking time, steps at work) and cardiometabolic risk factors (systolic blood pressure, weight, lean mass, BMI) over the entire sample. Conclusions: Employees with long-term access to sit-stand desks sat less and stood more compared with employees with sitting desks. These findings hold public health significance, as sit-stand desks represent a potentially sustainable approach for reducing sedentary behavior among the large, growing number of sedentary workers at increased risk for sedentariness-related pathologies.
Article
Background: Sedentary work is associated with many adverse health outcomes, and sit-stand workstations in offices have emerged as a way to counteract sedentary work. Objective: This paper reviews the existing knowledge on sit-stand workstations, treadmill workstations and bicycle workstations. Methods: The inclusion/exclusion criteria were: 1) empirical research examining the effectiveness of sit-stand workstations in lab or field studies, 2) working adult population, 3) sit-stand workstation interventions where workers performed the same task from a seated or standing position, 4) outcomes measures of discomfort (comfort), performance, sit-stand behaviors, user satisfaction, and kinematic and physiological measures. Search terms were sit-stand, treadmill, bicycle, workstations, sedentary behavior, office ergonomics, and comfort. Results: Many studies considered productivity, comfort and physiological measures as important outcomes to assess the efficacy of sit-stand workstations and the experimental design was variable. Preliminary data suggests that some amount of standing during an 8-hour workday could be beneficial without compromising user comfort or productivity; however, there is very little data on the efficacy of treadmill and bicycle workstations. Conclusions: Based on these preliminary data from 26 studies, conducting large scale randomized controlled trials with ergonomic training as their essential component is recommended to understand the benefits of sit-stand workstations for prevention of sedentary work.
Article
Active workstations, such as treadmill and sit-to-stand workstations, enable office employees to break prolonged sitting with bouts of light-intensity walking and/or standing. Compared with sitting, walking and/or standing accumulated during the workday using these workstations will increase muscle contractions, which may influence blood flow, energy expenditure, metabolism, musculoskeletal health, and brain function. Physiological responses when using treadmill and sit-to-stand workstations may vary due to differences in muscle contraction type (dynamic vs. static) and may thus affect cardio-metabolic and musculoskeletal health and brain function in different ways.
Article
Emerging research demonstrates that sedentary behavior is associated with various individual chronic conditions, independent of physical activity. Despite multimorbidity (having at least 2 chronic diseases) being highly prevalent (≥23% of adults) and associating with premature mortality, to my knowledge, no study has examined the association between sedentary behavior and multimorbidity, which was the purpose of this research letter. Data from the 2005-2006 NHANES were used (analyzed in 2015). A multimorbidity index variable was created indicating the number of 14 morbidities each patient had; sedentary behavior and physical activity were assessed via accelerometry. For every 60min/day increase in sedentary behavior, participants had a higher multimorbidity index (βadjusted=0.08; 95% CI: 0.04-0.11, p<0.001) and had an 11% (ORadjusted=1.11; 95% CI: 1.01-1.21; p=0.03) increased odds of being multimorbid (i.e., having ≥2 morbidities). Sedentary behavior is associated with multimorbidity (independent of light-intensity physical activity and adherence to moderate-to-vigorous physical activity guidelines), which underscores the importance of minimizing prolonged sedentary behavior (in addition to promoting physical activity) among adults. Copyright © 2015. Published by Elsevier Inc.
Article
An international group of experts was invited by Public Health England and a UK community interest company (Active Working CIC) to provide guidelines for employers to promote the avoidance of prolonged periods of sedentary work. The set of recommendations was developed from the totality of the current evidence, including long-term epidemiological studies and interventional studies of getting workers to stand and/or move more frequently. The evidence was ranked in quality using the four levels of the American College of Sports Medicine. The derived guidance is as follows: for those occupations which are predominantly desk based, workers should aim to initially progress towards accumulating 2 h/day of standing and light activity (light walking) during working hours, eventually progressing to a total accumulation of 4 h/day (prorated to part-time hours). To achieve this, seated-based work should be regularly broken up with standing-based work, the use of sit–stand desks, or the taking of short active standing breaks. Along with other health promotion goals (improved nutrition, reducing alcohol, smoking and stress), companies should also promote among their staff that prolonged sitting, aggregated from work and in leisure time, may significantly and independently increase the risk of cardiometabolic diseases and premature mortality. It is appreciated that these recommendations should be interpreted in relation to the evidence from which they were derived, largely observational and retrospective studies, or short-term interventional studies showing acute cardiometabolic changes. While longer term intervention studies are required, the level of consistent evidence accumulated to date, and the public health context of rising chronic diseases, suggest initial guidelines are justified. We hope these guidelines stimulate future research, and that greater precision will be possible within future iterations.
Article
Background: The magnitude, consistency, and manner of association between sedentary time and outcomes independent of physical activity remain unclear. Purpose: To quantify the association between sedentary time and hospitalizations, all-cause mortality, cardiovascular disease, diabetes, and cancer in adults independent of physical activity. Data sources: English-language studies in MEDLINE, PubMed, EMBASE, CINAHL, Cochrane Library, Web of Knowledge, and Google Scholar databases were searched through August 2014 with hand-searching of in-text citations and no publication date limitations. Study selection: Studies assessing sedentary behavior in adults, adjusted for physical activity and correlated to at least 1 outcome. Data extraction: Two independent reviewers performed data abstraction and quality assessment, and a third reviewer resolved inconsistencies. Data synthesis: Forty-seven articles met our eligibility criteria. Meta-analyses were performed on outcomes for cardiovascular disease and diabetes (14 studies), cancer (14 studies), and all-cause mortality (13 studies). Prospective cohort designs were used in all but 3 studies; sedentary times were quantified using self-report in all but 1 study. Significant hazard ratio (HR) associations were found with all-cause mortality (HR, 1.240 [95% CI, 1.090 to 1.410]), cardiovascular disease mortality (HR, 1.179 [CI, 1.106 to 1.257]), cardiovascular disease incidence (HR, 1.143 [CI, 1.002 to 1.729]), cancer mortality (HR, 1.173 [CI, 1.108 to 1.242]), cancer incidence (HR, 1.130 [CI, 1.053 to 1.213]), and type 2 diabetes incidence (HR, 1.910 [CI, 1.642 to 2.222]). Hazard ratios associated with sedentary time and outcomes were generally more pronounced at lower levels of physical activity than at higher levels. Limitation: There was marked heterogeneity in research designs and the assessment of sedentary time and physical activity. Conclusion: Prolonged sedentary time was independently associated with deleterious health outcomes regardless of physical activity. Primary funding source: None.
Article
Prolonged sedentary time (ST) is associated with adverse health outcomes, while decreasing ST improves health outcomes. The use of sit-stand desks (SSDs) in workplaces has been proposed as a means of reducing ST. The purpose of this study was to gain knowledge about participants' experience and perceptions of a workplace intervention involving the introduction of SSDs. Focus groups and interviews were conducted with 28 study participants who used SSDs for 4 weeks. Data were analyzed using a grounded theory approach. Participants reported a high level of satisfaction with the SSDs and 96% chose to use them permanently. Participants experienced greater energy and alertness at work and reported increased face-to-face interaction with coworkers. Lack of work-surface space was the most significant problem with the use of SSDs. There was no perception of decreased productivity or reduced workplace privacy among participants.
Article
Objectives To examine whether the introduction of intermittent standing bouts during the workday using a height-adjustable workstation can improve subjective levels of fatigue, musculoskeletal discomfort and work productivity relative to seated work. Methods Overweight/obese office workers (n=23; age 48.2±7.9 years, body mass index 29.6±4 kg/m2) undertook two, 5-day experimental conditions in an equal, randomised (1:1) order. In a simulated office environment, participants performed their usual occupational tasks for 8 h/day in a: seated work posture (SIT condition); or interchanging between a standing and seated work posture every 30 min using an electric, height-adjustable workstation (STAND-SIT condition). Self-administered questionnaires measuring fatigue, musculoskeletal discomfort and work productivity were performed on day 5 of each experimental condition. Results Participants’ total fatigue score was significantly higher during the SIT condition (mean 67.8 (95% CI 58.8 to 76.7)) compared with the STAND-SIT condition (52.7 (43.8 to 61.5); p<0.001). Lower back musculoskeletal discomfort was significantly reduced during the STAND-SIT condition compared with the SIT condition (31.8% reduction; p=0.03). Despite concentration/focus being significantly higher during the SIT condition (p=0.006), there was a trend towards improved overall work productivity in favour of the STAND-SIT condition (p=0.053). Conclusions Transitioning from a seated to a standing work posture every 30 min across the workday, relative to seated work, led to a significant reduction in fatigue levels and lower back discomfort in overweight/obese office workers, while maintaining work productivity. Future investigations should be directed at understanding whether sustained use of height-adjustable workstations promote concentration and productivity at work. Trial Registration Number ACTRN12611000632998.
Article
Desk-based office employees sit for most of their working day. To address excessive sitting as a newly identified health risk, best practice frameworks suggest a multi-component approach. However, these approaches are resource intensive and knowledge about their impact is limited. To compare the efficacy of a multi-component intervention to reduce workplace sitting time, to a height-adjustable workstations-only intervention, and to a comparison group (usual practice). Three-arm quasi-randomized controlled trial in three separate administrative units of the University of Queensland, Brisbane, Australia. Data were collected between January and June 2012 and analyzed the same year. Desk-based office workers aged 20-65 (multi-component intervention, n=16; workstations-only, n=14; comparison, n=14). The multi-component intervention comprised installation of height-adjustable workstations and organizational-level (management consultation, staff education, manager e-mails to staff) and individual-level (face-to-face coaching, telephone support) elements. Workplace sitting time (minutes/8-hour workday) assessed objectively via activPAL3 devices worn for 7 days at baseline and 3 months (end-of-intervention). At baseline, the mean proportion of workplace sitting time was approximately 77% across all groups (multi-component group 366 minutes/8 hours [SD=49]; workstations-only group 373 minutes/8 hours [SD=36], comparison 365 minutes/8 hours [SD=54]). Following intervention and relative to the comparison group, workplace sitting time in the multi-component group was reduced by 89 minutes/8-hour workday (95% CI=-130, -47 minutes; p<0.001) and 33 minutes in the workstations-only group (95% CI=-74, 7 minutes, p=0.285). A multi-component intervention was successful in reducing workplace sitting. These findings may have important practical and financial implications for workplaces targeting sitting time reductions. Australian New Zealand Clinical Trials Registry 00363297.
Article
Prolonged sitting time is a health risk. We describe a practice-based study designed to reduce prolonged sitting time and improve selected health factors among workers with sedentary jobs. We conducted our study during Marchƒ?"May 2011 in Minneapolis, Minnesota, among employees with sedentary jobs. Project implementation occurred over 7 weeks with a baseline period of 1 week (period 1), an intervention period of 4 weeks (period 2), and a postintervention period of 2 weeks (period 3). The intervention group (n = 24) received a sit-stand device during period 2 designed to fit their workstation, and the comparison group (n = 10) did not. We used experience-sampling methods to monitor sitting behavior at work during the 7 weeks of the project. We estimated change scores in sitting time, health risk factors, mood states, and several office behaviors on the basis of survey responses. The Take-a-Stand Project reduced time spent sitting by 224% (66 minutes per day), reduced upper back and neck pain by 54%, and improved mood states. Furthermore, the removal of the device largely negated all observed improvements within 2 weeks. Our findings suggest that using a sit-stand device at work can reduce sitting time and generate other health benefits for workers.
Article
Work Related Musculoskeletal Disorders (WMSDs) among office workers with intensive computer use is widespread and the prevalence of symptoms is growing. This randomized controlled trial investigated the effects of an office ergonomics training combined with a sit-stand workstation on musculoskeletal and visual discomfort, behaviors and performance. Participants performed a lab-based customer service job for 8 h per day, over 15 days and were assigned to: Ergonomics Trained (n = 11) or Minimally Trained (n = 11). The training consisted of: a 1.5-h interactive instruction, a sit/stand practice period, and ergonomic reminders. Ergonomics Trained participants experienced minimal musculoskeletal and visual discomfort across the 15 days, varied their postures, with significantly higher performance compared to the Minimally Trained group who had a significantly higher number of symptoms, suggesting that training plays a critical role. The ability to mitigate symptoms, change behaviors and enhance performance through training combined with a sit-stand workstation has implications for preventing discomforts in office workers.
Article
Sitting time is an emerging health risk, and many working adults spend large amounts of time sitting each day. It is important to have reliable and accurate measurement tools to assess sitting time in different contexts. To validate the Workforce Sitting Questionnaire (WSQ), an adapted measure of total and domain-specific sitting time based on work and non-workdays for use in working adults. A convenience sample (N=95, 63.2% women) was recruited from two workplaces and by word-of-mouth in Sydney, Australia. Participants completed the WSQ, which asked about sitting time (1) while travelling to and from places; (2) while at work; (3) while watching TV; (4) while using a computer at home; and (5) while doing other leisure activities on work and non-workdays on two occasions, 7 days apart. Participants also wore an accelerometer for the 7 days between test and retest. They recorded the times they wore the accelerometer, the days they worked and their work times in a logbook. Analyses determined test-retest reliability with intraclass correlation coefficients (ICCs) and assessed criterion validity against accelerometers using Spearman's r and Bland-Altman plots. Measuring total sitting time based on a workday, non-workday and on average had fair to excellent test-retest reliability (ICC=0.46-0.90) and had sufficient criterion validity against accelerometry in women (r=0.22-0.46) and men (r=0.18-0.29). Measuring domain-specific sitting at work on a workday was also reliable (ICC=0.63) and valid (r=0.45). The WSQ has acceptable measurement properties for measuring sitting time at work on a workday and for assessing total sitting time based on work and non-workdays. This questionnaire would be suitable for use in research investigating the relationships between sitting time and health in working populations.
Article
This systematic review summarizes the current evidence on the financial return of worksite health promotion programmes aimed at improving nutrition and/or increasing physical activity. Data on study characteristics and results were extracted from 18 studies published up to 14 January 2011. Two reviewers independently assessed the risk of bias of included studies. Three metrics were (re-)calculated per study: the net benefits, benefit cost ratio (BCR) and return on investment (ROI). Metrics were averaged, and a post hoc subgroup analysis was performed to compare financial return estimates between study designs. Four randomized controlled trials (RCTs), 13 non-randomized studies (NRSs) and one modelling study were included. Average financial return estimates in terms of absenteeism benefits (NRS: ROI 325%, BCR 4.25; RCT: ROI -49%, BCR 0.51), medical benefits (NRS: ROI 95%, BCR 1.95; RCT: ROI -112%, BCR -0.12) or both (NRS: ROI 387%, BCR 4.87; RCT: ROI -92%, BCR 0.08) were positive in NRSs, but negative in RCTs. Worksite health promotion programmes aimed at improving nutrition and/or increasing physical activity generate financial savings in terms of reduced absenteeism costs, medical costs or both according to NRSs, whereas they do not according to RCTs. Since these programmes are associated with additional types of benefits, conclusions about their overall profitability cannot be made.
Article
Television viewing time, independent of leisure time physical activity, has cross-sectional relationships with the metabolic syndrome and its individual components. We examined whether baseline and 5-yr changes in self-reported television viewing time are associated with changes in continuous biomarkers of cardiometabolic risk (waist circumference, triglycerides, HDL-cholesterol, systolic and diastolic blood pressure, fasting plasma glucose, and a clustered cardiometabolic risk score) in Australian adults. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) is a prospective, population-based cohort study with biological, behavioral, and demographic measures collected in 1999-2000 and 2004-2005. Noninstitutionalized adults aged > or =25 yr were measured at baseline (11,247; 55% of those completing an initial household interview); 6400 took part in the 5-yr follow-up biomedical examination, and 3846 met the inclusion criteria for this analysis. Multiple linear regression analysis was used, and unstandardized B coefficients (95% confidence intervals (CI)) are provided. Baseline television viewing time (10 h.wk-1 unit) was not significantly associated with change in any of the biomarkers of cardiometabolic risk. Increases in television viewing time over 5 yr (10 h.wk-1 unit) were associated with increases in waist circumference (men: 0.43 cm, 95% CI = 0.08-0.78 cm, P = 0.02; women: 0.68 cm, 95% CI = 0.30-1.05, P < 0.001), diastolic blood pressure (women: 0.47 mm Hg, 95% CI = 0.02-0.92 mm Hg, P = 0.04), and the clustered cardiometabolic risk score (women: 0.03, 95% CI = 0.01-0.05, P = 0.007). These associations were independent of baseline television viewing time and baseline and change in physical activity and other potential confounders. These findings indicate that an increase in television viewing time is associated with adverse cardiometabolic biomarker changes. Further prospective studies using objective measures of several sedentary behaviors are required to confirm causality of the associations found.
Article
Television viewing time, the predominant leisure-time sedentary behavior, is associated with biomarkers of cardiometabolic risk, but its relationship with mortality has not been studied. We examined the associations of prolonged television viewing time with all-cause, cardiovascular disease (CVD), cancer, and non-CVD/noncancer mortality in Australian adults. Television viewing time in relation to subsequent all-cause, CVD, and cancer mortality (median follow-up, 6.6 years) was examined among 8800 adults > or =25 years of age in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). During 58 087 person-years of follow-up, there were 284 deaths (87 CVD deaths, 125 cancer deaths). After adjustment for age, sex, waist circumference, and exercise, the hazard ratios for each 1-hour increment in television viewing time per day were 1.11 (95% confidence interval [CI], 1.03 to 1.20) for all-cause mortality, 1.18 (95% CI, 1.03 to 1.35) for CVD mortality, and 1.09 (95% CI, 0.96 to 1.23) for cancer mortality. Compared with a television viewing time of <2 h/d, the fully adjusted hazard ratios for all-cause mortality were 1.13 (95% CI, 0.87 to 1.36) for > or =2 to <4 h/d and 1.46 (95% CI, 1.04 to 2.05) for > or =4 h/d. For CVD mortality, corresponding hazard ratios were 1.19 (95% CI, 0.72 to 1.99) and 1.80 (95% CI, 1.00 to 3.25). The associations with both cancer mortality and non-CVD/noncancer mortality were not significant. Television viewing time was associated with increased risk of all-cause and CVD mortality. In addition to the promotion of exercise, chronic disease prevention strategies could focus on reducing sitting time, particularly prolonged television viewing.
Article
Although independent relationships between sitting behaviors (mainly television viewing) and health outcomes have been reported, few studies have examined the measurement properties of self-report sitting questions. This study assessed gender-specific test-retest reliability and validity of a questionnaire that assessed time spent sitting on weekdays and weekend days: 1) traveling to and from places, 2) at work, 3) watching television, 4) using a computer at home, and 5) for leisure, not including television. Test-retest reliability of domain-specific sitting time (min x d(-1)) on weekdays and weekend days was assessed using data collected on two occasions (median = 11 d apart). Validity of domain-specific self-reported sitting time on weekdays and weekend days was assessed against log data and sedentary accelerometer data. Complete repeat questionnaire and log data were obtained from 157 women (aged 51-59 yr) and 96 men (aged 45-63 yr). Reliability coefficients were high for weekday sitting time at work, watching television, and using a computer at home (r = 0.84-0.78) but lower for weekend days across all domains (r = 0.23-0.74). Validity coefficients were highest for weekday sitting time at work and using a computer at home (r = 0.69-0.74). With the exception of computer use and watching television for women, validity of the weekend-day sitting time items was low. This study confirms the importance of measuring domain- and day-specific sitting time. The measurement properties of questions that assess structured domain-specific and weekday sitting time were acceptable and may be used in future studies that aim to elucidate associations between domain-specific sitting and health outcomes.
Article
Although moderate-to-vigorous physical activity is related to premature mortality, the relationship between sedentary behaviors and mortality has not been fully explored and may represent a different paradigm than that associated with lack of exercise. We prospectively examined sitting time and mortality in a representative sample of 17,013 Canadians 18-90 yr of age. Evaluation of daily sitting time (almost none of the time, one fourth of the time, half of the time, three fourths of the time, almost all of the time), leisure time physical activity, smoking status, and alcohol consumption was conducted at baseline. Participants were followed prospectively for an average of 12.0 yr for the ascertainment of mortality status. There were 1832 deaths (759 of cardiovascular disease (CVD) and 547 of cancer) during 204,732 person-yr of follow-up. After adjustment for potential confounders, there was a progressively higher risk of mortality across higher levels of sitting time from all causes (hazard ratios (HR): 1.00, 1.00, 1.11, 1.36, 1.54; P for trend <0.0001) and CVD (HR:1.00, 1.01, 1.22, 1.47, 1.54; P for trend <0.0001) but not cancer. Similar results were obtained when stratified by sex, age, smoking status, and body mass index. Age-adjusted all-cause mortality rates per 10,000 person-yr of follow-up were 87, 86, 105, 130, and 161 (P for trend <0.0001) in physically inactive participants and 75, 69, 76, 98, 105 (P for trend = 0.008) in active participants across sitting time categories. These data demonstrate a dose-response association between sitting time and mortality from all causes and CVD, independent of leisure time physical activity. In addition to the promotion of moderate-to-vigorous physical activity and a healthy weight, physicians should discourage sitting for extended periods.
Article
The introduction of sit-stand worktables was examined in this study. Purchasers at four companies were interviewed regarding preparations prior to purchase, follow-up after installation, and if expectations had been fulfilled. Personnel at the four companies answered a questionnaire examining use of the worktables' sit-stand function, and the influence of some variables on this. Utilisation of the sit-stand function was less than what could be expected to relieve static musculoskeletal loading during VDU work. Pain experienced during the past year, and education on the use of the worktable gave rise to modest increases in utilisation. Investment in sit-stand worktables was satisfactory to purchasers, in terms of providing flexible furniture to suit modern organisational dynamics. Users were, in general, positive to the worktables, but showed poor compliance in using them. User and purchaser satisfaction with regard to improving individual health ergonomics was questionable in respect of the low level of usage.
A cluster randomized controlled trial to reduce office workers’ sitting time
Television viewing time and mortality