Occupational sitting and health risks: a systematic review

Sedentary and Physical Activity Behavior in "Blue-Collar" Workers: A Systematic Review of Accelerometer Studies

BACKGROUND

This systematic review assessed evidence on the accelerometer-measured sedentary and physical activity (PA) behavior of nonoffice workers in "blue-collar" industries.

METHODS

The databases CINAHL, Embase, MEDLINE, PubMed, and Scopus were searched up to April 6, 2018. Eligibility criteria were accelerometer-measured sedentary, sitting, and/or PA behaviors in "blue-collar" workers (≥10 participants; agricultural, construction, cleaning, manufacturing, mining, postal, or transport industries). Data on participants' characteristics, study protocols, and measured behaviors during work and/or nonwork time were extracted. Methodologic quality was assessed using a 12-item checklist.

RESULTS

Twenty studies (representing 11 data sets), all from developed world economies, met inclusion criteria. The mean quality score for selected studies was 9.5 (SD 0.8) out of a maximum of 12. Data were analyzed using a range of analytical techniques (eg, accelerometer counts or pattern recognition algorithms). "Blue-collar" workers were more sedentary and less active during nonwork compared with work time (eg, sitting 5.7 vs 3.2 h/d; moderate to vigorous PA 0.5 vs 0.7 h/d). Drivers were the most sedentary (work time 5.1 h/d; nonwork time 8.2 h/d).

CONCLUSIONS

High levels of sedentary time and insufficient PA to offset risk are health issues for "blue-collar" workers. To better inform interventions, research groups need to adopt common measurement and reporting methodologies.

Effects of Full Body Exergaming in Virtual Reality on Cardiovascular and Muscular Parameters: Cross-Sectional Experiment

BACKGROUND

In recent years, many studies have associated sedentary behavior in front of screens with health problems in infants, children, and adolescents. Yet options for exergaming-playing video games that require rigorous physical exercise-seem to fall short of the physical activity levels recommended by the World Health Organization.

OBJECTIVE

The purpose of this study was to investigate the effect of a fully immersive virtual reality (VR)-based training system on cardiovascular and muscular parameters of young adults.

METHODS

A cross-sectional experiment design was used to analyze muscle activity (surface electromyography), heart rate, perceived exertion (RPE), cybersickness symptoms, perceived workload, and physical activity enjoyment (PACES) in 33 participants performing two 5-minute flights on a new training device.

RESULTS

Participants' performance of the planking position required to play the game resulted in moderate aerobic intensity (108 [SD 18.69] bpm). Due to the mainly isometric contraction of the dorsal muscle chain (with a mean activation between 20.6% [SD 10.57] and 26.7% [SD 17.39] maximum voluntary isometric contraction), participants described the exercise as a moderate to vigorous activity (RPE 14.6 [SD 1.82]). The majority reported that they enjoyed the exercise (PACES 3.74 [SD 0.16]). However, six participants had to drop out because of cybersickness symptoms and two because of muscle pain due to prior injuries.

CONCLUSIONS

Our findings suggest that fully immersive VR training systems can contribute to muscle-strengthening activities for healthy users. However, the dropout rate highlights the need for technological improvements in both software and hardware. In prevention and therapy, movement quality is a fundamental part of providing effective resistance training that benefits health. Exergaming on a regular basis has the potential to develop strong muscles and a healthy back. It is essential that future VR-based training systems take into account the recommendations of sport and exercise science.

Calibration of Self-Reported Time Spent Sitting, Standing and Walking among Office Workers: A Compositional Data Analysis

We developed and evaluated calibration models predicting objectively measured sitting, standing and walking time from self-reported data using a compositional data analysis (CoDA) approach. A total of 98 office workers (48 women) at the Swedish Transport Administration participated. At baseline and three-months follow-up, time spent sitting, standing and walking at work was assessed for five working days using a thigh-worn accelerometer (Actigraph), as well as by self-report (IPAQ). Individual compositions of time spent in the three behaviors were expressed by isometric log-ratios (ILR). Calibration models predicting objectively measured ILRs from self-reported ILRs were constructed using baseline data, and then validated using follow-up data. Un-calibrated self-reports were inaccurate; root-mean-square (RMS) errors of ILRs for sitting, standing and walking were 1.21, 1.24 and 1.03, respectively. Calibration reduced these errors to 36% (sitting), 40% (standing), and 24% (walking) of those prior to calibration. Calibration models remained effective for follow-up data, reducing RMS errors to 33% (sitting), 51% (standing), and 31% (walking). Thus, compositional calibration models were effective in reducing errors in self-reported physical behaviors during office work. Calibration of self-reports may present a cost-effective method for obtaining physical behavior data with satisfying accuracy in large-scale cohort and intervention studies.

Classifying Diverse Physical Activities Using "Smart Garments"

Physical activities can have important impacts on human health. For example, a physically active lifestyle, which is one of the most important goals for overall health promotion, can diminish the risk for a range of physical disorders, as well as reducing health-related expenditures. Thus, a long-term goal is to detect different physical activities, and an important initial step toward this goal is the ability to classify such activities. A recent and promising technology to discriminate among diverse physical activities is the smart textile system (STS), which is becoming increasingly accepted as a low-cost activity monitoring tool for health promotion. Accordingly, our primary aim was to assess the feasibility and accuracy of using a novel STS to classify physical activities. Eleven participants completed a lab-based experiment to evaluate the accuracy of an STS that featured a smart undershirt (SUS) and commercially available smart socks (SSs) in discriminating several basic postures (sitting, standing, and lying down), as well as diverse activities requiring participants to walk and run at different speeds. We trained three classification methods—K-nearest neighbor, linear discriminant analysis, and artificial neural network—using data from each smart garment separately and in combination. Overall classification performance (global accuracy) was ~98%, which suggests that the STS was effective for discriminating diverse physical activities. We conclude that, overall, smart garments represent a promising area of research and a potential alternative for discriminating a range of physical activities, which can have positive implications for health promotion.

Sedentary Behavior, Physical Activity, and All-Cause Mortality: Dose-Response and Intensity Weighted Time-Use Meta-analysis

OBJECTIVES

Previous studies have placed those with excessive sedentary behavior at increased risk of all-cause mortality. There is evidence of interdependency of sedentary behavior with physical activity, and its elucidation will have implications for guidelines and practice. This study investigated if sedentary behavior-related mortality risk can be offset by moderate- to vigorous-intensity physical activity (MVPA) considered in a time-use fashion.

DESIGN

PubMed was searched (from its inception till May 2018) for studies or meta-analyses that used data harmonized for MVPA. Of the 17 data-custodians located, 7 provided data on sitting time or TV viewing time, or both. A dose-response meta-analysis modeling log relative risks of all-cause mortality against uncompensated sedentary behavior metabolic equivalent hours (USMh) was run using the robust error meta-regression method. (Registration: CRD42017062439) SETTING: Individual subject data held by data custodians on this topic.

PARTICIPANTS

General adults.

MEASUREMENTS

Sedentary time, MVPA.

RESULTS

Five harmonized cohorts of sitting time (258,688 participants) and 4 of TV viewing time (156,593 participants) demonstrated that sedentary behavior was significantly associated with mortality, but this risk was attenuated with increasing energy expenditure through MVPA modeled in a time-use fashion. The average increment in mortality per USMh spent on sitting was 1% [relative risk (RR) 1.01, 95% confidence interval (CI) 1.00, 1.02; P = .01] and that per USMh spent on TV viewing was 7% (RR 1.07, 95% CI 1.04, 1.10; P < .001). The thresholds for risk started at 7 USMh for sitting and 3 USMh for TV viewing.

CONCLUSIONS/IMPLICATIONS

Our findings suggest that overall daily sitting time energy expenditure of 7 MET-hours (or TV viewing of 3 MET-hours) in excess of that expended on MVPA is independently related to all-cause mortality. These findings support the view that sitting is strongly influenced by consideration of concurrent MVPA in its impact on adverse health consequences and that the USMh is a more practical metric of sedentary behavior.

Physiological and cognitive measures during prolonged sitting: Comparisons between a standard and multi-axial office chair

Prolonged sitting, common in many workplaces, reduces blood flow to the lower limb and has negative health outcomes. CoreChair is an active-sitting chair that encourages increased movement to help mitigate these outcomes. Physiological and cognitive measures were recorded in ten subjects over 4 h of sitting in both the CoreChair and a traditional office chair. Sitting in both chairs led to increases in calf circumference (p < 0.0001), reduced tactile sensitivity (p = 0.02), and a cognitive decline in attention (p = 0.035) over time. However, the increase in calf circumference was smaller in the CoreChair at the second (p = 0.017) and third hour (p = 0.012) compared to the traditional chair. Additionally, for the attention task, the traditional chair generated more attention-task errors (p = 0.005), while no changes were observed with the CoreChair (p = 0.13). These findings suggest that during prolonged sitting CoreChair may have modest physiological and cognitive benefits compared to a traditional chair.

Standing desks for sedentary occupations: Assessing changes in satisfaction and health outcomes after six months of use

BACKGROUND

Standing desks are a low cost option for the reduction of sedentary behavior.

OBJECTIVE

This study evaluated changes in utility and health outcomes during a standing desk intervention.

METHODS

Thirty-five participants (BMI >25) who reported sitting an average of≥six hours per workday were recruited. Participants were randomized into a control or intervention group. Eleven were enrolled in the control group and 24 in the intervention group. Participants in the intervention group were outfitted with an adjustable standing desktop accessory while participants in the control group maintained a standard work desk. Self-reported and objective measures of sedentary time during an eight hour workday were captured for a baseline and intervention period. Changes in health outcomes and workplace satisfaction were assessed after six months.

RESULTS

Self-recorded sedentary behavior decreased by 25% after six months though no changes in health outcomes were observed. Subjective assessments of standing time were over-estimated by 10% (compared to accelerometer recordings) in the intervention group. The intervention group reported higher levels of satisfaction with comfort, customizability, and overall personal workplace.

CONCLUSIONS

Despite a decrease in sedentary behavior, no changes in health outcomes occurred after a six month intervention. Future studies should incorporate objective measures of diet and physical activity to assess compensatory behaviors that may offset sedentary reduction. More sensitive health outcome measures should also be considered.

The effect of sit-stand desks on office worker behavioral and health outcomes: A scoping review

This scoping review examines the effects of sit-stand desks (SSDs) on six domains: behavior (e.g. time sitting and standing), physiological, work performance, psychological, discomfort, and posture. Fifty-three articles met criteria. We determined the percentage of significant results for each domain. Forty-seven studies were experimental trials. Sample sizes ranged from six to 231 participants. Follow-up time-frames ranged from one day to one year. Sixty-one percent of behavioral (24 studies), 37% of physiological (28 studies), 7% of work performance (23 studies), 31% of psychological (11 studies), 43% of discomfort (22 studies), and 18% of posture domain results (4 studies) were significant. We conclude that SSDs effectively change behaviors, but these changes only mildly effect health outcomes. SSDs seem most effective for discomfort and least for productivity. Further study is needed to examine long-term effects, and to determine clinically appropriate dosage and workstation setup.

Types of Sedentary Behavior and Risk of Cardiovascular Events and Mortality in Blacks: The Jackson Heart Study

Background

Previous cross‐sectional studies have shown conflicting results regarding the effects of television viewing and occupational sitting on cardiovascular disease (CVD) risk factors. The purpose of this study was to compare the association of both television viewing and occupational sitting with CVD events and all‐cause mortality in blacks.

Methods and Results

Participants included 3592 individuals enrolled in the Jackson Heart Study, a community‐based study of blacks residing in Jackson, Mississippi. Television viewing (<2, 2–4, and >4 h/day) and occupational sitting (never/seldom, sometimes, often/always) were self‐reported. Over a median follow‐up of 8.4 years, there were 129 CVD events and 205 deaths. The highest category of television viewing (>4 h/day) was associated with a greater risk for a composite CVD events/all‐cause mortality end point compared with the lowest category (<2 h/day; hazard ratio, 1.49; 95% CI, 1.13–1.97). In contrast, the highest category of occupational sitting (often/always) was not associated with risk for a composite CVD events/all‐cause mortality end point compared with the lowest category (never/seldom; hazard ratio, 0.90; 95% CI, 0.69–1.18). Moderate‐to‐vigorous physical activity moderated the association of television viewing with CVD events/all‐cause mortality such that television viewing was not associated with greater risk among those with high moderate‐to‐vigorous physical activity levels.

Conclusions

Television viewing was associated with greater risk of CVD events and all‐cause mortality, while occupational sitting had no association with these outcomes. These findings suggest that minimizing television viewing may be more effective for reducing CVD and mortality risk in blacks compared with reducing occupational sedentary behavior.

Medium-term effects of a two-desk sit/stand workstation on cognitive performance and workload for healthy people performing sedentary work: a secondary analysis of a randomised controlled trial

Implementing sit/stand workstations in sedentary work environments is a common way to reduce sedentary time, but their medium-term effect on cognitive performance is unclear. To address this circumstance, eighteen office workers participated in a two-arm, randomised controlled cross-over trial (ClinicalTrials.gov Identifier: NCT02825303), either working at a traditional (sit) or an interventional (sit/stand) workplace for 23 weeks. Cognitive performance (working speed, reaction time, concentration performance, accuracy), workload and relevant covariates (salivary cortisol level, heart rate, physical activity, sitting time) were measured pre- and post-intervention under laboratory conditions. MANOVA and RMANOVA results did not show differences in performance parameters and workload, respectively, between sit/stand and traditional workplace users. Differences in text editing accuracy and cortisol levels for sit/stand workstation users indicate potential connectivity to cognitive parameters which should be further examined with large-scale studies. Practitioner summary: Medium-term effects of working at sit/stand workstations on cognitive performance and workload are unexplored. This randomised controlled trial suggests that cognitive performance and workload are unaffected for sit/stand workstation users after 23 weeks of use. However, accuracy appeared to improve and physiological stress appeared to be altered. Abbreviations: BMI: body mass index; IPAQ: International physical activity questionnaire; MET: metabolic equivalent of task; MANOVA: multivariate ANOVA; NASA TLX: NASA task load index; RMANOVA: repeated measures ANOVA.

Consistency of Sedentary Behavior Patterns among Office Workers with Long-Term Access to Sit-Stand Workstations

INTRODUCTION

Sit-stand workstations are a popular intervention to reduce sedentary behavior (SB) in office settings. However, the extent and distribution of SB in office workers long-term accustomed to using sit-stand workstations as a natural part of their work environment are largely unknown. In the present study, we aimed to describe patterns of SB in office workers with long-term access to sit-stand workstations and to determine the extent to which these patterns vary between days and workers.

METHODS

SB was objectively monitored using thigh-worn accelerometers for a full week in 24 office workers who had been equipped with a sit-stand workstation for at least 10 months. A comprehensive set of variables describing SB was calculated for each workday and worker, and distributions of these variables between days and workers were examined.

RESULTS

On average, workers spent 68% work time sitting [standard deviation (SD) between workers and between days (within worker): 10.4 and 18.2%]; workers changed from sitting to standing/walking 3.2 times per hour (SDs 0.6 and 1.2 h-1); with bouts of sitting being 14.9 min long (SDs 4.2 and 8.5 min). About one-third of the workers spent >75% of their workday sitting. Between-workers variability was significantly different from zero only for percent work time sitting, while between-days (within-worker) variability was substantial for all SB variables.

CONCLUSIONS

Office workers accustomed to using sit-stand workstations showed homogeneous patterns of SB when averaged across several days, except for percent work time seated. However, SB differed substantially between days for any individual worker. The finding that many workers were extensively sedentary suggests that just access to sit-stand workstations may not be a sufficient remedy against SB; additional personalized interventions reinforcing use may be needed. To this end, differences in SB between days should be acknowledged as a potentially valuable source of variation.

Physical heaviness of work and sitting at work as predictors of mortality: a 26-year follow-up of the Helsinki Birth Cohort Study

OBJECTIVES

To examine the relationships of late-career physical heaviness of work and sitting at work with mortality. A national-level job exposure matrix was used to determine the occupation-specific level of physical heaviness and sitting.

DESIGN

Prospective cohort study between years 1990 and 2015.

SETTING

Community.

PARTICIPANTS

5210 men and 4725 women from the Helsinki Birth Cohort Study with an occupational code at baseline (ages 45-57 years).

PRIMARY AND SECONDARY OUTCOME MEASURES

Total, cardiovascular (International Classification of Diseases 10th Revision I00-I99), cancer (C00-C97) and external (S00-Y84) mortality.

RESULTS

The exposures, physical heaviness and sitting had a non-linear, inverse relationship. During the 26-year follow-up, 1536 men and 759 women died. Among men, physical heaviness of work was positively associated and sitting at work was negatively associated with all-cause, cardiovascular and external cause mortality but they were not associated with cancer mortality. The HRs for men in the highest quartile of physical heaviness of work compared with men in the lowest quartile were 1.54 (1.31-1.80) for all-cause mortality, 1.70 (1.30-2.23) for cardiovascular mortality and 3.18 (1.75-5.78) for external cause mortality (adjusted for age and years of education). Compared with the lowest quartile, the HRs for the highest quartile of sitting at work among men were 0.71 (0.61-0.82) for all-cause mortality, 0.59 (0.45-0.77) for cardiovascular mortality and 0.38 (0.22-0.66) for external cause mortality. In women, neither physical heaviness of work nor sitting at work was associated with mortality.

CONCLUSIONS

Men in physically heavy work at their late-work career are at higher risk of death than men in physically light work.

Moving to an "Active" Biophilic Designed Office Workplace: A Pilot Study about the Effects on Sitting Time and Sitting Habits of Office-Based Workers

Promising initial insights show that offices designed to permit physical activity (PA) may reduce workplace sitting time. Biophilic approaches are intended to introduce natural surroundings into the workplace, and preliminary data show positive effects on stress reduction and elevated productivity within the workplace. The primary aim of this pilot study was to analyze changes in workplace sitting time and self-reported habit strength concerning uninterrupted sitting and PA during work, when relocating from a traditional office setting to “active” biophilic-designed surroundings. The secondary aim was to assess possible changes in work-associated factors such as satisfaction with the office environment, work engagement, and work performance, among office staff. In a pre-post designed field study, we collected data through an online survey on health behavior at work. Twelve participants completed the survey before (one-month pre-relocation, T₁) and twice after the office relocation (three months (T₂) and seven months post-relocation (T₃)). Standing time per day during office hours increased from T₁ to T₃ by about 40 min per day (p < 0.01). Other outcomes remained unaltered. The results suggest that changing office surroundings to an active-permissive biophilic design increased standing time during working hours. Future larger-scale controlled studies are warranted to investigate the influence of office design on sitting time and work-associated factors during working hours in depth.

Estimates of the current and future burden of cancer attributable to sedentary behavior in Canada

Leisure-time sedentary behavior is an emerging modifiable risk factor for cancer. We estimated the proportion of cancers attributed to leisure-time sedentary behavior as a separate risk factor from physical activity in Canada for 2015. We projected numbers of future avoidable cancers by 2042 using various assumed levels of reduced leisure-time sedentary behavior in the population. We calculated population attributable risks (PAR) for associated cancers and all-cancers associated with leisure-time sedentary behavior. Our analysis used pooled data on leisure-time sedentary behavior from the Canadian Community Health Survey (CCHS), and incident cancer data from the Canadian Cancer Registry (CCR). Survey respondents were categorized into three levels of leisure-time sedentary behavior, "<3 h/day", "≥3-<6 h/day", and "≥6 h/day". Estimates for the future burden of leisure-time sedentary behavior were calculated using the potential impact fractions framework (PIF) and counterfactual scenarios, from 10% to 50% decreases in leisure-time sedentary behavior. The estimated prevalence of leisure-time sedentary behavior at the highest level (≥6 h/day) in Canada during the 2000s was 9.9% among both sexes combined across age-groups. The total attributable burden due to leisure-time sedentary behavior was estimated to be 10.3% for associated cancers and 6.5% for all-cancers in 2015. A 50% reduction in leisure-time sedentary behavior across the Canadian population could avoid 4054 cancers by 2042. We estimated that over 3000 cancer cases in Canada were attributable to leisure-time sedentary behavior in 2015, and that that 4054 incident cancer cases could be prevented by 2042 with meaningful reductions in leisure-time sedentary behavior.

Influence of the wearable posture correction sensor on head and neck posture: Sitting and standing workstations

BACKGROUND

Flexed head and neck postures are associated with the development of neck pain in the office environment. There is little evidence regarding whether a wearable posture sensor would improve the head and neck postures of office workers.

OBJECTIVE

The aim of this study was to evaluate the effect of the wearable posture sensor on the posture and physical demands on the head and neck during office work.

METHODS

Nineteen participants performed a typing task with and without the wearable sensor in the sitting and standing positions. They were allowed to adjust their workstation during the experiment based on a psychophysical method. The flexion angles of the head and neck, the gravitational moment on the neck, and the positions of the workstation components were measured.

RESULTS

On average, participants with the wearable sensor had 8% lower neck flexion angles and 14% lower gravitational moments on the neck than those of participants without the wearable sensor. The effect of the wearable sensor on reducing postural stress of the neck was more significant when using the standing workstation compared to the sitting workstation.

CONCLUSIONS

The wearable posture sensor could be an effective tool to alleviate the postural stress of the neck in the office setting.

Device-measured physical activity, sedentary behaviour and cardiometabolic health and fitness across occupational groups: a systematic review and meta-analysis

BACKGROUND

With approximately 8 hours of one's waking day spent at work, occupational tasks and environments are important influencers on an individual's physical activity (PA) and sedentary behaviours. Little research has compared device-measured physical activity, sedentary behaviour and cardiometabolic outcomes between occupational groups.

OBJECTIVE

To compare device-measured movement (sedentary time [ST], light intensity physical activity [LPA], moderate-to-vigorous intensity physical activity [MVPA], and steps) across occupations. The secondary objective was to examine whether cardiometabolic and fitness outcomes differed by occupation.

METHODS

Five bibliographic databases were searched to identify all studies which included working age, employed adults from high-income countries, and reported on device-measured movement within occupations. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses and narrative syntheses.

RESULTS

The review includes 132 unique studies with data from 15,619 participants. Working adults spent ~ 60% of their working and waking time engaged in sedentary behaviour; a very small proportion (~ 4%) of the day included MVPA. On average, workers accumulated 8124 steps/day. Office and call center workers' steps/day were among the lowest, while those of postal delivery workers were highest. Office workers had the greatest ST and the lowest time in LPA both at work and during wakeful time. However, office workers had the greatest minutes sent in MVPA during wakeful hours. Laborers had the lowest ST and spent a significantly greater proportion of their work time in LPA and MVPA. Healthcare and protective services workers had higher levels of LPA at work compared to other occupations. Workers in driving-based occupations tended to have a higher body mass index and blood pressure.

CONCLUSION

This review identifies that occupational and wakeful time PA and ST differed between occupations. Future studies are needed to assess whether patterns differ by age and sex, describe leisure-time movement and movement patterns, and the relationship with cardiometabolic health.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42017070448 .

A Sitting Posture Monitoring Instrument to Assess Different Levels of Cognitive Engagement

An office chair for analyzing the seated posture variation during the performance of a stress-level test is presented in this work. To meet this aim, we placed a set of textile pressure sensors both on the backrest and on the seat of the chair. The position of the sensors was selected for maximizing the detection of variations of user’s posture. The effectiveness of the designed system was evaluated through an experiment where increasing stress levels were obtained by administering a Stroop test. The collected results had been analyzed by considering three different time intervals based on the difficulty level of the test (low, medium, and high). A transition analysis conducted on postures assumed during the test showed that participants reached a different posture at the end of the test, when the cognitive engagement increased, with respect to the beginning. This evidence highlighted the presence of movement presumably due to the increased cognitive engagement. Overall, the performed analysis showed the proposed monitoring system could be used to identify body posture variations related to different levels of engagement of a seated user while performing cognitive tasks.

Physical activity levels of allied health professionals working in a large Australian metropolitan health district - an observational study

PURPOSE

The aim of this observational cross-sectional study was to determine if allied health professionals working in a large metropolitan health district were meeting the minimal physical activity (PA) recommendations and the proportion that occupational PA contributed to the recommended PA levels. A secondary aim was to determine possible relationships between self-report questionnaire measures of PA and PA measured by accelerometry.

MATERIALS AND METHODS

Allied health professionals, working in the Sydney Local Health District (SLHD) in 2016-2017, completed the Active Australia Survey (AAS), Occupational Sitting and Physical Activity Questionnaire (OSPAQ), International Physical Activity Questionnaire Long form (IPAQ-L), and wore the ActiGraph GT1M accelerometer for 7 days consecutively.

RESULTS

Based on accelerometry results, allied health professionals (N=126) spent a mean (SD) of 51 (23) minutes in moderate-to-vigorous physical activity (MVPA)/day, representing 171% of the total recommended MVPA/day, with work contributing 76% to this recommendation. Participants walked a mean of 10,077 (2,766) steps/day, meeting 100% of the recommended 10,000 steps/day, with work contributing 54% to this recommendation. Sedentary behaviors were predominant throughout the entire day and work day. Compared with the ActiGraph MVPA time measurements, AAS MVPA time showed a fair level of agreement [intraclass correlation coefficient (ICC)=0.44, P<0.01], while OSPAQ and IPAQ-L MVPA time showed no agreement (ICC=0.05, P=0.27; ICC=0.13, P=0.10, respectively).

CONCLUSION

Allied health professionals working in a large metropolitan health district met the daily PA recommendations based on accelerometry measures but tended to overreport their MVPA on self-report questionnaires.

Walking Works Wonders: a tailored workplace intervention evaluated over 24 months

This article presents longitudinal data from 1120 participants across 10 worksites enrolled in Walking Works Wonders, a tailored intervention designed to increase physical activity and reduce sedentary behaviour. The intervention was evaluated over 2 years, using a quasi-experimental design comprising 3 conditions: tailored information; standard information and control. This study explored the impact of the intervention on objective measures (BMI, %Fat, waist circumference, blood pressure and heart rate) and self-reported measures of physical activity, sedentary behaviour, physical and psychological health. Interventions tailored to employees' stage of change significantly reduced BMI and waist circumference compared to standard and control conditions. Employees who received either a standard or tailored intervention demonstrated significantly higher work ability, organizational commitment, job motivation, job satisfaction and a reduction in intention to quit the organization. The results suggest that adopting a tailored approach to interventions is particularly effective in terms of improving health in the workplace. Practitioner Summary: This study describes Walking Works Wonders, a tailored intervention, which aims to encourage physical activity in the workplace. The study evaluated Walking Works Wonders over a 2 year period and demonstrated that interventions are more effective in improving health outcomes where the information is tailored to employees' stage of change.

Sedentary behaviour and health at work: an investigation of industrial sector, job role, gender and geographical differences

This article presents baseline data from 1120 employees across 10 worksites enrolled in a workplace physical activity intervention. The study provides new data on physical activity, sedentary behaviour, and health and highlights gender, geographical, job type and industrial sector differences. Sitting at work accounted for more than 60% of participants' total daily sitting time on work days. Weekly and monthly hours worked, body mass index (BMI) and waist circumference were significantly higher for workers in the private sector compared to the public sector. Employees in sales and customer services had significantly higher BMI scores and significantly lower scores for workability index (WAI), job satisfaction, organisational commitment and job motivation, compared to other groups. This study provides further evidence that work is a major contributor to sedentary behaviour and supports the pressing need for interventions particularly targeting private sector industries and sales and customer service sectors. Practitioner Summary: Work accounts for more than 60% of the daily sitting time. Private sector employees had higher BMIs than those in the public sector and employees in sales and customer services had higher BMIs and poorer health compared to other occupations, suggesting that these groups should be targeted in workplace interventions.

Dynamic Office Workstations: Initial Insights into User Usability Evaluations and Motivation

Dynamic office workstations present a promising way to address the problem of inactivity at work, as they combine light physical activity with office tasks. In order to overcome the lack of structured implementation of such devices in office environments and the difficulty of stimulating employees to engage in healthy behaviors, the aim of this study was to investigate employees' motivation and perceived usability (e.g. operability) regarding the use of dynamic office workstations. Two different types of devices were made available to 30 employees (13 females, 17 males, mean ± SD = 43 ± 11.51 years) for 6 weeks. Motivation to the use of the workstations was assessed pre- and post-intervention, and usability was assessed post-intervention. Descriptive statistics and Wilcoxon tests were conducted. Employees reported the usability of the workstations to be acceptable, as they did not impede their work activities, whilst they were autonomously motivated towards using either workstation. Dynamic office workstations are suitable for daily use, although a flexible use of such devices should be guaranteed, depending on the task at hand.

Assessment of the ergonomic risk from saddle and conventional seats in dentistry: A systematic review and meta-analysis

Objective

This study aimed to verify whether the saddle seat provides lower ergonomic risk than conventional seats in dentistry.

Methods

This review followed the PRISMA statement and a protocol was created and registered in PROSPERO (CRD42017074918). Six electronic databases were searched as primary study sources. The "grey literature" was included to prevent selection and publication biases. The risk of bias among the studies included was assessed with the Joanna Briggs Institute Critical Appraisal Tool for Systematic Reviews. Meta-analysis was performed to estimate the effect of seat type on the ergonomic risk score in dentistry. The heterogeneity among studies was assessed using I² statistics.

Results

The search resulted in 3147 records, from which two were considered eligible for this review. Both studies were conducted with a total of 150 second-year dental students who were starting their laboratory activities using phantom heads. Saddle seats were associated with a significantly lower ergonomic risk than conventional seats [right side (mean difference = -3.18; 95% CI = -4.96, -1.40; p < 0.001) and left side (mean difference = -3.12; 95% CI = -4.56, -1.68; p < 0.001)], indicating posture improvement.

Conclusion

The two eligible studies for this review provide moderate evidence that saddle seats provided lower ergonomic risk than conventional seats in the examined population of dental students.

Workplace interventions for reducing sitting at work

BACKGROUND

A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality.

OBJECTIVES

To evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, OSH UPDATE, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 9 August 2017. We also screened reference lists of articles and contacted authors to find more studies.

SELECTION CRITERIA

We included randomised controlled trials (RCTs), cross-over RCTs, cluster-randomised controlled trials (cluster-RCTs), and quasi-RCTs of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies. The primary outcome was time spent sitting at work per day, either self-reported or measured using devices such as an accelerometer-inclinometer and duration and number of sitting bouts lasting 30 minutes or more. We considered energy expenditure, total time spent sitting (including sitting at and outside work), time spent standing at work, work productivity and adverse events as secondary outcomes.

DATA COLLECTION AND ANALYSIS

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.

MAIN RESULTS

We found 34 studies - including two cross-over RCTs, 17 RCTs, seven cluster-RCTs, and eight controlled before-and-after studies - with a total of 3,397 participants, all from high-income countries. The studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi-component interventions (four studies). One study included both physical workplace changes and information and counselling components. We did not find any studies that specifically investigated the effects of standing meetings or walking meetings on sitting time.Physical workplace changesInterventions using sit-stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short-term follow-up (up to three months) compared to sit-desks (95% confidence interval (CI) -116 to -84, 10 studies, low-quality evidence). The pooled effect of two studies showed sit-stand desks reduced sitting time at medium-term follow-up (3 to 12 months) by an average of 57 minutes per day (95% CI -99 to -15) compared to sit-desks. Total sitting time (including sitting at and outside work) also decreased with sit-stand desks compared to sit-desks (mean difference (MD) -82 minutes/day, 95% CI -124 to -39, two studies) as did the duration of sitting bouts lasting 30 minutes or more (MD -53 minutes/day, 95% CI -79 to -26, two studies, very low-quality evidence).We found no significant difference between the effects of standing desks and sit-stand desks on reducing sitting at work. Active workstations, such as treadmill desks or cycling desks, had unclear or inconsistent effects on sitting time.Workplace policy changesWe found no significant effects for implementing walking strategies on workplace sitting time at short-term (MD -15 minutes per day, 95% CI -50 to 19, low-quality evidence, one study) and medium-term (MD -17 minutes/day, 95% CI -61 to 28, one study) follow-up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI -66 to -15, one study, low-quality evidence) compared to long breaks (two 15-minute breaks per workday) at short-term follow-up.Information and counsellingProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short-term follow-up (MD -19 minutes per day, 95% CI -57 to 19, two studies, low-quality evidence). However, the reduction was significant at medium-term follow-up (MD -28 minutes per day, 95% CI -51 to -5, two studies, low-quality evidence).Computer prompts combined with information resulted in no significant change in sitting time at work at short-term follow-up (MD -14 minutes per day, 95% CI -39 to 10, three studies, low-quality evidence), but at medium-term follow-up they produced a significant reduction (MD -55 minutes per day, 95% CI -96 to -14, one study). Furthermore, computer prompting resulted in a significant decrease in the average number (MD -1.1, 95% CI -1.9 to -0.3, one study) and duration (MD -74 minutes per day, 95% CI -124 to -24, one study) of sitting bouts lasting 30 minutes or more.Computer prompts with instruction to stand reduced sitting at work on average by 14 minutes per day (95% CI 10 to 19, one study) more than computer prompts with instruction to walk at least 100 steps at short-term follow-up.We found no significant reduction in workplace sitting time at medium-term follow-up following mindfulness training (MD -23 minutes per day, 95% CI -63 to 17, one study, low-quality evidence). Similarly a single study reported no change in sitting time at work following provision of highly personalised or contextualised information and less personalised or contextualised information. One study found no significant effects of activity trackers on sitting time at work.Multi-component interventions Combining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low-quality evidence) and on time spent in prolonged sitting bouts (two studies, very low-quality evidence) at short-term follow-up.

AUTHORS' CONCLUSIONS

At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.

Current and ceased users of sit stand workstations: a qualitative evaluation of ergonomics, safety and health factors within a workplace setting

Background

Many workplaces have implemented sit-stand workstations (SSW), which enable a worker to transition between sitting and standing as they perform their work activities. The factors which determine the initial adoption, sustainability or cessation of use for a SSW, remain largely unexamined. This study investigates the experiences of workers who had previously used or were currently using a SSW.

Methods

The study setting was within an Australian university. Participants who were current or past SSW users, as well as workplace key informants, were interviewed for the study. All interviews were recorded, transcribed and analysed. Transcripts were coded by two researchers for concepts and themes regarding uptake and sustainability of SSW. Discussion and validation of themes was undertaken by the team of three researchers.

Results

A total of 24 interviews were conducted. Twenty-two interviews were with ceased and current users (16 current and six ceased users) and two interviews were with workplace key informants. Analysis of the interviews with current and ceased users identified three main themes: Personal considerations for use/sustainability; Posture; and Usability. Analysis of the interviews with key informants identified two themes: Considerations and concerns and Policies and procedures. Little information was provided to workers when first using a SSW. Workers who were able to adopt their working style to the new workstations were able to sustain ongoing use of a SSW. Key informants were concerned that employees believed using a SSW would provide a health benefit in its own right without an understanding of the possible risks that might be associated with use.

Conclusions

Sustainable usage of this type of SSW is achievable, however, it requires some element of adaptation at the individual worker level. Participants spoke about how the use of the SSW in a standing position was typically associated with the time of day, specific task selection and musculoskeletal comfort or fatigue factors. The provision of education to new SSW users with relevant supporting information by a subject matter expert should enable the worker to obtain a more holistic understanding of the safety and health risks and benefits embedded in the use of a SSW.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6296-6) contains supplementary material, which is available to authorized users.

Associations of context-specific sitting time with markers of cardiometabolic risk in Australian adults

Background

High volumes of sitting time are associated with an elevated risk of type 2 diabetes and cardiovascular disease, and with adverse cardiometabolic risk profiles. However, previous studies have predominately evaluated only total sitting or television (TV) viewing time, limiting inferences about the specific cardiometabolic health impacts of sitting accumulated in different contexts. We examined associations of sitting time in four contexts with cardiometabolic risk biomarkers in Australian adults.

Methods

Participants (n = 3429; mean ± SD age 58 ± 10 years) were adults without clinically diagnosed diabetes or cardiovascular disease from the 2011–2012 Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Multiple linear regressions examined associations of self-reported context-specific sitting time (occupational, transportation, TV-viewing and leisure-time computer use) with a clustered cardiometabolic risk score (CMR) and with individual cardiometabolic risk biomarkers (waist circumference, BMI, resting blood pressure, triglycerides, HDL- and LDL-cholesterol, and fasting and 2-h post-load plasma glucose).

Results

Higher CMR was significantly associated with greater TV-viewing and computer sitting time (b [95%CI] = 0.07 [0.04, 0.09] and 0.06 [0.03, 0.09]), and tended to be associated with higher occupational and transport sitting time (0.01 [− 0.01, 0.03] and 0.03 [− 0.00, 0.06]), after adjustment for potential confounders. Furthermore, keeping total sitting time constant, accruing sitting via TV-viewing and computer use was associated with significantly higher CMR (0.05 [0.02, 0.08] and 0.04 [0.01, 0.06]), accruing sitting in an occupational context was associated with significantly lower CMR (− 0.03 [− 0.05, − 0.01]), while no significant association was seen for transport sitting (0.00 [− 0.03, 0.04]). Results varied somewhat between the respective biomarkers; however, higher sitting time in each domain tended to be associated detrimentally with individual biomarkers except for fasting glucose (non-significant associations) and systolic blood pressure (a beneficial association was observed). Overall, associations were stronger for TV-viewing and computer use, and weaker for occupational sitting.

Conclusions

Higher context-specific sitting times tended to be detrimentally associated, albeit modestly, with CMR and several cardiometabolic risk biomarkers. There was some evidence suggesting that the context in which people sit is relevant above and beyond total sitting time. Methodological issues notwithstanding, these findings may assist in identifying priorities for sitting-reduction initiatives, in order to achieve optimal cardiometabolic health benefits.

Electronic supplementary material

The online version of this article (10.1186/s12966-018-0748-3) contains supplementary material, which is available to authorized users.

Correlates of sedentary behaviour in university students: A systematic review

High levels of sedentary behaviour are associated with negative health-related outcomes. However, there is limited evidence on the variables influencing sedentary behaviour in university students. The aim of this systematic review was to identify the intrapersonal, interpersonal, environmental, and time correlates of sedentary behaviour in university students. Records from 12 electronic databases were screened by two independent reviewers. Inclusion criteria included: (i) peer-reviewed articles written in English, Spanish, or French; (ii) studies including undergraduate or postgraduate university students; (iii) studies reporting on the association between sedentary behaviour and at least one variable. The protocol is registered in PROSPERO (CRD42017074198). A total of 126 studies published between 1994 and 2017 met the inclusion criteria. The primary measure of sedentary behaviour was self-reported screen time (61%), followed by total sitting time (28%). Most studies were cross-sectional (86%). After excluding high risk of bias studies (58%), only three intrapersonal variables were sufficiently investigated (≥4) to determine an association with sedentary behaviour: physical activity (negative association with sitting time), obesity markers (indeterminate associations with TV viewing), and gender - female (null associations with total sitting time and screen time). Overall, most of the reported correlates of sedentary behaviour were intrapersonal, non-modifiable factors. Further research on modifiable correlates covering all socio-ecologic levels is required to inform future intervention development. In addition, longitudinal studies are needed to enable the identification of determinants. Improvements in designing and reporting future studies are recommended to help strengthen the available evidence and facilitate future reviewing efforts.

Workplace-Related Factors Associated With Employees’ Standing Time at Work: A Research Brief

Purpose:

The purpose of this study was to identify the relationship between work-related, individual, and environmental factors and self-reported standing time during the workday.

Design:

Cross-sectional study design.

Setting:

Participants were recruited from a large, public university in the southeastern United States.

Measures:

Data were collected through an 87-item online survey using previously validated scales that assessed workplace standing time, demographic variables, work-related psychosocial factors, and workplace environment factors.

Analysis:

One-way analysis of variance, Pearson correlation coefficients, and nonparametric tests were used to determine univariate relationships between standing time and independent work-related variables and demographic factors.

Results:

Mean standing time among the sample (n = 502) was 72.49 minutes (standard deviation = 73.48) daily. There was a significant relationship between standing time and barrier self-efficacy for standing at work, self-regulation strategies, social norms, local connectivity in the workplace, overall connectivity in the workplace, and proximity of coworkers. Standing time was significantly higher for men, employees with an advanced degree, employees with a standing desk, and faculty.

Conclusion:

Health promotion researchers and practitioners should consider factors at multiple levels of influence when designing studies to explore workplace sedentary behavior. The findings regarding variations in workplace behavior by employee subgroups should be taken into consideration when designing future studies in the workplace.

Prolonged Sitting Interrupted by 6-Min of High-Intensity Exercise: Circulatory, Metabolic, Hormonal, Thermal, Cognitive, and Perceptual Responses

The aim was to examine certain aspects of circulatory, metabolic, hormonal, thermoregulatory, cognitive, and perceptual responses while sitting following a brief session of high-intensity interval exercise. Twelve students (five men; age, 22 ± 2 years) performed two trials involving either simply sitting for 180 min (SIT) or sitting for this same period with a 6-min session of high-intensity exercise after 60 min (SIT+HIIT). At T₀ (after 30 min of resting), T₁ (after a 20-min breakfast), T₂ (after sitting for 1 h), T₃ (immediately after the HIIT), T₄, T₅, T₆, and T₇ (30, 60, 90, and 120 min after the HIIT), circulatory, metabolic, hormonal, thermoregulatory, cognitive, and perceptual responses were assessed. The blood lactate concentration (at T₃-T₅), heart rate (at T₃-T₆), oxygen uptake (at T₃-T₇), respiratory exchange ratio, and sensations of heat (T₃-T₅), sweating (T₃, T₄) and odor (T₃), as well as perception of vigor (T₃-T₆), were higher and the respiratory exchange ratio (T₄-T₇) and mean body and skin temperatures (T₃) lower in the SIT+HIIT than the SIT trial. Levels of blood glucose and salivary cortisol, cerebral oxygenation, and feelings of anxiety/depression, fatigue or hostility, as well as the variables of cognitive function assessed by the Stroop test did not differ between SIT and SIT+HIIT. In conclusion, interruption of prolonged sitting with a 6-min session of HIIT induced more pronounced circulatory and metabolic responses and improved certain aspects of perception, without affecting selected hormonal, thermoregulatory or cognitive functions.

Effectiveness of the Stand More AT (SMArT) Work intervention: cluster randomised controlled trial

OBJECTIVES

To evaluate the impact of a multicomponent intervention (Stand More AT (SMArT) Work) designed to reduce sitting time on short (three months), medium (six months), and longer term (12 months) changes in occupational, daily, and prolonged sitting, standing, and physical activity, and physical, psychological, and work related health.

DESIGN

Cluster two arm randomised controlled trial.

SETTING

National Health Service trust, England.

PARTICIPANTS

37 office clusters (146 participants) of desk based workers: 19 clusters (77 participants) were randomised to the intervention and 18 (69 participants) to control.

INTERVENTIONS

The intervention group received a height adjustable workstation, a brief seminar with supporting leaflet, workstation instructions with sitting and standing targets, feedback on sitting and physical activity at three time points, posters, action planning and goal setting booklet, self monitoring and prompt tool, and coaching sessions (month 1 and every three months thereafter). The control group continued with usual practice.

MAIN OUTCOME MEASURES

The primary outcome was occupational sitting time (thigh worn accelerometer). Secondary outcomes were objectively measured daily sitting, prolonged sitting (≥30 minutes), and standing time, physical activity, musculoskeletal problems, self reported work related health (job performance, job satisfaction, work engagement, occupational fatigue, sickness presenteeism, and sickness absenteeism), cognitive function, and self reported psychological measures (mood and affective states, quality of life) assessed at 3, 6, and 12 months. Data were analysed using generalised estimating equation models, accounting for clustering.

RESULTS

A significant difference between groups (in favour of the intervention group) was found in occupational sitting time at 12 months (-83.28 min/workday, 95% confidence interval -116.57 to -49.98, P=0.001). Differences between groups (in favour of the intervention group compared with control) were observed for occupational sitting time at three months (-50.62 min/workday, -78.71 to -22.54, P<0.001) and six months (-64.40 min/workday, -97.31 to -31.50, P<0.001) and daily sitting time at six months (-59.32 min/day, -88.40 to -30.25, P<0.001) and 12 months (-82.39 min/day, -114.54 to -50.26, P=0.001). Group differences (in favour of the intervention group compared with control) were found for prolonged sitting time, standing time, job performance, work engagement, occupational fatigue, sickness presenteeism, daily anxiety, and quality of life. No differences were seen for sickness absenteeism.

CONCLUSIONS

SMArT Work successfully reduced sitting time over the short, medium, and longer term, and positive changes were observed in work related and psychological health.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN10967042.

Physical Activity, Inactivity, and Sedentary Behaviors: Definitions and Implications in Occupational Health

Based on the increasing evidence linking excessive sedentary behaviors and adverse health outcomes, public health strategies have been developed and constantly improved to reduce sedentary behaviors and increase physical activity levels at all ages. Although the body of literature in this field has grown, confusion still exists regarding the correct definition for sedentary behaviors. Thus, there is a need to provide a clear definition in order to distinguish sedentary behaviors from physical activity and inactivity. This paper will briefly review the most recent and accepted definitions of these concepts and illustrate their relationships. Nowadays, since most working adults spend a high proportion of their waking hours in increasingly sedentary tasks, there will be a particular focus on the field of occupational health. Finally, simple modifications in the workplace will be suggested in order to decrease sedentary behaviors.

Sedentary Behavior at Work and Cognitive Functioning: A Systematic Review

Background: It is now well-established that sedentarity has a negative impact on the physiological functioning and health of humans, whereas very little is known about the psychological repercussions, especially in cognitive functioning. Yet, studying the cognitive effects of the sedentary lifestyle is particularly relevant in the short term for productivity and in the long term for cognitive health (accelerated aging). This systematic review therefore aims to make an inventory of the potential cognitive effects of sedentarity at the workplace. Methods: Pubmed, PsycINFO, Cochrane, Web of Science, and Scopus were searched for English-language peer-reviewed articles published between January 1, 2000 and December 31, 2017 to identify studies including sedentary behavior and objective measures from cognitive domains (cognitive inhibition, cognitive flexibility, working memory, etc.). To carry out this systematic review, the 3 keywords "Sedentary" and "Cognition" and "Work" (and their derivatives) had to appear in the title or in the summary of the paper. Results: Of the 13 papers that met the inclusion criteria, 9 were short-term interventions, 3 medium-term interventions, and 1 long-term intervention. Nine of them reported non-significant results. Two studies study reported deterioration in cognitive performance. Two reported an improvement in performance in cognitive tasks with one study with overweight adults and the only one study with a long-term intervention. However, these studies intend to reduce sedentary behavior, but do not allow answering the question of the potential cognitive effects of the sedentary lifestyle. Conclusion: These data suggest that sedentary behavior is not associated with changes in cognitive performance in interventions that intend to reduce sedentary behavior. Then, and given the trend toward increased time in sedentary behavior, long-term prospective studies of high methodological quality are recommended to clarify the relationships between sedentary behavior and the cognitive functioning. Our systematic review identifies also the need for retrospective, longitudinal, or epidemiologic studies. It also recognizes the need to standardize methodology for collecting, defining, and reporting sedentary behavior and the need to standardize the cognitive tests used. The relationship between sedentary behavior and cognitive functioning remaining uncertain, further studies are warranted for which 8 recommendations are proposed.

The Short Term Musculoskeletal and Cognitive Effects of Prolonged Sitting During Office Computer Work

Office workers are exposed to high levels of sedentary time. In addition to cardio-vascular and metabolic health risks, this sedentary time may have musculoskeletal and/or cognitive impacts on office workers. Participants (n = 20) undertook two hours of laboratory-based sitting computer work to investigate changes in discomfort and cognitive function (sustained attention and problem solving), along with muscle fatigue, movement and mental state. Over time, discomfort increased in all body areas (total body IRR [95% confidence interval]: 1.43 [1.33–1.53]) reaching clinically meaningful levels in the low back and hip/thigh/buttock areas. Creative problem solving errors increased (β = 0.25 [0.03–1.47]) while sustained attention did not change. There was no change in erector spinae, trapezius, rectus femoris, biceps femoris and external oblique median frequency or amplitude; low back angle changed towards less lordosis, pelvis movement increased, and mental state deteriorated. There were no substantial correlations between discomfort and cognitive function. The observed changes suggest prolonged sitting may have consequences for musculoskeletal discomfort and cognitive function and breaks to interrupt prolonged sitting are recommended.

Longitudinal associations between TV viewing and BMI not explained by the 'mindless eating' or 'physical activity displacement' hypotheses among adults

BACKGROUND

The mechanisms explaining the positive relationship between television (TV) viewing and body mass index (BMI) are unclear. 'Mindless eating' and 'physical activity displacement' theories have been suggested, but have not been tested longitudinally among young adults. This study aimed to determine whether longitudinal associations between young adults' TV viewing and BMI are explained by changes in TV-related food and beverage consumption (FBC) and/or leisure-time physical activity (LTPA) over 5 years among young adults.

METHODS

A cohort of young Australian adults (n = 1068) was assessed in 2004-6 (T1) and 2009-2011 (T2), height and weight were measured (T1) or self-reported (T2), and participants self-reported TV viewing time (hours/day), weekly TV-related FBC and LTPA (mins/week). Linear regression was used to examine direct pathways between TV viewing and BMI, adjusting for TV-related FBC and LTPA to examine indirect pathways.

RESULTS

The association between TV viewing time and BMI (β: 0.41, 95% CI 0.03, 0.78 for > 1-h increase in TV viewing/day) was not explained by TV-related FBC (β: 0.37, 95% CI -0.18, 0.91) or LTPA (β: 0.38, 95% CI -0.17, 0.93) hypotheses. Increased TV-related FBC was associated with increased TV viewing (0.39 ± 1.54 h/day) and greater increases in BMI (0.92 ± 2.28 kg/m², p = 0.16). LTPA increases were not associated with changes in TV viewing (- 0.07 ± 1.42 h/day), and increases in BMI were smallest when LTPA increased (0.44 ± 2.25 kg/m²) and greatest when LTPA decreased (0.82 ± 2.30 kg/m²) (p = 0.13).

CONCLUSIONS

Factors other than changes in TV-related FBC or LTPA may explain the longitudinal relationship between TV viewing and increasing BMI among young adults. Findings confirm that TV viewing is a risk factor for weight gain in young adults but the underlying causal mechanisms remain unclear.

Workplace interventions for reducing sitting at work

BACKGROUND

A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality.

OBJECTIVES

To evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, OSH UPDATE, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 9 August 2017. We also screened reference lists of articles and contacted authors to find more studies.

SELECTION CRITERIA

We included randomised controlled trials (RCTs), cross-over RCTs, cluster-randomised controlled trials (cluster-RCTs), and quasi-RCTs of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies. The primary outcome was time spent sitting at work per day, either self-reported or measured using devices such as an accelerometer-inclinometer and duration and number of sitting bouts lasting 30 minutes or more. We considered energy expenditure, total time spent sitting (including sitting at and outside work), time spent standing at work, work productivity and adverse events as secondary outcomes.

DATA COLLECTION AND ANALYSIS

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.

MAIN RESULTS

We found 34 studies - including two cross-over RCTs, 17 RCTs, seven cluster-RCTs, and eight controlled before-and-after studies - with a total of 3,397 participants, all from high-income countries. The studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi-component interventions (four studies). One study included both physical workplace changes and information and counselling components. We did not find any studies that specifically investigated the effects of standing meetings or walking meetings on sitting time.Physical workplace changesInterventions using sit-stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short-term follow-up (up to three months) compared to sit-desks (95% confidence interval (CI) -116 to -84, 10 studies, low-quality evidence). The pooled effect of two studies showed sit-stand desks reduced sitting time at medium-term follow-up (3 to 12 months) by an average of 57 minutes per day (95% CI -99 to -15) compared to sit-desks. Total sitting time (including sitting at and outside work) also decreased with sit-stand desks compared to sit-desks (mean difference (MD) -82 minutes/day, 95% CI -124 to -39, two studies) as did the duration of sitting bouts lasting 30 minutes or more (MD -53 minutes/day, 95% CI -79 to -26, two studies, very low-quality evidence).We found no significant difference between the effects of standing desks and sit-stand desks on reducing sitting at work. Active workstations, such as treadmill desks or cycling desks, had unclear or inconsistent effects on sitting time.Workplace policy changesWe found no significant effects for implementing walking strategies on workplace sitting time at short-term (MD -15 minutes per day, 95% CI -50 to 19, low-quality evidence, one study) and medium-term (MD -17 minutes/day, 95% CI -61 to 28, one study) follow-up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI -66 to -15, one study, low-quality evidence) compared to long breaks (two 15-minute breaks per workday) at short-term follow-up.Information and counsellingProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short-term follow-up (MD -19 minutes per day, 95% CI -57 to 19, two studies, low-quality evidence). However, the reduction was significant at medium-term follow-up (MD -28 minutes per day, 95% CI -51 to -5, two studies, low-quality evidence).Computer prompts combined with information resulted in no significant change in sitting time at work at short-term follow-up (MD -10 minutes per day, 95% CI -45 to 24, two studies, low-quality evidence), but at medium-term follow-up they produced a significant reduction (MD -55 minutes per day, 95% CI -96 to -14, one study). Furthermore, computer prompting resulted in a significant decrease in the average number (MD -1.1, 95% CI -1.9 to -0.3, one study) and duration (MD -74 minutes per day, 95% CI -124 to -24, one study) of sitting bouts lasting 30 minutes or more.Computer prompts with instruction to stand reduced sitting at work on average by 14 minutes per day (95% CI 10 to 19, one study) more than computer prompts with instruction to walk at least 100 steps at short-term follow-up.We found no significant reduction in workplace sitting time at medium-term follow-up following mindfulness training (MD -23 minutes per day, 95% CI -63 to 17, one study, low-quality evidence). Similarly a single study reported no change in sitting time at work following provision of highly personalised or contextualised information and less personalised or contextualised information. One study found no significant effects of activity trackers on sitting time at work.Multi-component interventions Combining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low-quality evidence) and on time spent in prolonged sitting bouts (two studies, very low-quality evidence) at short-term follow-up.

AUTHORS' CONCLUSIONS

At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.

Lower limb blood flow and mean arterial pressure during standing and seated work: Implications for workplace posture recommendations

Sit-stand workstations are a popular workplace intervention. Organizations often require a medical professional's guidance for implementation. Therefore, it is important to understand potential negative outcomes associated with standing work, such as lower limb discomfort and peripheral vascular issues. The objective of this study was to compare changes in lower limb discomfort, blood pressure and blood flow accumulation during a light-load repetitive upper limb work task accomplished from seated and standing postures. At the Jewish Rehabilitation Hospital (Laval, Quebec, Canada), 16 participants were outfitted with Laser Doppler Flow (LDF) electrodes to measure blood flow in the lower limb, and a sphygmomanometer to measure lower limb mean arterial blood pressure (MAP). Participants completed simulated work over 34 min in standing and seated conditions. Repeated measures ANOVAs (Posture x Time) were used to assess the differences. There were significant effects for both Posture (p = 0.003) and Time (p = 0.007) for LDF-measured of blood flow accumulation in the soleus and the foot, with a mean increase of 77% blood flow over time in the standing posture, when compared to seated work. There was a significant 'Posture × Time' (p = 0.0034) interaction effect and a significant Posture (p = 0.0001) effect for MAP, with higher values in the standing posture by a mean of 37.2 mmHg. Posture had a significant effect (p < 0.001) on lower limb discomfort, with standing posture reporting higher levels. These results suggest that recommendations for using static standing work postures should be tempered, and physicians' guidance on workstation changes should consider the impacts on the lower limb.

Inverse Piezoresistive Nanocomposite Sensors for Identifying Human Sitting Posture

Sitting posture is the position in which one holds his/her body upright against gravity while sitting. Poor sitting posture is regarded as an aggravating factor for various diseases. In this paper, we present an inverse piezoresistive nanocomposite sensor, and related deciphering neural network, as a new tool to identify human sitting postures accurately. As a low power consumption device, the proposed tool has simple structure, and is easy to use. The strain gauge is attached to the back of the user to acquire sitting data. A three-layer BP neural network is employed to distinguish normal sitting posture, slight hunchback and severe hunchback according to the acquired data. Experimental results show that our method is both realizable and effective, achieving 98.75% posture identification accuracy. This successful application of inverse piezoresistive nanocomposite sensors reveals that the method could potentially be used for monitoring of diverse physiological parameters in the future.

The Impact of Activity Based Working (ABW) on Workplace Activity, Eating Behaviours, Productivity, and Satisfaction

The redesign of the physical workplace according to activity-based working (ABW) principles has potential to influence employee health and workplace outcomes. This natural experiment examined changes in accelerometer-derived workplace activity, self-reported eating behaviours, productivity, workplace satisfaction before (March to November 2014) and six to nine months after moving to an ABW workplace compared to a comparison workplace (n = 146 at baseline (56% ABW, aged 40.1 ± 8.5 years, 72% female). Interviews were also conducted with 21 ABW participants. Between- and within-group differences were examined and mixed model analysis examined intervention effects over time. Effect sizes were calculated on change scores (Cohen’s d). Although not statistically significant, ABW participants had meaningful improvements in workday sedentary time, light-, and moderate-to-vigorous intensity physical activity, job satisfaction and relationship with co-workers (d = 0.379–0.577), and small declines in productivity (d = 0.278). There were significant, meaningful, and beneficial intervention effects on perceived organisational support for being active in the workplace, frequency of eating lunch with colleagues, and satisfaction with the physical environment in ABW compared to comparison participants (d = 0.501–0.839). Qualitative data suggested that ABW employees associated ABW with greater opportunities for movement and collaboration, but had mixed views on the impact on productivity. Future research with larger samples and over longer follow-up periods is warranted.

Physical activity and sedentary behaviour in a flexible office-based workplace: Employee perceptions and priorities for change

ISSUE ADDRESSED

Many Australian employees now regularly work from home in some capacity. This new way of working has not been widely studied in relation to the potential implications for employees' health-related behaviour or workplace health promotion. The aim of this study was to explore office-based employees' perceptions of the impact of flexible work on physical activity and sedentary behaviour; and preferences for associated interventions.

METHODS

Three focus groups were conducted with office-based employees (n = 28) 6 months after the introduction of a flexible work policy. A semi-structured interview format with open-ended questions was used with summary statements to check understanding. Sessions were audiotaped, and dominant themes were identified. Findings on intervention preferences were interpreted using a social cognitive framework. An overview of results was provided to a group of managers (n = 9) for comment.

RESULTS

Employees reported that physical activity was not impacted, but sedentary behaviour had increased, with flexible work. Intervention preferences focussed on occupational sedentary behaviour, self-regulation, prompts and social connections, and not the physical work environment. Managers agreed with employees' preferences and also wanted interventions to be sustainable.

CONCLUSION

Self-directed interventions with social components and targeting occupational sedentary behaviour were more acceptable than physical activity interventions in this flexible workplace. SO WHAT?: Health promotion for workplaces with flexible work practices may benefit from prioritising strategies that promote self-regulation and social connections rather than being linked to the physical worksite.

Ecological Influences on Employees' Workplace Sedentary Behavior: A Cross-Sectional Study

PURPOSE

The purpose of this study was to explore the relationship between ecological factors and occupational sedentary behavior (SB).

DESIGN

Cross-sectional online survey.

SETTING

Participants were employees recruited from a large, public university in the Southeastern United States from August to November 2016.

PARTICIPANTS

The final sample included 527 (56% response rate) employees.

MEASURES

Data were collected through an 87-item survey using previously validated scales that assessed occupational SB, perceived behavioral control, barrier self-efficacy, self-regulation strategies, organizational social norms, office environment, and worksite climate.

ANALYSIS

One-way analysis of variance analyses were used to determine differences in occupational SB by demographic factors. A multivariate regression model was used to determine significant ecological determinants of occupational SB.

RESULTS

Mean SB was 342.45 (standard deviation = 133.25) minutes. Significant differences in SB were found by gender, education, and employment classification. Barrier self-efficacy and workplace connectivity, which evaluates the spatial layout of the office setting that may impact mobility within the workplace, were significant predictors of SB in the multivariate model.

CONCLUSION

Results from this study provide new information regarding the potential impact of workplace barriers and connectivity on occupational SB. The findings from this study support the inclusion of intervention modalities to minimize workplace barriers and increase workplace connectivity to increase workplace mobility and decrease SB.

Metabolic Rate during a Cognitive Vigilance Challenge at Alternative Workstations

OBJECTIVE

The aim of this study was to compare energy expenditure (EE, kcal/min) at three workstations during an attention-demanding cognitive function task (Test of Variables of Attention or TOVA). Workstations included the seated desk (SIT), standing desk (STAND), and seated workstation designed to promote spontaneous movement (SWING).

METHODS

Adult males (n = 11) and females (n = 13) were assessed for EE using VO2 and VCO2 per quarter of the 22-min TOVA.

RESULTS

Average EE were 1.39 ± 0.06 (SIT), 1.55 ± 0.08 (SWING), and 1.44 ± 0.08 (STAND). Main effects (P < 0.05) were seen for workstation (SWING, STAND > SIT), and quarter of TOVA (Q2 < Q1,Q3,Q4). TOVA errors and response times were not different for workstations but increased for Q3 and Q4.

CONCLUSION

Spontaneous movement at an alternative workstation elevated EE 10% to 11% compared with sitting and could increase daily nonexercise activity thermogenesis without diminishing mental attention to desk work.

I Can Stand Learning: A Controlled Pilot Intervention Study on the Effects of Increased Standing Time on Cognitive Function in Primary School Children

Sedentarism is considered an independent cardiovascular risk factor. Thus, the present study investigated the effects of employing standing desks in classrooms on cognitive function. The intervention class (IG; n = 19) was supplied with standing desks and balance pads for 11 weeks. The control class (CG; n = 19) received lessons as usual. Standing time was assessed objectively (accelerometers) and subjectively (self-report sheets, external classroom observers). The impact of standing on the digit span task and Eriksen flanker task was analysed. The standing time of the IG was higher during the school day in comparison to the CG (lesson: p = 0.004; break: p = 0.003). The intra-class correlation coefficient between self-reports and external observation was high (ICC = 0.94). The IG improved slightly on the Digit Span Task compared to CG. Employing standing desks for at least 1 h per school day serves as a feasible and effective opportunity to improve cognitive function.

Patterns of sedentary behavior in overweight and moderately obese users of the Catalan primary-health care system

Background and objectives

Prolonged sitting time (ST) has negative consequences on health. Changing this behavior is paramount in overweight/obese individuals because they are more sedentary than those with normal weight. The aim of the study was to establish the pattern of sedentary behavior and its relationship to health, socio-demographics, occupation, and education level in Catalan overweight/obese individuals.

Methods

A descriptive study was performed at 25 healthcare centers in Catalonia (Spain) with 464 overweight/moderately obese patients, aged25 to 65 years. Exclusion criteria were chronic diseases which contraindicated physical activity and language barriers. Face-to-face interviews were conducted to collect data on age, gender, educational level, social class, and marital status. Main outcome was ‘sitting time’ (collected by the Marshall questionnaire); chronic diseases and anthropometric measurements were registered.

Results

464 patients, 58.4% women, mean age 51.9 years (SD 10.1), 76.1% married, 60% manual workers, and 48.7% had finished secondary education. Daily sitting time was 6.2 hours on working days (374 minutes/day, SD: 190), and about 6 hours on non-working ones (357 minutes/day, SD: 170). 50% of participants were sedentary ≥6 hours. The most frequent sedentary activities were: working/academic activities around 2 hours (128 minutes, SD: 183), followed by watching television, computer use, and commuting. Men sat longer than women (64 minutes more on working days and 54 minutes on non-working days), and individuals with office jobs (91 minutes),those with higher levels of education (42 minutes), and younger subjects (25 to 35 years) spent more time sitting.

Conclusions

In our study performed in overweight/moderately obese patients the mean sitting time was around 6 hours which was mainly spent doing work/academic activities and watching television. Men, office workers, individuals with higher education, and younger subjects had longer sitting time. Our results may help design interventions targeted at these sedentary patients to decrease sitting time.

Office-Cycling: A Promising Way to Raise Pain Thresholds and Increase Metabolism with Minimal Compromising of Work Performance

Aim

Establishing the effects of low intensity cycling (LC), moderate intensity cycling (MC), and standing at a simulated office workstation on pain modulation, work performance, and metabolic expenditure.

Methods

36 healthy adults (21 females), mean age 26.8 (SD 7.6) years, partook in this randomized 3 × 3 crossover trial with 75 minutes of LC on 20% of maximum aerobic power (MAP) output, 30 minutes of MC on 50% of MAP, and standing 30 minutes with 48-hour wash-out periods. Outcome measures were pain modulation (pressure pain threshold (PPT) and thermal pain threshold)), work performance (transcription, mouse pointing, and cognitive performance), and metabolic expenditure.

Results

PPTs increased in all conditions. PPT trapezius showed the highest increase after LC, 39.3 kilopascals (kPa) (15.6; 78.6), compared to MC, 17.0 kPa (2.8; 49.9), and standing, 16.8 kPa (-5.6; 39.4), p = 0.015. Transcription was reduced during LC and MC. Mouse pointing precision was best during standing and worst and slowest during MC. Cognitive performance did not differ between conditions. Metabolic expenditure rates were 1.4 (1.3; 1.7), 3.3 (2.3; 3.7), and 7.5 (5.8; 8.7) kcal/minute during standing, LC, and MC, respectively (p < 0.001).

Conclusions

LC seems to be the preferred option; it raised PPTs, more than doubled metabolic expenditure, whilst minimally influencing work performance.

Frequent Exertion and Frequent Standing at Work, by Industry and Occupation Group - United States, 2015

Repeated exposure to occupational ergonomic hazards, such as frequent exertion (repetitive bending or twisting) and frequent standing, can lead to injuries, most commonly musculoskeletal disorders (1). Work-related musculoskeletal disorders have been estimated to cost the United States approximately $2.6 billion in annual direct and indirect costs (2). A recent literature review provided evidence that prolonged standing at work also leads to adverse health outcomes, such as back pain, physical fatigue, and muscle pain (3). To determine which industry and occupation groups currently have the highest prevalence rates of frequent exertion at work and frequent standing at work, CDC analyzed data from the 2015 National Health Interview Survey (NHIS) Occupational Health Supplement (OHS) regarding currently employed adults in the United States. By industry, the highest prevalence of both frequent exertion and frequent standing at work was among those in the agriculture, forestry, fishing, and hunting industry group (70.9%); by occupation, the highest prevalence was among those in the construction and extraction occupation group (76.9%). Large differences among industry and occupation groups were found with regard to these ergonomic hazards, suggesting a need for targeted interventions designed to reduce workplace exposure.

Work, Health, Safety and Well-Being: Current State of the Art

This introductory chapter will present a review of the current state of the art in relation to employee health, safety and well-being (HSW). The work environment and the nature of work itself are both important influences on HSW. A substantial part of the general morbidity of the population is related to work. It is estimated that workers suffer 270 million occupational accidents and 160 million occupational diseases each year. The chapter will first define HSW. It will then review the current state of the art by outlining key HSW issues in the contemporary world of work, identifying key needs. It will then discuss the evolution of key theoretical perspectives in this area by linking theory to practice and highlighting the need for aligning perspectives and integrating approaches to managing HSW in the workplace.

The Relationship Between Occupational Standing and Sitting and Incident Heart Disease Over a 12-Year Period in Ontario, Canada

While a growing body of research is examining the impacts of prolonged occupational sitting on cardiovascular and other health risk factors, relatively little work has examined the effects of occupational standing. The objectives of this paper were to examine the relationship between occupations that require predominantly sitting and those that require predominantly standing and incident heart disease. A prospective cohort study combining responses to a population health survey with administrative health-care records, linked at the individual level, was conducted in Ontario, Canada. The sample included 7,320 employed labor-market participants (50% male) working 15 hours a week or more and free of heart disease at baseline. Incident heart disease was assessed using administrative records over an approximately 12-year follow-up period (2003-2015). Models adjusted for a wide range of potential confounding factors. Occupations involving predominantly standing were associated with an approximately 2-fold risk of heart disease compared with occupations involving predominantly sitting. This association was robust to adjustment for other health, sociodemographic, and work variables. Cardiovascular risk associated with occupations that involve combinations of sitting, standing, and walking differed for men and women, with these occupations associated with lower cardiovascular risk estimates among men but elevated risk estimates among women.

Sedentary Time in Male and Female Masters and Recreational Athletes Aged 55 and Older

The purpose of this study was to quantify sedentary time among recreational and Masters (competitive) athletes aged 55 and older. A cross-sectional survey including questions on demographics, sport participation, as well as a short form of the International Physical Activity Questionnaire, and the Measure of Older Adult’s Sedentary Time questionnaire was administered (n = 203). Male Masters athletes reported more time spent in vigorous intensity physical activity and less time watching TV than recreational athletes. Among females, being a Masters athlete was associated with being more sedentary than being a recreational athlete, while among males, being a recreational athlete was associated with being more sedentary. The intensity and duration that older Masters and recreational athletes spent in their sport was inversely associated with the amount of sedentary time accumulated. Future research using inclinometers is needed to further elucidate sedentary time in older male and female athletes.