Occupational sitting and health risks: a systematic review

Evidence of increasing sedentarism in Mexico City during the last decade: Sitting time prevalence, trends, and associations with obesity and diabetes

INTRODUCTION

Sedentary behaviors such as sitting time are associated with obesity and diabetes independently of total reported physical activity. This study aimed to describe the current sitting time/day prevalence and trends and to examine the association of sitting time with sociodemographic and clinical variables in Mexico City.

METHODS

Two cross-sectional representative surveys in Mexico City were used for this analysis (2006: n = 1148 and 2015: n = 1329). Sedentary behavior questions from the International Physical Activity Questionnaire included time spent sitting on a weekday in the last week or on a Wednesday. Sitting time /day was divided into deciles, and participants in the highest decile (≥ 420 minutes/day) were classified within the high sitting category; others were classified in the low sitting time category. Multivariate logistic regression was used to evaluate the associations of sitting time with sociodemographic and clinical indicators, controlling for confounders and testing for potential interactions.

RESULTS

A total of 13.7% (2006) and 14.8% (2015) adults were classified in the highest sitting time category (≥ 420 minutes/day). There was a significant increase in the average sitting time/day between the surveys (216.0 minutes in 2006 vs. 233.3 minutes in 2015, p < 0.001). In 2015, men, those aged 20-49 years, those in low-intensity jobs, students, and those with a high socioeconomic level were more likely to be in the highest sitting time category. Participants with overweight/obesity (OR = 2.37, 95% CI: 1.11, 5.09) and those with high glucose levels (survey finding) (OR = 2.34, 95% CI: 1.04, 5.25) were more likely to report sitting time in the highest category.

DISCUSSION

Sitting time/day prevalence increased 8%, and average daily sitting minutes significantly increased by 8.2% (18 minutes) in the nine-year study period (2006-2015). Current public health policies should consider strategies not only for increasing physical activity levels, but also for reducing sitting time/day among the population as a measure to fight the growing epidemic of obesity and diabetes in Mexico.

Breastfeeding and maternal cardiovascular risk factors and outcomes: A systematic review

Background

There is growing evidence that breastfeeding has short- and long-term cardiovascular health benefits for mothers. The objectives of this systematic review were to examine the association between breastfeeding and maternal cardiovascular risk factors and outcomes that have not previously been synthesized systematically, including metabolic syndrome, hypertension and cardiovascular disease.

Methods and findings

This systematic review meets PRISMA guidelines. The MEDLINE, EMBASE and CINAHL databases were systematically searched for relevant publications of any study design from the earliest publication date to March 2016. The reference lists from selected articles were reviewed, and forward and backward referencing were conducted. The methodological quality of reviewed articles was appraised using validated checklists.

Twenty-one studies meeting the inclusion criteria examined the association between self-reported breastfeeding and one or more of the following outcomes: metabolic syndrome/metabolic risk factors (n = 10), inflammatory markers/adipokines (n = 2), hypertension (n = 7), subclinical cardiovascular disease (n = 2), prevalence/incidence of cardiovascular disease (n = 3) and cardiovascular disease mortality (n = 2). Overall, 19 studies (10 cross-sectional/retrospective, 9 prospective) reported significant protective effects of breastfeeding, nine studies (3 cross-sectional/retrospective, 5 prospective, 1 cluster randomized controlled trial) reported non-significant findings and none reported detrimental effects of breastfeeding. In most studies reporting significant associations, breastfeeding remained associated with both short- and long-term maternal cardiovascular health risk factors/outcomes, even after covariate adjustment. Findings from several studies suggested that the effects of breastfeeding may diminish with age and a dose-response association between breastfeeding and several metabolic risk factors. However, further longitudinal studies, including studies that measure exclusive breastfeeding, are needed to confirm these findings.

Conclusions

The evidence from this review suggests that breastfeeding is associated with cardiovascular health benefits. However, results should be interpreted with caution as the evidence gathered for each individual outcome was limited by the small number of observational studies. Additional prospective studies are needed.

PROSPERO registration number

CRD42016047766.

Self-reported actual and desired proportion of sitting, standing, walking and physically demanding tasks of office employees in the workplace setting: do they fit together?

OBJECTIVE

Occupational sitting time in white-collar workers represents a prominent contributor to overall daily sitting time, which is associated with various health risks. Workplace interventions intending to reduce sitting time during work typically focus on replacing sitting with standing. The aim was to investigate and compare actual and desired proportions of time spent sitting, standing, walking, and doing physically demanding tasks at work reported by desk-based workers. Cross-sectional data were collected from German desk-based workers (n = 614; 53.3% men; 40.9 ± 13.5 years). All were interviewed about their self-reported actual and desired level of sitting, standing, walking and physically demanding tasks at work.

RESULTS

Desk-based workers reported to sit 73.0%, stand 10.2%, walk 12.9% and do physically demanding tasks 3.9% of their working hours. However, the individuals desire to sit, stand, walk and do physically demand tasks significantly different [53.8% sit, 15.8% stand, 22.8% walk, physically demanding tasks (7.7%), p < 0.001]. The present data revealed greatest mismatch between the desk-based workers' actual and desired time for sitting and walking. Health promotion programs should offer not only options for more standing but also opportunities for more walking within the workplace setting to better match workers' desires.

RAAAF's office landscape The End of Sitting: Energy expenditure and temporary comfort when working in non-sitting postures

An earlier study suggested that the activity-inviting office landscape called “The End of Sitting”, designed by Rietveld Architecture Art Affordances (RAAAF), should be considered as an alternative working environment to prevent sedentary behavior. The End of Sitting lacks chairs and tables but consists instead of a myriad of sloped surfaces at different heights that afford workers to stand, lean or recline at different locations. In this study, we assessed the impact of four of its workspaces on physical intensity, temporary comfort and productivity of office work and compared the outcomes with sitting and standing behind a desk. Twenty-four participants worked for 10 minutes in each of the six test conditions. Energy expenditure, measured by indirect calorimetry, and heart rate were recorded. Questionnaires were used to assess the perceived comfort. The number of words found in the word search test was counted as a measure of productivity. The majority of The End of Sitting workspaces led to a significant increase in energy expenditure compared with sitting behind a desk (ps < .05). Average MET values ranged from 1.40 to 1.58 which is a modest rise in energy expenditure compared to sitting (1.32 METs) and not significantly different from standing (1.47 METs). The scores on the general comfort scale indicated that some workspaces were less comfortable than sitting (ps < .05), but the vast majority of participants reported that at least one of The End of Sitting workspaces was equally or more comfortable than sitting. No differences in productivity between the test conditions were found. Further long-term studies are required to assess the behavioral adaptations, productivity and the level of comfort when using The End of Sitting as a permanent office.

Using systematic review in occupational safety and health

Evaluation of scientific evidence is critical in developing recommendations to reduce risk. Healthcare was the first scientific field to employ a systematic review approach for synthesizing research findings to support evidence-based decision-making and it is still the largest producer and consumer of systematic reviews. Systematic reviews in the field of occupational safety and health are being conducted, but more widespread use and adoption would strengthen assessments. In 2016, NIOSH asked RAND to develop a framework for applying the traditional systematic review elements to the field of occupational safety and health. This paper describes how essential systematic review elements can be adapted for use in occupational systematic reviews to enhance their scientific quality, objectivity, transparency, reliability, utility, and acceptability.

Can a smart chair improve the sitting behavior of office workers?

Prolonged sitting can cause health problems and musculoskeletal discomfort. There is a need for objective and non-obstructive means of measuring sitting behavior. A 'smart' office chair can monitor sitting behavior and provide tactile feedback, aiming to improve sitting behavior. This study aimed to investigate the effect of the feedback signal on sitting behavior and musculoskeletal discomfort. In a 12-week prospective cohort study (ABCB design) among office workers (n = 45) was measured sitting duration and posture, feedback signals and musculoskeletal discomfort. Between the study phases, small changes were observed in mean sitting duration, posture and discomfort. After turning off the feedback signal, a slight increase in sitting duration was observed (10 min, p = 0.04), a slight decrease in optimally supported posture (2.8%, p < 0.01), and musculoskeletal discomfort (0.8, p < 0.01) was observed. We conclude that the 'smart' chair is able to monitor the sitting behavior, the feedback signal, however, led to small or insignificant changes.

Energy Expenditure of Standing Compared to Sitting While Conducting Office Tasks

Objectives This study aimed to investigate the energy expenditure of common office-based tasks. The objectives were to: (a) test the classification of tasks as sedentary or light-intensity physical activity and (b) compare the energy expenditure of tasks under two postural conditions (sitting and standing). Background The sedentary nature of office work has been highlighted as a health risk, and strategies to reduce sedentary behavior at work have been developed. However, there is limited evidence to guide the utilization of sit-stand workstations in the workplace for metabolic health benefits. Method A repeated measures laboratory-based study compared the energy expenditure of common office tasks in sitting and standing using indirect calorimetry ( n = 22). Four standardized tasks (sitting/standing quietly, reading, typing, sorting paper) under two postural conditions (sitting, standing) were performed in a randomized order. Results The mean energy expenditure for all tasks in sitting and standing was <1.5 METs. There were no significant differences in the energy expenditure of doing the same task in sitting compared to standing. In a repeated measures ANOVA, task ( p < .001) had a greater influence on METs expended than posture ( p = .030). Conclusion The study confirmed that the difference in energy expenditure of tasks carried out in sitting compared to standing is negligible. Application The ubiquitous use and utility of sit-stand workstations in the workplace needs to be reviewed. Notwithstanding the potential benefits of movement that may occur naturally, this study confirmed that standing as opposed to sitting does not produce a clinically important increase in energy expenditure.

Is sedentary behaviour just physical inactivity by another name?

The relationship between sedentary behaviour and physical activity and their role in the development of health conditions is an ongoing topic of research. This debate paper presents arguments in favour and against the statement: "Is sedentary behaviour just physical inactivity by another name?" The paper finishes with recommendations for future research in the field of sedentary behaviour, physical activity and public health.

Study on association of working hours and occupational physical activity with the occurrence of coronary heart disease in a Chinese population

Objective

To explore the association of working hours and occupational physical activity (OPA) with the occurrence of coronary heart disease (CHD) in a Chinese population.

Methods

A total of 595 participants (354 and 241 patients with and without CHD, respectively) aged between 24 and 65 were enrolled in our study, which was conducted at the First Affiliated Hospital of Nanjing Medical University between December 2015 and October 2016. Participant characteristics were collected from face-to-face questionnaires, and logistic regression analysis was conducted to examine the association of working hours and OPA with the occurrence of CHD.

Results

Compared with non-employed people, long working hours (especially ≥55 hours/week) contributed to the occurrence of CHD (adjusted odds ratio[OR] = 2.213, 95% confidence interval [CI]: 1.125, 4.355, P = 0.021) after multivariate adjustment in the Chinese population. With the extension of worktime, the CHD risk increased (P for the dose-response trend = 0.022). Meanwhile, even after adjusting for engagement in physical activity during leisure time, sedentary behavior at work had an adverse effect on CHD risk (adjusted OR = 2.794, 95%CI: 1.526, 5.115, P = 0.001), and a linear relationship was also found between OPA and CHD (P for the trend = 0.005).

Conclusions

Long working hours and sedentary behavior at work are associated with a high risk of CHD. In addition, prolonged working hours in sedentary occupations increases the risk of CHD, independent of engagement in leisure time physical activity.

The effect of a dynamic chair on seated energy expenditure

Dynamic sitting approaches have been advocated to increase seated energy expenditure with the view of lessening the sedentary nature of the task. This study compared energy expenditure (EE) and overall body discomfort on a novel dynamic chair with a standard office chair. Fifteen pain-free participants completed a DVD viewing task on both chairs in a randomised order. Energy expenditure and discomfort were collected simultaneously. Linear mixed models were used to analyse steady-state EE recorded on each of the chairs. Differences in discomfort were analysed using Wilkoxon Signed Rank Tests. Sitting on the novel dynamic chair significantly (p = 0.005) increased energy expenditure compared to a standard office chair. The discomfort experienced was mild overall, but was significantly greater on the dynamic chair (p = 0.004). Whilst the EE was seen to be significantly higher on the dynamic chair, the MET values are still below 1.5 METS. Thus, the use of a dynamic chair does not seem to be the most effective measure to prevent sedentary behaviour. Practitioner Summary: Sitting on a dynamic chair increased energy expenditure compared to sitting on a standard office chair among pain-free participants. Whilst the EE was seen to be significantly higher on the dynamic chair, the MET values are still below 1.5 METS (low level EE).

[Evaluation of Worker's Living Activity-time Questionnaire (JNIOSH-WLAQ) primarily to assess workers' sedentary behavior]

OBJECTIVES

The National Institute of Occupational Safety and Health, Japan (JNIOSH) developed a new Worker's Living Activity-time Questionnaire (JNIOSH-WLAQ) which primarily evaluates workers' sedentary behavior. The purpose of this study was to investigate the test-retest reliability and criterion validity of the WLAQ.

METHODS

One hundred and thirty eight workers completed the WLAQ twice in one week. During the week, they wore a thigh-worn inclinometer (activPAL) and maintained a daily log as criteria measurements. The WLAQ measures working time, commuting time, daily rest period (DRP), sleeping time, and time spent sitting within the four typical domains of a worker's life: (a) working time, (b) commuting time, (c) non-working time on a workday, and (d) non-workday. We calculated intraclass correlation coefficients (ICC) as a reliability value and Spearman's ρ as a validity value. Bland-Altman plots were used to assess any bias.

RESULTS

The analysis of WLAQ indicated favorable ICCs (0.72-0.98) for all living activity-times. The WLAQ had "strong" ρ values for working time (0.80) and DRP (0.83), a "very strong" ρ value for commuting time (0.96), and "moderate" ρ values for sleeping time during a workday (0.69) and a non-workday (0.53). As for the sitting time, the WLAQ had "moderate" ρ values for working time (0.67) and non-working time on a workday (0.59), a "strong" ρ value for commuting time (0.82), and a "low" ρ value for a non-workday (0.40). Bland-Altman plots showed a significant fixed bias for sitting time during working time and significant fixed and proportional biases for sitting time on a non-workday.

CONCLUSIONS

The study showed that the WLAQ has acceptable measurement features, which makes this questionnaire a reliable resource for future epidemiological surveys.

A practical guidance for assessments of sedentary behavior at work: A PEROSH initiative

Sedentary behavior is defined as sitting or lying with low energy expenditure. Humans in industrialized societies spend an increasing amount of time in sedentary behaviors every day. This has been associated with detrimental health outcomes. Despite a growing interest in the health effects of sedentary behavior at work, associations remain unclear, plausibly due to poor and diverse methods for assessing sedentary behavior. Thus, good practice guidance for researchers and practitioners on how to assess occupational sedentary behavior are needed. The aim of this paper is to provide a practical guidance for practitioners and researchers on how to assess occupational sedentary behavior. Ambulatory systems for use in field applications (wearables) are a promising approach for sedentary behavior assessment. Many different small-size consumer wearables, with long battery life and high data storage capacity are commercially available today. However, no stand-alone commercial system is able to assess sedentary behavior in accordance with its definition. The present paper offers decision support for practitioners and researchers in selecting wearables and data collection strategies for their purpose of study on sedentary behavior. Valid and reliable assessment of occupational sedentary behavior is currently not easy. Several aspects need to be considered in the decision process on how to assess sedentary behavior. There is a need for development of a cheap and easily useable wearable for assessment of occupational sedentary behavior by researchers and practitioners.

Taking a Stand: The Effects of Standing Desks on Task Performance and Engagement

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.

Inter-relationships between physical activity, body mass index, sedentary time, and cognitive functioning in younger and older adults: cross-sectional analysis of the Canadian Community Health Survey

OBJECTIVES

Engagement in leisure-time physical activity (LTPA) is protective against cognitive decline whereas obesity and sedentary behaviors are associated with impairments in perceived cognitive function. Currently, little is known about how these relationships vary across the lifespan. This study investigated the inter-relationships between LTPA, leisure-time sedentary time (LTST), body mass index (BMI), and perceived cognitive functioning in younger and older Canadian adults.

STUDY DESIGN

This is a cross-sectional study.

METHODS

Data from the 2012 annual component of the Canadian Community Health Survey (n = 45,522; ≥30 y) were used to capture LTPA, BMI, LTST, and perceived cognitive function. The inter-relationships were assessed using both mediation analyses and general linear models.

RESULTS

Lower LTPA and higher BMI and LTST were related to poorer perceived cognitive functioning (P < 0.0001) and LTPA mediated the BMI-perceived cognitive functioning (Sobel's test: t = 3.24; P < 0.002) and LTST-perceived cognitive functioning (Sobel test: t = 3.35; P < 0.002) relationships.

CONCLUSION

Higher LTPA levels contribute to better perceived cognitive functioning scores both independently and by way of offsetting the impact of elevated BMI and LTST on cognitive function.

Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence

The lifestyle factors of physical activity, sedentary behaviour, and diet are increasingly being studied for their associations with cancer. Physical activity is inversely associated with and sedentary behaviour is positively (and independently) associated with an increased risk of more than ten types of cancer, including colorectal cancer (and advanced adenomas), endometrial cancers, and breast cancer. The most consistent dietary risk factor for premalignant and invasive breast cancer is alcohol, whether consumed during early or late adult life, even at low levels. Epidemiological studies show that the inclusion of wholegrain, fibre, fruits, and vegetables within diets are associated with reduced cancer risk, with diet during early life (age <8 years) having the strongest apparent association with cancer incidence. However, randomised controlled trials of diet-related factors have not yet shown any conclusive associations between diet and cancer incidence. Obesity is a key contributory factor associated with cancer risk and mortality, including in dose-response associations in endometrial and post-menopausal breast cancer, and in degree and duration of fatty liver disease-related hepatocellular carcinoma. Obesity produces an inflammatory state, characterised by macrophages clustered around enlarged hypertrophied, dead, and dying adipocytes, forming crown-like structures. Increased concentrations of aromatase and interleukin 6 in inflamed breast tissue and an increased number of macrophages, compared with healthy tissue, are also observed in women with normal body mass index, suggesting a metabolic obesity state. Emerging randomised controlled trials of physical activity and dietary factors and mechanistic studies of immunity, inflammation, extracellular matrix mechanics, epigenetic or transcriptional regulation, protein translation, circadian disruption, and interactions of the multibiome with lifestyle factors will be crucial to advance this field.

[Occupational sedentary behaviors and physical activity at work]

Sedentary behaviors are a leading cause of preventable mortality in developed countries. We mainly have sedentary behaviors at work. Sedentary behaviors must be considered as an occupational risk, and therefore must be a major concern for managers and physicians/health researchers. Recreational physical activity only partly compensates for the negative effects of physical inactivity at work. Physical activity at work without excess (walking, standing) is beneficial. Initiatives to reduce physical inactivity and increase physical activity among employees are effective in terms of mental health, physical health, and productivity. Prevention of sedentary behaviors at work is a win-win partnership between employers and employees.

A Community-Based Physical Activity Counselling Program for People With Knee Osteoarthritis: Feasibility and Preliminary Efficacy of the Track-OA Study

Background

Physical activity can improve health outcomes in people with knee osteoarthritis (OA); however, participation in physical activity is very low in this population.

Objective

The objective of our study was to assess the feasibility and preliminary efficacy of the use of wearables (Fitbit Flex) and telephone counselling by a physical therapist (PT) for improving physical activity in people with a physician-confirmed diagnosis of knee OA, or who have passed 2 validated criteria for early OA.

Methods

We conducted a community-based feasibility randomized controlled trial. The immediate group (n=17) received a brief education session by a physical therapist, a Fitbit Flex activity tracker, and a weekly telephone call for activity counselling with the physical therapist. The delayed group (n=17) received the same intervention 1 month later. All participants were assessed at baseline (T0), and the end of 1 month (T1) and 2 months (T2). Outcomes were (1) mean moderate to vigorous physical activity time, (2) mean time spent on sedentary behavior, (3) Knee Injury and Osteoarthritis Outcome Score (KOOS), and (4) Partners in Health Scale. Feasibility data were summarized with descriptive statistics. We used analysis of covariance to evaluate the effect of the group type on the outcome measures at T1 and T2, after adjusting for blocking and T0. We assessed planned contrasts of changes in outcome measures over measurement periods.

Results

We identified 46 eligible individuals; of those, 34 (74%) enrolled and no one dropped out. All but 1 participant adhered to the intervention protocol. We found a significant effect, with the immediate intervention group having improved in the moderate to vigorous physical activity time and in the Partners in Health Scale at T0 to T1 compared with the delayed intervention group. The planned contrast of the immediate intervention group at T0 to T1 versus the delayed group at T1 to T2 showed a significant effect in the sedentary time and the KOOS symptoms subscale, favoring the delayed group.

Conclusions

This study demonstrated the feasibility of a behavioral intervention, supported by the use of a wearable device, to promote physical activity among people with knee OA.

Trial Registration

ClinicalTrials.gov NCT02313506; https://clinicaltrials.gov/ct2/show/NCT02313506 (Archived by WebCite at http://www.webcitation.org/6r4P3Bub0)

Physical working conditions as covered in European monitoring questionnaires

Background

The prevalence of workers with demanding physical working conditions in the European work force remains high, and occupational physical exposures are considered important risk factors for musculoskeletal disorders (MSD), a major burden for both workers and society. Exposures to physical workloads are therefore part of the European nationwide surveys to monitor working conditions and health. An interesting question is to what extent the same domains, dimensions and items referring to the physical workloads are covered in the surveys. The purpose of this paper is to determine 1) which domains and dimensions of the physical workloads are monitored in surveys at the national level and the EU level and 2) the degree of European consensus among these surveys regarding coverage of individual domains and dimensions.

Method

Items on physical workloads used in one European wide/Spanish and five other European nationwide work environment surveys were classified into the domains and dimensions they cover, using a taxonomy agreed upon among all participating partners.

Results

The taxonomy reveals that there is a modest overlap between the domains covered in the surveys, but when considering dimensions, the results indicate a lower agreement. The phrasing of items and answering categories differs between the surveys. Among the domains, the three domains covered by all surveys are “lifting, holding & carrying of loads/pushing & pulling of loads”, “awkward body postures” and “vibrations”. The three domains covered less well, that is only by three surveys or less, are “physical work effort”, “working sitting”, and “mixed exposure”.

Conclusions

This is the fırst thorough overview to evaluate the coverage of domains and dimensions of self-reported physical workloads in a selection of European nationwide surveys. We hope the overview will provide input to the revisions and updates of the individual countries’ surveys in order to enhance coverage of relevant domains and dimensions in all surveys and to increase the informational value of the surveys.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4465-7) contains supplementary material, which is available to authorized users.

Screen Time, Other Sedentary Behaviours, and Obesity Risk in Adults: A Review of Reviews

PURPOSE OF REVIEW

The aim of this paper is to assess the association between sedentary behaviours, including screen time, and risk of obesity in adults. A review of 10 systematic reviews was undertaken.

RECENT FINDINGS

Available evidence is generally not supportive of associations between sedentary behaviour and obesity in adults. Most studies that found significant associations indicated mostly small effect sizes. Somewhat more consistent associations were shown for screen time (mainly TV viewing), among older adults, and for pre-adult sedentary behaviour to increase the risk of obesity in adulthood. Some evidence also exists for breaks in sedentary time to be associated with a more favourable BMI, and for use of a car to be associated with greater risk of obesity. There is limited evidence for an association between sedentary behaviour in adulthood and obesity and any association that exists does not seem to be causal. Future research is required investigating potentially positive effects for frequent breaks from sitting, less car use, and an uncoupling of TV viewing and dietary intake.

Work-related correlates of occupational sitting in a diverse sample of employees in Midwest metropolitan cities

The worksite serves as an ideal setting to reduce sedentary time. Yet little research has focused on occupational sitting, and few have considered factors beyond the personal or socio-demographic level. The current study i) examined variation in occupational sitting across different occupations, ii) explored whether worksite level factors (e.g., employer size, worksite supports and policies) may be associated with occupational sitting. Between 2012 and 2013, participants residing in four Missouri metropolitan areas were interviewed via telephone and provided information on socio-demographic characteristics, schedule flexibility, occupation, work related factors, and worksite supports and policies. Occupational sitting was self-reported (daily minutes spent sitting at work), and dichotomized. Occupation-stratified analyses were conducted to identify correlates of occupational sitting using multiple logistic regressions. A total of 1668 participants provided completed data. Those employed in business and office/administrative support spent more daily occupational sitting time (median 330 min) compared to service and blue collar employees (median 30 min). Few worksite supports and policies were sitting specific, yet factors such as having a full-time job, larger employer size, schedule flexibility, and stair prompt signage were associated with occupational sitting. For example, larger employer size was associated with higher occupational sitting in health care, education/professional, and service occupations. Work-related factors, worksite supports and policies are associated with occupational sitting. The pattern of association varies among different occupation groups. This exploratory work adds to the body of research on worksite level correlates of occupational sitting. This may provide information on priority venues for targeting highly sedentary occupation groups.

Break in Sedentary Behavior Reduces the Risk of Noncommunicable Diseases and Cardiometabolic Risk Factors among Workers in a Petroleum Company

Although prolonged sitting appears as a novel risk factor related to health outcomes for all ages, its association needs to be replicated in occupational conditions. This study explored the associations between sedentary behavior and four noncommunicable diseases (NCDs) as well as two cardiometabolic risk factors (CMRFs) among workers in a petroleum company, Thailand. All workers were invited to complete the online self-report questionnaire. Sedentary behavior was measured as the amount of time sitting at work, during recreation, and while commuting. Out of 3365 workers contacted, 1133 (34%) participated. Prevalence of NCDs and CMRFs was 36% and was positively associated with sedentary behavior. After adjusting for age, BMI, and exercise, the risk of NCDs and CMRFs for sedentary office work was 40% greater compared with more active field work. Those who took a break without sitting more than twice a day and commuted by walking or cycling had less risk of NCDs and CMRFs. The total duration of sedentary behavior was 10 h/day, and two-thirds of that total was workplace sitting. This was significantly associated with NCDs and CMRFs (p < 0.001). Day-and-night rotating shiftwork was negatively associated with NCDs and CMRFs (p < 0.001). Sedentary behavior should be considered a health risk among workers. Hence, to promote a healthy lifestyle and safe workplace, organizations should encourage standing activities during break and physically active commutes, and have workers avoid prolonged sitting.

Uprising: An examination of sit-stand workstations, mental health and work ability in sedentary office workers, in Western Australia

BACKGROUND

Office-based staff spend around three quarters of their work day sitting. People who sit for long periods while at work are at greater risk of adverse health outcomes.

OBJECTIVE

The pilot study aimed to determine the effect of sit-stand workstations on office-based staff sedentary and physical activity behaviors, work ability and self-reported physical and mental health outcomes.

METHODS

A two-group pre-post study design assessed changes in sedentary and physical activity behaviors (time spent sitting, standing and stepping and sit-stand transitions and number of steps taken) work ability and physical and mental health. Physical activity behaviors were measured using activPAL activity monitors and self-reported data on work ability and physical and mental health were collected using an online questionnaire.

RESULTS

Relative to the controls (n=19), the intervention group (n=18) significantly decreased time spent sitting by 100 minutes (p<0.001) and increased standing time by 99 minutes (p<0.001). There was a decrease in self-reported current work ability when compared to lifetime best (p=0.008). There were no significant differences for all other sedentary behavior, other workability outcomes, physical health or mental health outcomes at follow-up.

CONCLUSIONS

The Uprising Study found that sit-stand workstations are an effective strategy to reduce occupational sitting time in office-based workers over a one month period.

Does a dynamic chair increase office workers' movements? - Results from a combined laboratory and field study

PURPOSE

Dynamic chairs have the potential to facilitate movements that could counteract health problems associated with sedentary office work. This study aimed to evaluate whether a dynamic chair can increase movements during desk-based office work.

METHODS

Fifteen healthy subjects performed desk-based office work using a dynamic office chair and compared to three other conditions in a movement laboratory. In a field study, the dynamic office chair was studied during three working days using accelerometry.

RESULTS

Equivocal results showed that the dynamic chair increased upper body and chair movements as compared to the conventional chair, but lesser movements were found compared to standing. No differences were found between the conditions in the field study.

CONCLUSIONS

A dynamic chair may facilitate movements in static desk-based office tasks, but the results were not consistent for all outcome measures. Validation of measuring protocols for assessing movements during desk-based office work is warranted.

Utilizing anthropometric data to improve the usability of desk bikes, and influence of desk bikes on reading and typing performance

This study investigated the feasibility of using a desk bike in an office setting. Workstation measurements were introduced to accommodate 95% of the general U.S. population in using desk bikes. Reading and typing performances were compared at three different cycling conditions (no cycling, 10 and 25 W). Thirty healthy individuals (15 female and 15 male; Age mean: 23.1, σ: 4.19) were recruited based on 5/50/95th percentile stature. Participants were required to select preferred workstation settings and perform reading and typing tasks while pedaling. According to anthropometric measurements and variability from user preference, recommended adjustable ranges of workstation settings for the general U.S. population were derived. Repeated measures ANOVA showed that pedaling had no significant effect on reading comprehension (p > 0.05), but had significant effect on typing performance (p < 0.001). A preferred level of cycling intensity was determined (mean 17.3 W, σ: 3.69).

A qualitative review of existing national and international occupational safety and health policies relating to occupational sedentary behaviour

Prolonged sedentary time is now recognised as an emergent ergonomics issue. We aimed to review current occupational safety and health policies relevant to occupational sedentary behaviour. An electronic search for documents was conducted on websites of ergonomics and occupational safety and health organisations from 10 countries and six international/pan-European agencies. Additionally, 43 informants (nine countries) were contacted and an international conference workshop held. 119 documents (e.g. legislation, guidelines, codes of practice) were identified. Using a qualitative synthesis, it was observed that many jurisdictions had legal frameworks establishing a duty of care for employers, designers/manufacturers/suppliers and employees. While no occupational authority policies focusing specifically on sedentary behaviour were found, relevant aspects of existing policies were identified. We highlight implications for ergonomics research and practice and recommend the development of policy to specifically address occupational sedentary behaviour and support workplace initiatives to assess and control the risks of this emergent hazard.

Telephone Crisis Support Workers' Psychological Distress and Impairment

BACKGROUND

In order to respond to crises with appropriate intervention, crisis workers are required to manage their own needs as well as the needs of those they respond to.

AIMS

A systematic review of the literature was conducted to examine whether telephone crisis support workers experience elevated symptoms of psychological distress and are impaired by elevated symptoms.

METHOD

Studies were identified in April 2015 by searching three databases, conducting a gray literature search, and forward and backward citation chaining.

RESULTS

Of 113 identified studies, seven were included in the review. Results suggest that that telephone crisis support workers experience symptoms of vicarious traumatization, stress, burnout, and psychiatric disorders, and that they may not respond optimally to callers when experiencing elevated symptoms of distress. However, definitive conclusions cannot be drawn due to the paucity and methodological limitations of available data.

LIMITATIONS

While the most comprehensive search strategy possible was adopted, resource constraints meant that conference abstracts were not searched and authors were not contacted for additional unpublished information.

CONCLUSION

There is an urgent need to identify the impact of telephone crisis support workers' role on their well-being, the determinants of worker well-being in the telephone crisis support context, and the extent to which well-being impacts their performance and caller outcomes. This will help inform strategies to optimize telephone crisis support workers' well-being and their delivery of support to callers.

Who uses height-adjustable desks? - Sociodemographic, health-related, and psycho-social variables of regular users

BACKGROUND

Sit-to-stand height-adjustable desks (HAD) may promote workplace standing, as long as workers use them on a regular basis. The aim of this study was to investigate (i) how common HAD in German desk-based workers are, and how frequently HADs are used, (ii) to identify sociodemographic, health-related, and psycho-social variables of workday sitting including having a HAD, and (iii) to analyse sociodemographic, health-related, and psycho-social variables of users and non-users of HADs.

METHODS

A cross-sectional sample of 680 participants (51.9% men; 41.0 ± 13.1 years) in a desk-based occupation was interviewed by telephone about their occupational sitting and standing proportions, having and usage of a HAD, and answered questions concerning psycho-social variables of occupational sitting. The proportion of workday sitting was calculated for participants having an HAD (n = 108) and not-having an HAD (n = 573), as well as for regular users of HAD (n = 54), and irregular/non-users of HAD (n = 54). Linear regressions were conducted to calculate associations between socio-demographic, health-related, psychosocial variables and having/not having an HAD, and the proportion of workday sitting. Logistic regressions were executed to examine the association of mentioned variables and participants' usage of HADs.

RESULTS

Sixteen percent report that they have an HAD, and 50% of these report regular use of HAD. Having an HAD is not a correlate of the proportion of workday sitting. Further analysis restricted to participants having available a HAD highlights that only the 'perceived advantages of sitting less' was significantly associated with HAD use in the fully adjusted model (OR 1.75 [1.09; 2.81], p < 0.05).

CONCLUSIONS

The present findings indicate that accompanying behavioral action while providing an HAD is promising to increase the regular usage of HAD. Hence, future research needs to address the specificity of behavioral actions in order to enhance regular HAD use, and needs to give more fundamental insights into these associations.

Is sedentary behaviour unhealthy and if so, does reducing it improve this?

PURPOSE

To provide a qualitative synthesis of the available literature on the role of sedentary behavior in health.

AIMS

We sought to determine if (i) being sedentary 'causes' health problems and (ii) interventions to reduce sedentary behavior improve health status.

METHODS

PubMed and Google Scholar databases were utilized. Manuscripts published from 2001 to 2015 using specific keyword combinations (eg sedentary behavior, physical activity, sitting, intervention) were included and qualitatively reviewed.

RESULTS

Data is suggestive of an association of sedentary behavior and negative health indicators. The association between sedentary behavior and mortality is stronger. There is some limited evidence suggesting short-term health benefit to reducing sedentary behavior.

DISCUSSION

Evidence linking sedentary behavior to negative health outcomes is incomplete and often largely associational in nature thus not allowing for causal inference. In addition, interventional literature frequently fails to measure health outcomes, relying instead on the erroneous endpoint of changing sedentary behavior alone.

CONCLUSION

Taken as a whole the literature is suggestive that there may be value in reducing sedentary behavior to have modest impact on health. However, the magnitude of the benefit appears minor and must be considered before making largescale and potentially costly clinical and public health recommendations.

A 30-month worksite-based lifestyle program to promote cardiovascular health in middle-aged bank employees: Design of the TANSNIP-PESA randomized controlled trial

BACKGROUND

Cardiovascular disease (CVD) is the leading cause of death worldwide. With atherosclerosis as the underlying cause for many CVD events, prevention or reduction of subclinical atherosclerotic plaque burden (SAPB) through a healthier lifestyle may have substantial public health benefits.

OBJECTIVE

The objective was to describe the protocol of a randomized controlled trial investigating the effectiveness of a 30-month worksite-based lifestyle program aimed to promote cardiovascular health in participants having a high or a low degree of SAPB compared with standard care.

METHODS

We will conduct a randomized controlled trial including middle-aged bank employees from the Progression of Early Subclinical Atherosclerosis cohort, stratified by SAPB (high SAPB n=260, low SAPB n=590). Within each stratum, participants will be randomized 1:1 to receive a lifestyle program or standard care. The program consists of 3 elements: (a) 12 personalized lifestyle counseling sessions using Motivational Interviewing over a 30-month period, (b) a wrist-worn physical activity tracker, and (c) a sit-stand workstation. Primary outcome measure is a composite score of blood pressure, physical activity, sedentary time, body weight, diet, and smoking (ie, adapted Fuster-BEWAT score) measured at baseline and at 1-, 2-, and 3-year follow-up.

CONCLUSIONS

The study will provide insights into the effectiveness of a 30-month worksite-based lifestyle program to promote cardiovascular health compared with standard care in participants with a high or low degree of SAPB.

Sitting behaviour is not associated with incident diabetes over 13 years: the Whitehall II cohort study

BACKGROUND

Although certain types of sedentary behaviour have been linked to metabolic risk, prospective studies describing the links between sitting with incident diabetes are scarce and often do not account for baseline adiposity. We investigate the associations between context-specific sitting and incident diabetes in a cohort of mid-aged to older British civil servants.

METHODS

Using data from the Whitehall II study (n=4811), Cox proportional hazards models (adjusted for age, sex, ethnicity, employment grade, smoking, alcohol intake, fruit and vegetable consumption, self-rated health, physical functioning, walking and moderate-to-vigorous physical activity, and body mass index (BMI)) were fitted to examine associations between total sitting and context-specific sitting time (work, television (TV), non-TV leisure time sitting at home) at phase 5 (1997-1999) and fasting glucose-defined incident diabetes up to 2011.

RESULTS

Total sitting (HR of the top compared with the bottom group: 1.26; 95% CI 1.00 to 1.62; p=0.01) and TV sitting (1.33; 95% CI 1.03 to 1.88; p=0.05) showed associations with incident diabetes; once BMI was included in the model these associations were attenuated for both total sitting (1.19; 95% CI 0.92 to 1.55; p=0.22) and TV sitting (1.31; 95% CI 0.96 to 1.76; p=0.14).

CONCLUSION

We found limited evidence linking sitting and incident diabetes over 13 years in this occupational cohort of civil servants.

Self-reported sitting time and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: The Dogo Study

AIMS

No evidence exists regarding the association between sitting time and erectile dysfunction (ED) among patients with type 2 diabetes mellitus. The aim of this study was to evaluate the association between self-reported sitting time and ED among patients with type 2 diabetes mellitus.

METHODS

Study subjects were 430 male Japanese patients with type 2 diabetes mellitus (mean age, 60.5years). A self-administered questionnaire was used to collect information on the variables under study. The study subjects were asked about time spent sitting during typical 24-hour periods over the past 12months. Subjects were divided into four groups according to self-reported sitting time: 1) <5hours, 2) 5-7hours, 3) 7-9hours, and 4) ≥9hours. ED was defined as present when a subject had a Sexual Health Inventory for Men score <8. Adjustment was made for age, body mass index, duration of type 2 diabetes, current smoking, current drinking, hypertension, coronary artery disease, stroke, glycated hemoglobin, walking habit, and diabetic neuropathy.

RESULTS

The prevalence values of moderate to severe ED and severe ED were 36.1% and 49.8%. At least 9hours sitting was independently positively associated with severe ED but not moderate to severe ED; the adjusted OR was 1.84 (95% CI: 1.06-3.33). In the multivariate model, there was a statistically significant inverse exposure-response relationship between the self-reported sitting time and severe ED (p for trend=0.029).

CONCLUSIONS

Self-reported sitting time may be positively associated with ED in Japanese patients with type 2 diabetes mellitus.

Intra-individual variability in day-to-day and month-to-month measurements of physical activity and sedentary behaviour at work and in leisure-time among Danish adults

Background

Accelerometers can obtain precise measurements of movements during the day. However, the individual activity pattern varies from day-to-day and there is limited evidence on measurement days needed to obtain sufficient reliability. The aim of this study was to examine variability in accelerometer derived data on sedentary behaviour and physical activity at work and in leisure-time during week days among Danish office employees.

Methods

We included control participants (n = 135) from the Take a Stand! Intervention; a cluster randomized controlled trial conducted in 19 offices. Sitting time and physical activity were measured using an ActiGraph GT3X+ fixed on the thigh and data were processed using Acti4 software. Variability was examined for sitting time, standing time, steps and time spent in moderate-to-vigorous physical activity (MVPA) per day by multilevel mixed linear regression modelling.

Results

Results of this study showed that the number of days needed to obtain a reliability of 80% when measuring sitting time was 4.7 days for work and 5.5 days for leisure time. For physical activity at work, 4.0 days and 4.2 days were required to measure steps and MVPA, respectively. During leisure time, more monitoring time was needed to reliably estimate physical activity (6.8 days for steps and 5.8 days for MVPA).

Conclusions

The number of measurement days needed to reliably estimate activity patterns was greater for leisure time than for work time. The domain specific variability is of great importance to researchers and health promotion workers planning to use objective measures of sedentary behaviour and physical activity.

Trial registration

Clinical trials NCT01996176.

Work Site-Based Environmental Interventions to Reduce Sedentary Behavior: A Systematic Review

OBJECTIVE

The purpose of this investigation was to systematically review work site-based, environmental interventions to reduce sedentary behavior following preferred reporting items for systematic reviews and meta-analyses guidelines.

DATA SOURCE

Data were extracted from Medical Literature Analysis and Retrieval System Online, Cochrane Central Register of Controlled Trials, and Web of Science between January 2005 and December 2015.

STUDY INCLUSION AND EXCLUSION CRITERIA

Inclusion criteria were work site interventions, published in peer-reviewed journals, employing environmental modalities, targeting sedentary behavior, and using any quantitative design. Exclusion criteria were noninterventions and non-English publications.

DATA EXTRACTION

Data extracted included study design, population, intervention dosage, intervention activities, evaluation measures, and intervention effects.

DATA SYNTHESIS

Data were tabulated quantitatively and synthesized qualitatively.

RESULTS

A total of 15 articles were identified for review and 14 reported statistically significant decreases in sedentary behavior. The majority of studies employed a randomized controlled trial design (n = 7), used inclinometers to measure sedentary behavior (n = 9), recruited predominantly female samples (n = 15), and utilized sit-to-stand desks as the primary intervention modality (n = 10). The mean methodological quality score was 6.2 out of 10.

CONCLUSION

Environmental work site interventions to reduce sedentary behavior show promise because work sites often have more control over environmental factors. Limitations of this intervention stream include inconsistent measurement of sedentary behavior, absence of theoretical frameworks to guide program development, and absence of long-term evaluation. Future studies should include clear reporting of intervention strategies and explicit operationalization of theoretical constructs.

What is the metabolic and energy cost of sitting, standing and sit/stand transitions?

PURPOSE

Modern lifestyles require people to spend prolonged periods of sitting, and public health messages recommend replacing sitting with as much standing as is feasible. The metabolic/energy cost (MEC) of sitting and standing is poorly understood, and MEC associated with a transition from sitting to standing has not been reported. Thus, we carefully quantified the MEC for sitting, standing and sit/stand transitions, adjusting for age and fat-free mass (FFM) in a sample of adults with no known disease.

METHODS

Participants (N = 50; 25 women), 20–64 years, randomly performed three conditions for 10 min each (sitting, standing, 1 sit/stand transition min(−1) and then sitting back down). MEC was measured by indirect calorimetry and FFM by dual-energy X-ray absorptiometry.

RESULTS

V̇O2 (ml kg(−1) min(−1)) for sitting (2.93 ± 0.61; 2.87 ± 0.37 in men and women respectively), standing (3.16 ± 0.63; 3.03 ± 0.40), and steady-state cost of repeated sit/stand transitions (1 min(−1)) (3.86 ± 0.75; 3.79 ± 0.57) were significantly different regardless of sex and weight (p < 0.001). EE (kcal min(−1)) also differed from sitting (1.14 ± 0.18; 0.88 ± 0.11), to standing (1.23 ± 0.19; 0.92 ± 0.13), and sit/stand transitions (1 min(−1)) (1.49 ± 0.25; 1.16 ± 0.16). Heart-rate increased from sitting to standing (~13 bpm; p < 0.001). Neither sex nor FFM influenced the results (p ≥ 0.05).

CONCLUSIONS

This study found in a sample of adults with no known disease that continuous standing raised MEC 0.07 kcal min(−1) above normal sitting. The transition from sitting to standing (and return to sitting) had a metabolic cost of 0.32 kcal min(−1) above sitting. Therefore, public health messages recommending to interrupt sitting frequently should be informed of the modest energetic costs regardless of sex and body composition.

Sitting time and obesity in a sample of adults from Europe and the USA

BACKGROUND

Obesity is a risk factor for many chronic diseases and the prevalence is increasing worldwide. Research suggests that sedentary behaviour (sitting) may be related to obesity.

AIM

To examine the association between sitting time and obesity, while controlling for physical activity, in a large international sample.

SUBJECTS AND METHODS

In total, 5338 adults from the UK, USA, Germany, Spain, Italy, France, Portugal, Austria and Switzerland self-reported their total daily sitting time, physical activity, age, height and weight. BMI (kg/m²), total physical activity (MET-minutes/week) and sitting time (hours/day) were derived. Participants were grouped into quartiles based on their daily sitting time (<4, 4-≤6, 6-≤8 and >8 hours/day) and logistic regression models explored the odds of being obese vs normal weight for each sitting time quartile.

RESULTS

Participants in the highest sitting time quartile (≥8 hours/day) had 62% higher odds of obesity compared to participants in the lowest quartile (<4 hours/day) after adjustment for physical activity and other confounding variables (OR = 1.62, 95% CI = 1.24-2.12, p < .01).

CONCLUSION

Sitting time is associated with obesity in adults, independent of physical activity. Future research should clarify this association using objective measures of sitting time and physical activity to further inform health guidelines.

Associations of sitting time and occupation with metabolic syndrome in South Korean adults: a cross-sectional study

BACKGROUND

Previous evidence suggests that there is a correlation between prolonged sitting time and cardio-metabolic disease, such as metabolic syndrome (MS). Cardiovascular disease is the second-leading cause of mortality in South Korea, a country with the longest working hours among all member states of the Organization for Economic Co-operation and Development. However, no previous study has investigated the relationships of overall sitting-time and occupation with MS in South Korea. Accordingly, the present study examined these relationships in a South Korean population.

METHODS

Data from the sixth Korean National Health and Nutrition Examination Survey (KNHANES), a nationally representative survey with a cross-sectional design, were used in the present study. MS diagnoses were evaluated using the International Diabetes Foundation (IDF) criteria. Participants self-reported their overall sitting times, and occupations were classified using the Korean version of the Standard Classification of Occupations (KSCO). A multiple logistic regression analysis was conducted to evaluate the associations of sitting time and occupation with MS.

RESULTS

The risk of MS was 1.21-fold higher among participants who sat for >7 h/day than among those who sat for ≤7 h/day (odds ratio [OR]: 1.21, 95 % confidence interval [CI]: 1.00-1.46). Regarding occupation, office workers had a two-fold higher risk of MS than did agriculture, forestry, and fishery (AFF) workers (OR: 2.01, 95 % CI: 1.26-3.22). In a combined analysis of sitting time and occupation, male participants who sat for >7 h/day and reported an occupation that involves office work (OW) or machine fitting (MF) were significantly more likely to have MS when compared to those who sat for ≤7 h/day and were employed as AFF workers (>7 h/day × OW, OR: 2.41, 95 % CI: 1.05-5.51; >7 h/day × MF, OR: 2.92, 95 % CI: 1.43-5.93).

CONCLUSIONS

Excessive sitting time and a sedentary occupation correlated positively with MS in South Korean adults. Accordingly, a reduction in the overall sitting time or inclusion of energy-expending activities in the workplace might improve the rate of MS.

The Impact of Obesity in the Workplace: a Review of Contributing Factors, Consequences and Potential Solutions

This narrative review summarized findings from previous reviews and the most recently published studies, regarding the following: (1) the association between two occupational risk factors-shift work and sedentary work-and obesity, (2) the effects of obesity on workplace productivity and (3) the effectiveness of workplace interventions aimed at preventing or reducing obesity. Despite some inconsistencies in findings, there is convincing evidence that shift work increases the risk of obesity, while most studies did not show a significant association between sedentary work and obesity. Overweight and obesity were found to be associated with absenteeism, disability pension and overall work impairment, whilst evidence of their relationship with presenteeism, unemployment and early retirement was not consistent. Due to the vast heterogeneity in the types of workplace-based interventions to prevent or treat obesity, no sound conclusions can as yet be drawn about their overall effectiveness and best practice recommendations for their implementation.

Stand by Me: Qualitative Insights into the Ease of Use of Adjustable Workstations

Background

Office workers sit for more than 80% of the work day making them an important target for work site health promotion interventions to break up prolonged sitting time. Adjustable workstations are one strategy used to reduce prolonged sitting time. This study provides both an employees' and employers' perspective into the advantages, disadvantages, practicality and convenience of adjustable workstations and how movement in the office can be further supported by organisations.

Methods

This qualitative study was part of the Uprising pilot study. Employees were from the intervention arm of a two group (intervention n = 18 and control n = 18) study. Employers were the immediate line-manager of the employee. Data were collected via employee focus groups (n = 17) and employer individual interviews (n = 12). The majority of participants were female (n = 18), had healthy weight, and had a post-graduate qualification. All focus group discussions and interviews were recorded, transcribed verbatim and the data coded according to the content. Qualitative content analysis was conducted.

Results

Employee data identified four concepts: enhanced general wellbeing; workability and practicality; disadvantages of the retro-fit; and triggers to stand. Most employees (n = 12) reported enhanced general well-being, workability and practicality included less email exchange and positive interaction (n = 5), while the instability of the keyboard a commonly cited disadvantage. Triggers to stand included time and task based prompts. Employer data concepts included: general health and wellbeing; work engagement; flexibility; employee morale; and injury prevention. Over half of the employers (n = 7) emphasised back care and occupational health considerations as important, as well as increased level of staff engagement and strategies to break up prolonged periods of sitting.

Discussion

The focus groups highlight the perceived general health benefits from this short intervention, including opportunity to sit less and interact in the workplace, creating an ‘energised’ work environment. The retro-fit workstation and keyboard platform provided challenges for some participants. Supervisors emphasised injury prevention and employee morale as two important by products of the adjustable workstation. These were not mentioned by employees. They called for champions to advocate for strategies to break up prolonged sitting.

Implications

The findings of this novel research from both the employee and employer perspective may support installation of adjustable workstations as one component of a comprehensive approach to improve the long term health of employees.

Increasing Nonsedentary Behaviors in University Students Using Text Messages: Randomized Controlled Trial

BACKGROUND

Sedentary behavior (SB) has been linked to many health problems such as type 2 diabetes and heart disease. Increasing the length and frequency of breaks from sitting and increasing the time spent standing and engaged in light and moderate physical activity are ways to decrease SB. Text message-based interventions have succeeded in aiding smoking cessation and increase both physical activity and healthy eating, but they have not been shown to reduce SB.

OBJECTIVE

The primary purpose of this pilot study was to determine the effectiveness of a text message-based intervention in increasing nonsedentary behaviors in university students. A secondary purpose was to (1) determine whether the intervention could enhance self-efficacy beliefs for decreasing SB and (2) whether these efficacious beliefs could predict actual SB.

METHODS

Eighty-two university students were recruited via mass emails and randomized into intervention (SB-related text messages) or control (text messages unrelated to SB) groups. Participants received daily text messages scheduled by the researcher encouraging breaks from sitting, standing, light- and moderate-intensity physical activity (PA). They then reported various SBs via Web-based questionnaires at four time points (baseline, 2, 4, and 6 weeks). Self-efficacious beliefs toward taking breaks from sitting and decreasing the amount of time spent sitting were assessed at the same time points.

RESULTS

Last observation carried forward (LOCF) method was used for incomplete data as an intent-to-treat (ITT) analysis (intervention group n=15, control group n=11). Small-to-moderate effects favoring the text intervention group were found at 6 weeks for break frequency -14.64 minutes, break length +.59 minutes, standing +24.30 min/day, light-intensity +74.34 min/day, and moderate-intensity + 9.97 min/day PA. Only light-intensity PA approached significance (P=.07). Self-efficacy beliefs also favored the text intervention group and reached significance (P=.032) for sitting less. Significant (P<.05) relations were found between the self-efficacy constructs and breaks, standing, and light or moderate PA.

CONCLUSIONS

Text messages have the potential to increase nonsedentary behaviors in university students. These messages can increase self-efficacy beliefs to take more breaks and reduce sitting time. Efficacious beliefs can predict actual SB and to a lesser extent light- and moderate-intensity PA.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02562937; https://clinicaltrials.gov/ct2/show/NCT02562937 (Archived by WebCite at http://www.webcitation.org/6jVLwXE5M).

Sedentary work and the risk of breast cancer in premenopausal and postmenopausal women: a pooled analysis of two case-control studies

OBJECTIVES

There is limited research on the association between sedentary behaviour and breast cancer risk, particularly whether sedentary behaviour is differentially associated with premenopausal and postmenopausal breast cancer. We pooled data from 2 case-control studies from Australia and Canada to investigate this association.

METHODS

This pooled analysis included 1762 incident breast cancer cases and 2532 controls. Participants in both studies completed a lifetime occupational history and self-rated occupational physical activity level. A job-exposure matrix (JEM) was also applied to job titles to assess sedentary work. Logistic regression analyses (6 pooled and 12 study-specific) were conducted to estimate associations between both self-reported and JEM-assessed sedentary work and breast cancer risk among premenopausal and postmenopausal women.

RESULTS

No association was observed in the 6 pooled analyses, and 10 of the study-specific analyses also showed null results. 2 study-specific analyses provided inconsistent and contradictory results, with 1 showing statistically significant increased risk of breast cancer for self-reported sedentary work among premenopausal women cancer in the Canadian study, and the other a non-significant inverse association between JEM-assessed sedentary work and breast cancer risk among postmenopausal women in the Australian study.

CONCLUSIONS

While a suggestion of increased risk was seen for premenopausal women in the Canadian study when using the self-reported measure, overall this pooled study does not provide evidence that sedentary work is associated with breast cancer risk.

Sedentary Behavior and Cardiovascular Morbidity and Mortality: A Science Advisory From the American Heart Association

Epidemiological evidence is accumulating that indicates greater time spent in sedentary behavior is associated with all-cause and cardiovascular morbidity and mortality in adults such that some countries have disseminated broad guidelines that recommend minimizing sedentary behaviors. Research examining the possible deleterious consequences of excess sedentary behavior is rapidly evolving, with the epidemiology-based literature ahead of potential biological mechanisms that might explain the observed associations. This American Heart Association science advisory reviews the current evidence on sedentary behavior in terms of assessment methods, population prevalence, determinants, associations with cardiovascular disease incidence and mortality, potential underlying mechanisms, and interventions. Recommendations for future research on this emerging cardiovascular health topic are included. Further evidence is required to better inform public health interventions and future quantitative guidelines on sedentary behavior and cardiovascular health outcomes.

Time kinetics of physical activity, sitting, and quality of life measures within a regional workplace: a cross-sectional analysis

Background

Interventions to increase physical activity and reduce sedentary behaviours within the workplace have been previously investigated. However, the evolution of these constructs without intervention has not been well documented. This retrospective study explored the natural progression or time kinetics of physical activity, sedentary behaviours and quality of life in a professional skilled workplace where focussed interventions were lacking.

Methods

Participants (n = 346) employed as full-time staff members at a regional university completed an online survey in 2013 assessing physical activity and sedentary behaviours via the International Physical Activity Questionnaire, and quality of life via the Short-Form 36v2 questionnaire. Differences between that cohort of participants and an initial sample of similar participants (2009, n = 297), accounting for gender and staff categories (academic vs. professional), were examined using ANCOVAs with working hours as a co-variate.

Results

In comparison to the initial cohort, the follow-up cohort reported significantly less leisure-time, total walking, total vigorous and total physical activity levels, and lower overall physical health for quality of life (p < 0.05). In contrast, the follow-up cohort reported a significantly greater weekly sitting time, greater mental health scores for quality of life and greater total moderate physical activity levels (p < 0.05) compared to the initial cohort.

Conclusions

Over a 4-year timeframe and without focussed workplace interventions, total physical activity levels were lower with sedentary behaviours greater at a rate twice that reported previously. Continuation of these undesirable health behaviours may impact negatively on worker productivity and health at a greater rate than that currently reported. Workplace interventions targeting sedentary behaviours and physical activity should be actively incorporated into organisations to counteract the alarming behavioural trends found in this study to maintain and/or enhance employee health and productivity.

Where to Sit? Type of Sitting Matters for the Framingham Cardiovascular Risk Score

Background

Current evidence on associations of type-specific sedentary behavior with cardiovascular disease (CVD) is limited to mainly screen-time sedentary behavior (SB). We aimed to study the associations of type-specific and total time spent sitting with the Framingham 10-year cardiovascular disease risk score (Framingham score) in Finnish adults.

Methods

Data comprise the National FINRISK 2007 and 2012 health examination surveys with 10,185 participants aged 25–74 years, apparently free of CVD. Participants reported average daily time spent sitting in different locations: work-related sitting, at home in front of television (TV), at home in front of computer, in a vehicle, and elsewhere. Total SB time was calculated from these context-specific self-reports. Accelerometer-based sedentary time was assessed in 988 FINRISK 2012 participants. Framingham score was calculated using information on blood pressure and its medication, cholesterol levels, age, diabetes status, and smoking. Analyses were adjusted for age, study year, education, employment status, leisure time physical activity, and body mass index.

Results

Out of several type-specific sitting behaviors, only TV sitting showed systematic associations with the Framingham score in both genders. The lowest Framingham risk was found for TV sitting from 6 minutes to less than 1 hour daily. Of other types of sitting, computer sitting was inversely associated with the Framingham risk in men only. Total self-reported sitting time did not show significant associations with the Framingham score, but instead higher objectively assessed sedentary time showed higher Framingham risk in men.

Conclusions

TV sitting showed most systematic associations with CVD risk score. This suggests that of all types of SB, reducing TV sitting should be targeted for reducing CVD risk.