Occupational sitting and health risks: a systematic review

A year-long case study of multicomponent interventions to promote physical activity in office workers: A randomized control trial

The purpose of this study was to identify if workplace interventions, (i.e., mindfulness classes and monetary incentives for gym attendance), influenced workers' physical activity. Office-based participants were randomized into one of four intervention assignments: 1) CONTROL (no interventions) (n = 40), 2) MINDFULNESS (n = 33), 3) GYM INCENTIVE (n = 41), or 4) BOTH mindfulness and gym incentive (n = 31). Activity-tracker and self-reported metabolic expenditure and step counts were gathered between January 2020 and December 2020 whereas the eight-week long interventions were provided between January and March 2020, when the impact of COVID-19 pandemic started. While physical activity decreased during the follow-up months, percent changes of physical activity at 1-, 2-, and 9-month follow-ups compared to baseline show no significant differences between or across the four intervention assignments (p > 0.05). These results suggest that the intervention assignments had no effect on physical activity from baseline. The lack of effectiveness of these interventions on participant physical activity could be attributed to the influence of the COVID-19 pandemic, and any effects of the interventions could not outweigh the effects of the pandemic.

Impact of Sedentary Behaviors on Blood Pressure and Cardiovascular Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses

BACKGROUND

Cardiovascular diseases (CVD) are among the leading causes of mortality in the western world, and high blood pressure is among the greatest risk factors for CVD. Given that most of a person's waking hours are spent in sedentary behaviors, understanding the cardiovascular impact of a sedentary lifestyle is imperative. Although limiting sedentary time is encouraged in public health messaging, individual reviews analyzing its impact on clinically relevant cardiovascular outcomes such as blood pressure and CVD exhibit conflicting results.

OBJECTIVE

We conducted an umbrella review of systematic reviews and meta-analyses synthesizing the effects of sedentary time/behaviors on blood pressure or CVD.

METHODS

To be included, studies had to be a systematic review and/or meta-analysis that studied the impact of sedentary time or a sedentary posture on blood pressure or CVD incidence/mortality. The review was preregistered in PROSPERO (CRD4202342568) and conducted in May 2023. The Joanna Briggs Institute and Risk of Bias in Systematic Reviews tools assessed study quality. PRISMA reporting was followed.

RESULTS

Our umbrella review screened 2215 citations with 40 review studies meeting our inclusion criteria (n = 22 meta-analyses) that included 234 unique individual studies of 3,769,755 unique participants. The average study quality was high (9.2 ± 1.7 out of 11). A minority of studies (n = 7/20) supported that less sedentary time was associated with lower blood pressure, with reviews of interventional studies typically not observing a consistent effect (n = 9/12), whereas reviews of cross-sectional studies observed a positive effect (n = 5/7). When hypertension rates were used as the outcome, most (n = 3/4) studies observed a deleterious impact of sedentary time. For CVD incidence/mortality, less sedentary time or screen time was consistently associated with a lower CVD incidence/mortality (n = 17/23), with studies exhibiting a null effect generally including small sample sizes and being of a lower study quality. Total sedentary time and specific behaviors (i.e., television and screen time) exhibited similar findings.

CONCLUSIONS

Based on a high quality of evidence and large sample size, existing systematic reviews and meta-analyses demonstrate the negative impact of sedentary behaviors on CVD incidence/mortality, with conflicting reports for blood pressure that vary based on the study design.

Boosting arousal and cognitive performance through alternating posture: Insights from a multi-method laboratory study

This study investigated the role of arousal and effort costs in the cognitive benefits of alternating between sitting and standing postures using a sit-stand desk, while measuring executive functions, self-reports, physiology, and neural activity in a 2-h laboratory session aimed to induce mental fatigue. Two sessions were conducted with a one-week gap, during which participants alternated between sitting and standing postures each 20-min block in one session and remained seated in the other. In each block, inhibition, switching, and updating were assessed. We examined effects of time-on-task, acute (local) effects of standing versus sitting posture, and cumulative (global) effects of a standing posture that generalize to the subsequent block in which participants sit. Results (N = 43) confirmed that time-on-task increased mental fatigue and decreased arousal. Standing (versus sitting) led to acute increases in arousal levels, including self-reports, alpha oscillations, and cardiac responses. Standing also decreased physiological and perceived effort costs. Standing enhanced processing speed in the flanker task, attributable to shortened nondecision time and speeded evidence accumulation processes. No significant effects were observed on higher-level executive functions. Alternating postures also increased heart rate variability cumulatively over time. Exploratory mediation analyses indicated that the positive impact of acute posture on enhanced drift rate was mediated by self-reported arousal, whereas decreased nondecision time was mediated by reductions in alpha power. In conclusion, alternating between sitting and standing postures can enhance arousal, decrease effort costs, and improve specific cognitive and physiological outcomes.

Leisure-Time Physical Activity, Time Spent Sitting and Risk of Non-alcoholic Fatty Liver Disease: A Cross-Sectional Study in Puglia

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world. The increasingly sedentary lifestyle in recent years may have accelerated the development of NAFLD, independent of the level of physical activity.

OBJECTIVE

The purpose of this cross-sectional study was to determine the association between leisure-time physical activity (LTPA) and time spent sitting (TSS) and the likelihood of developing NAFLD in a sample of men and women aged 18-64 years, from southern Italy.

DESIGN

The study is based on two cohort studies, a randomized clinical trial and an observational cost-benefit study.

PARTICIPANTS

A total of 1269 participants (51.5% women) drawn from 3992 eligible subjects were enrolled in this study.

EXPOSURES

Leisure-time physical activity (LTPA) and time spent sitting (TSS) were assessed using the Italian long form of the International Physical Activity Questionnaire (IPAQ-LF), designed for administration to adults aged 18 to 65 years.

MAIN MEASURES

The association of exposures with the probability of belonging to a certain NAFLD degree of severity.

KEY RESULTS

The probability of having mild, moderate, and severe NAFLD tends to decrease with increasing LTPA and decreasing TSS levels. We selected a combination of participants aged 50 years and older stratified by gender. Men had a statistically significant difference in the probability of developing moderate NAFLD if they spent 70 h per week sitting and had low LTPA, while among women there was a statistically significant difference in the probability of developing mild or moderate NAFLD if they had moderate LPTA and spent 35-70 h/week sitting.

CONCLUSIONS

The study thus showed that the amount of LTPA and the amount of TSS are associated with development and progression of NAFLD, but this relationship is not a linear one-especially in women aged ≥ 50 years old.

Venous disorders as an occupational disease - a systematic review on epidemiology, pathophysiology, and modification strategies

Forced postures are common in the workplace. Work in the primary economic sector is characterised by a high degree of physical activity and movement; however, activities in the secondary and tertiary sectors commonly require workers to stand or sit. An expansion of the tertiary sector in recent decades has meant that people in industrialised and emerging economies primarily sit or stand at work. The aim of the systematic review was to identify occupational factors relating to the presence of chronic venous disease (CVD), to place these in the context of developments in the workplace, and to determine whether measures are in place to prevent CVD. We performed a systematic literature review to analyse studies assessing work-related risk factors for CVD. We searched for publications in the PubMed database, the clinic library of BG Hospital Bergmannstrost Halle, and the registry of the German Statutory Accident Insurance. Using occupation-specific keyword combinations, we identified 27,522 publications. The publications underwent an automatic and manual filtering process according to the PRISMA guidelines and 81 publications qualified for the review. Ultimately 25 studies were included in the systematic review. All of the subjects of the studies worked in the secondary and tertiary sectors. No studies looked at the relationship between venous disorders and primary sector occupations. Standing at work for more than four hours a day, repeated heavy lifting, and cumulative time working in a sitting or standing position are risk factors for the development of CVD. Sitting is less of a risk factor than standing or walking. Occupational history and the patient's activity profile are important diagnostic tools which can help confirm a diagnosis and justify treatment when findings are inconsistent. Compression therapy is the primary form of secondary and tertiary prevention. There continues to be a lack of primary preventive measures related to workplace design.

The effectiveness of a 6-month intervention with sit-stand workstation in office workers: Results from the SUFHA cluster randomized controlled trial

BACKGROUND

Prolonged periods of sitting have been linked to negative health outcomes. Implementation of sit-stand desks in the workplace has been one strategy to reduce prolonged sitting.

OBJECTIVE

To assess the effectiveness of sit-stand workstations on reducing sitting time and improving other health outcomes of office-based workers.

METHODS

39 Portuguese office workers were randomized into a 6-month parallel-group cluster RCT consisting by the implementation of sit-stand desks in the workplace. The primary outcome of sitting time was assessed using ActivPAL. Secondary outcomes included biometric, psychological, and diet-related variables. All outcomes were assessed at baseline and 6 months for the whole sample and at 3 months for a sub-sample of the intervention group (n = 11).

RESULTS

No significant time*group interaction was found for the primary or secondary outcomes, apart from waist circumference favoring the control group (Δ-1.81 cm, pinteraction = 0.04). There were significant changes within the intervention group for sitting time (-44.0 min/day), prolonged sitting (>30 min) (-45.3 min/day) and standing time (51.7 min/day) at 3 months in the sub-sample and in prolonged sitting (>30 min) (-26 min/day) in the full intervention group (p < 0.05). Changes were also observed within the intervention group for percent body fat (Δ-3.7%) and ratings of quality of life (Δ2.2), musculoskeletal discomfort (Δ-4.9), overall fatigue (Δ-2.2), and the need for recovery after work (Δ-1.7) at 6-month follow-up (p < 0.05).

CONCLUSION

Although not being effective for reducing sitting time, the implementation of sit-stand desks in the Portuguese workspace was shown to be feasible over the long term, received well by users, and may offer other health benefits.

TRIAL REGISTRATION

OSF Registration, OSF.IO/JHGPW. Registered 15 November 2022. https://doi.org/10.17605/OSF.IO/JHGPW.

Sedentary time at school and work in Canada

OBJECTIVES

High levels of sedentary time (ST) are associated with poor physical and mental health. Given that Canadians spend a large portion of their days at school and work, they may be important targets for reducing ST. Our objectives are to estimate the daily amount of school and work ST among Canadians, examine differences by subgroups, and determine associations with health.

METHODS

Using the 2020 Canadian Community Health Survey Healthy Living Rapid Response module (N = 5242), the amount of time spent sitting while at school and work was estimated among youth (12-17 years) and adults (18-34 and 35-64 years). Differences by sociodemographics and 24-Hour Movement Guideline adherence were assessed with independent t-tests. Associations between school and work ST and health indicators were assessed using adjusted logistic regression.

RESULTS

Canadian youth aged 12-17 years and adults aged 18-34 years reported an average of 4.5 and 5.2 h/day of school ST, respectively. Adults 18-34 years and 35-64 years reported an average of 3.9 and 4.0 h/day of work ST, respectively. School and work ST differed within several subgroups. Among adults 18-34 years, higher school ST was associated with a reduced odds of 'excellent/very good' mental health, whereas higher work ST was associated with a greater likelihood of reporting 'excellent/very good' general health.

CONCLUSION

Canadian youth and working-age adults report an average of 4-5 h/day sedentary at school or work. This is the first study estimating school and work ST in a representative sample of Canadians and will aid in increasing awareness of setting-specific behaviours to better inform targeted interventions including addressing inequalities in ST.

Combining diaries and accelerometers to explain change in physical activity during a lifestyle intervention for adults with pre-diabetes: A PREVIEW sub-study

Self-report and device-based measures of physical activity (PA) both have unique strengths and limitations; combining these measures should provide complementary and comprehensive insights to PA behaviours. Therefore, we aim to 1) identify PA clusters and clusters of change in PA based on self-reported daily activities and 2) assess differences in device-based PA between clusters in a lifestyle intervention, the PREVIEW diabetes prevention study. In total, 232 participants with overweight and prediabetes (147 women; 55.9 ± 9.5yrs; BMI ≥25 kg·m-2; impaired fasting glucose and/or impaired glucose tolerance) were clustered using a partitioning around medoids algorithm based on self-reported daily activities before a lifestyle intervention and their changes after 6 and 12 months. Device-assessed PA levels (PAL), sedentary time (SED), light PA (LPA), and moderate-to-vigorous PA (MVPA) were assessed using ActiSleep+ accelerometers and compared between clusters using (multivariate) analyses of covariance. At baseline, the self-reported "walking and housework" cluster had significantly higher PAL, MVPA and LPA, and less SED than the "inactive" cluster. LPA was higher only among the "cycling" cluster. There was no difference in the device-based measures between the "social-sports" and "inactive" clusters. Looking at the changes after 6 months, the "increased walking" cluster showed the greatest increase in PAL while the "increased cycling" cluster accumulated the highest amount of LPA. The "increased housework" and "increased supervised sports" reported least favourable changes in device-based PA. After 12 months, there was only minor change in activities between the "increased walking and cycling", "no change" and "increased supervised sports" clusters, with no significant differences in device-based measures. Combining self-report and device-based measures provides better insights into the behaviours that change during an intervention. Walking and cycling may be suitable activities to increase PA in adults with prediabetes.

Facilitators and barriers to using a DeskCycle as a sedentary behavior intervention in the work environment

BACKGROUND

Sedentary behavior is a public health threat with extensive health burden on society. High levels of sedentary behavior have been associated with cardiovascular diseases, diabetes, obesity, and cancer. Individuals working in desk-related occupations are more likely to be sedentary for most of the day. Health researchers have responded by implementing and promoting interventions and wellness programs in work environments to reduce this behavior. This study examined the feasibility and experience of using the DeskCycle to reduce sedentary behavior among female workers in an academic office environment.

METHODS

This was an intervention study where participants used the DeskCycle in two consecutive eight-week phases and uploaded DeskCycle use data daily. A questionnaire was administered after week 2 and week 8 (pre-post) of DeskCycle use in each phase to assess dimensions of feasibility, including an open-ended question for user experience.

RESULTS

The participants (N = 78) had an average age of 44.4 (±11.3) years and were primarily non-Hispanic White (88.5%). DeskCycle daily use varied from Phase I: 84% to 64.9% (weeks 1-7), and 49.4% in week 8, to Phase II: 73.5% to 52.2% (week 1-7), and 40.2% in week 8. In Phase I, 96.6% (week 2) and 87% (week 8) agreed that the DeskCycle decreased sedentary behavior, and in Phase II, 74.3% (week 2) and 76.9% (week 8) agreed. The analysis of open-ended responses found challenges with the desk set up, cycling interfering with typing, and thinking critically, as barriers to DeskCycle use, while enjoying cycling and cycling improving mood were reported as facilitators.

CONCLUSIONS

Using a DeskCycle in an academic office environment to reduce sedentary behavior is feasible in female office workers. Consideration should be given to the type of tasks performed while cycling.

The association between sedentary behavior and obstructive sleep apnea: a cross-sectional study from the NHANES (2007-2008 to 2015-2020)

BACKGROUND

Sedentary behavior (SB) may contribute to obesity and lower extremity fluid retention, which may favor the development of obstructive sleep apnea (OSA). However, linking sedentary behavior to OSA is unclear. The purpose of this study was to determine if there is an association between SB and OSA.

METHODS

Three typical questions in the NHANES questionnaire(①The frequency of feeling excessively sleepy per month. ②The frequency of gasping, snorting or stopping breathing per week. ③The frequency of snoring per week.) have been used for the assessment of OSA. A physical activity questionnaire(On a typical day, the amount of time you spend sitting or reclining.) was used to assess SB. This secondary analysis included National Health and Nutrition Examination Survey (NHANES) participants (unweighted = 20,115). Weighted sample and multiple logistic regression complex sample analysis techniques were used in this study.

RESULTS

After adjustment for confounders, participants with SB(> 8 h/d) had a higher risk of OSA compared to SB(< 4 h/d). Stratified analysis by gender showed that there was no significant association of SB and OSA in men. However, in women, with SB(< 4 h/d) as the reference, participants with(≥ 4 h/d) had an increased risk of OSA. By age-stratified analysis, the association of SB with OSA was stronger among older participants.

CONCLUSION

Analysis in this study showed a positive association between SB and OSA, more pronounced in women and participants older than 60 years old.

Causal association of leisure sedentary behavior and cervical spondylosis, sciatica, intervertebral disk disorders, and low back pain: a Mendelian randomization study

Background

Some studies suggest sedentary behavior is a risk factor for musculoskeletal disorders. This study aimed to investigate the potential causal association between leisure sedentary behavior (LSB) (including television (TV) viewing, computer use, and driving) and the incidence of sciatica, intervertebral disk degeneration (IVDD), low back pain (LBP), and cervical spondylosis (CS).

Methods

We obtained the data of LSB, CS, IVDD, LBP, sciatica and proposed mediators from the gene-wide association studies (GWAS). The causal effects were examined by Inverse Variance Weighted (IVW) test, MR-Egger, weighted median, weighted mode and simple mode. And sensitivity analysis was performed using MR-Pleiotropy Residual Sum and Outlier (MR-PRESSO) and MR-Egger intercept test. Multivariable MR (MVMR) was conducted to investigate the independent factor of other LSB; while two-step MR analysis was used to explore the potential mediators including Body mass index (BMI), smoking initiation, type 2 diabetes mellitus (T2DM), major depressive disorder (MDD), schizophrenia, bipolar disorder between the causal association of LSB and these diseases based on previous studies.

Results

Genetically associated TV viewing was positively associated with the risk of CS (OR = 1.61, 95%CI = 1.25 to 2.07, p = 0.002), IVDD (OR = 2.10, 95%CI = 1.77 to 2.48, p = 3.79 × 10-18), LBP (OR = 1.84, 95%CI = 1.53 to 2.21, p = 1.04 × 10-10) and sciatica (OR = 1.82, 95% CI = 1.45 to 2.27, p = 1.42 × 10-7). While computer use was associated with a reduced risk of IVDD (OR = 0.66, 95%CI = 0.55 to 0.79, p = 8.06 × 10-6), LBP (OR = 0.49, 95%CI = 0.40 to 0.59, p = 2.68 × 10-13) and sciatica (OR = 0.58, 95%CI = 0.46 to 0.75, p = 1.98 × 10-5). Sensitivity analysis validated the robustness of MR outcomes. MVMR analysis showed that the causal effect of TV viewing on IVDD (OR = 1.59, 95%CI = 1.13 to 2.25, p = 0.008), LBP (OR = 2.15, 95%CI = 1.50 to 3.08, p = 3.38 × 10-5), and sciatica (OR = 1.61, 95%CI = 1.03 to 2.52, p = 0.037) was independent of other LSB. Furthermore, two-step MR analysis indicated that BMI, smoking initiation, T2DM may mediate the causal effect of TV viewing on these diseases.

Conclusion

This study provides empirical evidence supporting a positive causal association between TV viewing and sciatica, IVDD and LBP, which were potentially mediated by BMI, smoking initiation and T2DM.

Occupational Sitting Time, Leisure Physical Activity, and All-Cause and Cardiovascular Disease Mortality

Importance

For the first time, the 2020 World Health Organization guidelines on physical activity recommended reducing sedentary behaviors owing to their health consequences. Less is known on the specific association of prolonged occupational sitting with health, especially in the context of low physical activity engagement.

Objective

To quantify health risks associated with prolonged occupational sitting and to determine whether there is a certain threshold of physical activity that may attenuate it.

Design, Setting, and Participants

This prospective cohort study included participants in a health surveillance program in Taiwan who were followed-up between 1996 and 2017. Data on occupational sitting, leisure-time physical activity (LTPA) habits, lifestyle, and metabolic parameters were collected. Data analysis was performed in December 2020.

Main Outcomes and Measures

The all-cause and cardiovascular disease (CVD) mortality associated with 3 occupational sitting volumes (mostly sitting, alternating sitting and nonsitting, and mostly nonsitting) were analyzed applying multivariable Cox regression models to calculate the hazard ratios (HRs) for all participants and by subgroups, including 5 LTPA levels and a personal activity intelligence (PAI)-oriented metric. Deaths occurring within the initial 2 years of follow-up were excluded to prevent reverse causality.

Results

The total cohort included 481 688 participants (mean [SD] age, 39.3 [12.8] years; 256 077 women [53.2%]). The study recorded 26 257 deaths during a mean (SD) follow-up period of 12.85 (5.67) years. After adjusting for sex, age, education, smoking, drinking, and body mass index, individuals who mostly sat at work had a 16% higher all-cause mortality risk (HR, 1.16; 95% CI, 1.11-1.20) and a 34% increased mortality risk from CVD (HR, 1.34; 95% CI, 1.22-1.46) compared with those who were mostly nonsitting at work. Individuals alternating sitting and nonsitting at work did not experience increased risk of all-cause mortality compared with individuals mostly nonsitting at work (HR, 1.01; 95% CI, 0.97-1.05). For individuals mostly sitting at work and engaging in low (15-29 minutes per day) or no (<15 minutes per day) LTPA, an increase in LTPA by 15 and 30 minutes per day, respectively, was associated with a reduction in mortality to a level similar to that of inactive individuals who mostly do not sit at work. In addition, individuals with a PAI score exceeding 100 experienced a notable reduction in the elevated mortality risk associated with prolonged occupational sitting.

Conclusions and Relevance

As part of modern lifestyles, prolonged occupational sitting is considered normal and has not received due attention, even though its deleterious effect on health outcomes has been demonstrated. In this study, alternating between sitting and nonsitting at work, as well as an extra 15 to 30 minutes per day of LTPA or achieving a PAI score greater than 100, attenuated the harms of prolonged occupational sitting. Emphasizing the associated harms and suggesting workplace system changes may help society to denormalize this common behavior, similar to the process of denormalizing smoking.

Internal but Not External Building Design Associated With More Occupational Physical Activity

BACKGROUND

Few studies have explored the impact of internal building design features on physical activity. The purpose of this study is to determine building design features associate with physical activity and sedentary behaviors.

METHODS

Full-time workers (n = 114) wore an ActivPal monitor for 4 work days to measure physical activity and sedentary behaviors. Participants completed a 25-item survey about the presence of external, internal, and staircase design features at their worksite. Participants also reported their desk type. General linear models were used to examine relations between the number of features present for each category and physical activity (steps per hour) and sedentary behavior (sitting time per hour).

RESULTS

Internal design scores were positively associated with occupational physical activity. Each single item increase in facilitating internal design features was associated with +64.5 steps/hr (p = .045) at work. Workers who reported having a desk job walked 538 fewer steps/hr (p < .01) and sat 17 min more/hr at work than workers who reported not having a desk.

CONCLUSION

These results suggest that internal design features can promote more movement and less sitting at work. Future studies that examine the longitudinal effect of changing internal design features on occupational physical activity and sedentary behaviors are warranted.

Sitting may increase risk for radiographic incidence and progression of knee osteoarthritis over 2 years: Data from a large cohort study

OBJECTIVES

To examine the association of leisure-time sitting with radiographic incidence and progression of knee osteoarthritis (OA) over 2 years, and to determine whether worktime sitting modifies this association.

METHODS

We included adults with or at high risk for knee OA who enroled in the Osteoarthritis Initiative (OAI). Participants reported leisure-time sitting (≤4 vs. >4 h/day) and worktime sitting (frequent vs. infrequent) at enrolment, and had bilateral knee radiographs at enrolment and 2 years later. Our outcome, radiographic knee OA incidence/progression (yes/no), was defined as any increase in Kellgren-Lawrence grade over 2 years. We examined the association of leisure-time sitting (≤4 vs. >4 h/day) with risk of radiographic knee OA incidence/progression using binary linear regression, adjusting for potential confounders. We stratified by worktime sitting (frequent vs. infrequent) and repeated our analysis.

RESULTS

We included 4254 adults (mean age 61 years; 58% women; mean body mass index 29 kg/m2 ) who contributed a total of 8127 knees. Adults with >4 h/day of leisure-time sitting had 25% higher risk (adjusted risk ratio [RR] 1.25, 95% confidence interval [95% CI] 1.08-1.50) for radiographic knee OA incidence/progression compared with adults with ≤4 h/day of leisure-time sitting (referent group). Importantly, this association was intensified (RR 1.60, 95% CI 1.19-2.33) among adults with frequent worktime sitting, but was attenuated (RR 1.11, 95% CI 0.89-1.39) among adults with infrequent worktime sitting.

CONCLUSIONS

Higher leisure-time sitting (>4 h/day) may be associated with greater risk for radiographic knee OA incidence/progression over 2 years. Furthermore, this association was intensified among adults who also reported frequent worktime sitting.

The Association of Physical Activity Level with Micronutrient and Health Status of Austrian Bank Employees

BACKGROUND

Favorable health benefits of an active lifestyle have been clearly documented within the context of occupational health. However, a knowledge gap exists regarding the monitoring and comparison of micronutrient status across varying levels of physical activity (PA). This study aimed to investigate the association of PA level with micronutrient status and the associated health biomarkers among a cohort of Austrian bank employees.

METHODS

Using a cross-sectional design, this study involved the participation of bank employees (n = 123; average age: 43 years; 49% males) from the federal state of Tyrol, located in the western part of Austria. To assess PA levels and sedentary behavior, the Global Physical Activity Questionnaire (GPAQ; developed by the WHO) was administered. Accordingly, participants were categorized into three groups: low PA, moderate PA, and high PA. Participants' blood samples were obtained to measure blood levels of micronutrients, homocysteine, and CoQ10. The values of vitamins and minerals in whole-blood were compared to sex-specific reference ranges and grouped into three categories: below, within, or exceeding the reference range.

RESULTS

The prevalence of a high PA level was 61%, while 18% of participants had a low PA level. Overweight/obesity was significantly less prevalent among participants with high PA levels (22%) compared to those with moderate (50%) and low (50%) PA levels (p = 0.045). No significant differences between PA levels were found for sex, age, diet type, homocysteine, or CoQ10 markers (p > 0.05). There was no significant PA-based difference in blood concentrations of most vitamins and minerals (p > 0.05), except for vitamin D (p = 0.001) among females, as well as selenium (p = 0.040) and vitamin B12 (p = 0.048) among males.

CONCLUSION

The present findings offer initial insights into the link between PA behaviors, micronutrient status, and health, highlighting potential implications in occupational health and lifestyle, specifically in developing tailored approaches based on PA levels.

Real Life Impact of Dry Eye Disease

Dry Eye Disease (DED) is an increasingly common condition that affects between 5% and 50% of the global population. Even though DED is most frequently diagnosed in older people, it has also been diagnosed in young adults and adolescents more frequently in recent years (employees, gamers). People can experience different types of symptoms and find it challenging to read, watch TV, cook, climb stairs, and meet friends. Mild and severe dry eye can reduce quality of life similarly to mild psoriasis and moderate-to-severe angina. Furthermore, DED patients experience serious difficulties driving vehicles, especially at night, and show a decrease in work productivity, which, when combined with the relevant indirect cost that this condition produces, poses a serious challenge in our days. In addition, DED patients are more likely to develop depression and suicidal ideations and experience frequent sleep disorders. Finally, it is discussed how lifestyle changes, such as increased physical activity, blinking exercises, and a proper diet, have positive implications for the management of this condition. Our aim is to draw attention to the negative effects of dry eye in real life, which are unique to each patient, especially as they relate to the non-visual symptoms experienced by DED patients.

A Systematic Review of Workplace Physical Activity Coaching

Aim Studies show that about 60 min of moderate physical activity (PA) per day compensate for sitting all day at work. However, the workplace offers an ideal setting for health-promoting interventions such as PA coaching as a person-centered intervention aimed at achieving lasting health behavior changes. Given a good evidence base of health coaching studies in general, this systematic review aims to provide an overview of workplace PA coaching interventions. Methods This review was conducted according to PRISMA guidelines. Studies published up to July 2021 were considered based on the following inclusion criteria: (1) longitudinal intervention studies, (2) analysis of PA at work, (3) sedentary employees, (4) PA coaching in the workplace as intervention, (5) increasing workplace PA. Results Of 4323 studies found, 14 studies with 17 interventions met inclusion criteria. All 17 interventions indicated an increase in at least one PA outcome. Twelve interventions indicated significant improvements in at least one workplace or total PA outcome. There is a high variation within the different coaching parameters, such as behavior change techniques and communication channels. The study quality showed a moderate to high risk of bias. Conclusions The majority of interventions provided evidence for the effectiveness of workplace PA coaching. Nevertheless, the results are inconclusive with regard to the variety of coaching parameters and thus no general statement can be made about the effectiveness of individual parameters. However, this variety of parameters also leads to a high degree of individualization of workplace PA coaching interventions to increase PA for different groups of employees and different types of workplaces.

A Social Cognitive Assessment of Workplace Sedentary Behavior among a Sample of University Employees

Sedentary behavior (SB) is an important public health concern. Adults working in desk-based occupations spend a considerable proportion of the workday sitting. More information is needed regarding the factors that contribute to occupational SB. The aim of this study was to assess the utility of social cognitive theory (SCT) to explain work-related SB using a quantitative, cross-sectional design by administering an online questionnaire. Participants included 381 full-time employees at a large, public university in the south-central United States. Hierarchical multiple linear regression was used to determine the relationship between SCT constructs and SB. Mean work-related SB was 5.95 (SD = 1.30) h/8 h workday. In model 1, 9.6% of the total variance in SB was accounted for by standing desk ownership and physical activity level (p = 0.001; R2 = 0.096). In model 2, SCT constructs led to a statistically significant R2 increase of 4.9% (p < 0.001), where standing desk ownership, physical activity, and self-efficacy explained 13.3% of the variance in work-related SB. Findings from this study suggest that self-efficacy may be an important factor in explaining variation in occupational SB. Public health researchers and practitioners should consider strategies to address self-efficacy when developing workplace interventions to target occupational SB.

Neighborhood socioeconomic status and cardiometabolic risk: mediating roles of domain-specific physical activities and sedentary behaviors

PURPOSE

We examined the potential mediating roles of domain-specific physical activities and sedentary behaviors in the relationship between area-level socioeconomic status (SES) and cardiometabolic risk.

METHODS

Data were from the 2011/2012 Australian Diabetes, Obesity and Lifestyle study (n = 3431). The outcome was a clustered cardiometabolic risk (CCR) score, and the exposure was suburb-level SES. Potential mediators were domain-specific physical activities and sedentary behaviors. Multilevel linear regression models examined associations between SES and potential mediators (α) and between mediators and CCR (β). Mediation was assessed using the joint-significance test.

RESULTS

Higher SES was associated with a lower CCR score. Lower SES was associated with less frequent walking for transport, lower vigorous-intensity recreational physical activity, and higher TV time, which were associated with higher CCR scores. However, higher SES was associated with longer transport-related sitting time (all modes and in cars), which were associated with higher CCR scores.

CONCLUSIONS

The SES-cardiometabolic risk relationship may be partially explained by walking for transport, vigorous-intensity recreational physical activity, and TV viewing. These findings, which require corroboration from prospective evidence and clarification of the roles of transport-related sitting and occupational physical activity, can inform initiatives addressing socioeconomic inequalities in cardiometabolic health.

Impact assessment of e-trainings in occupational safety and health: a literature review

BACKGROUND

Implementing workplace preventive interventions reduces occupational accidents and injuries, as well as the negative consequences of those accidents and injuries. Online occupational safety and health training is one of the most effective preventive interventions. This study aims to present current knowledge on e-training interventions, make recommendations on the flexibility, accessibility, and cost-effectiveness of online training, and identify research gaps and obstacles.

METHOD

All studies that addressed occupational safety and health e-training interventions designed to address worker injuries, accidents, and diseases were chosen from PubMed and Scopus until 2021. Two independent reviewers conducted the screening process for titles, abstracts, and full texts, and disagreements on the inclusion or exclusion of an article were resolved by consensus and, if necessary, by a third reviewer. The included articles were analyzed and synthesized using the constant comparative analysis method.

RESULT

The search identified 7,497 articles and 7,325 unique records. Following the title, abstract, and full-text screening, 25 studies met the review criteria. Of the 25 studies, 23 were conducted in developed and two in developing countries. The interventions were carried out on either the mobile platform, the website platform, or both. The study designs and the number of outcomes of the interventions varied significantly (multi-outcomes vs. single-outcome). Obesity, hypertension, neck/shoulder pain, office ergonomics issues, sedentary behaviors, heart disease, physical inactivity, dairy farm injuries, nutrition, respiratory problems, and diabetes were all addressed in the articles.

CONCLUSION

According to the findings of this literature study, e-trainings can significantly improve occupational safety and health. E-training is adaptable, affordable, and can increase workers' knowledge and abilities, resulting in fewer workplace injuries and accidents. Furthermore, e-training platforms can assist businesses in tracking employee development and ensuring that training needs are completed. Overall, this analysis reveals that e-training has enormous promise in the field of occupational safety and health for both businesses and employees.

Providing office workers with height-adjustable workstation to reduce and interrupt workplace sitting time: protocol for the Stand Up for Healthy Aging (SUFHA) cluster randomized controlled trial

BACKGROUND

Sedentary behavior (SB) has been linked to several negative health outcomes. Therefore, reducing SB or breaking up prolonged periods of SB improves functional fitness, food consumption, job satisfaction, and productivity. Reducing SB can be achieved by introducing a health-enhancing contextual modification promoted by a sit-stand desk in the workplace. The primary goal will be to test the effectiveness of this intervention in reducing and breaking up SB, while improving health outcomes in office-based workers during a 6-month intervention.

METHODS

A two-arm (1:1), superiority parallel-group cluster RCT will be conducted to evaluate the effectiveness of this intervention in a sample of office-based workers from a university in Portugal. The intervention will consist of a psychoeducation session, motivational prompts, and contextual modification promoted by a sit-stand desk in the workplace for 6 months. The control group will work as usual in their workplace, with no contextual change or prompts during the 6-month intervention. Three assessment points will be conducted in both groups, pre-intervention (baseline), post-intervention, and a 3-month follow-up. The primary outcomes include sedentary and physical activity-related variables, which will be objectively assessed with 24 h monitoring using the ActivPAL for 7 days. The secondary outcomes include (a) biometric indices as body composition, body mass index, waist circumference, and postural inequalities; and (b) psychosocial variables such as overall and work-related fatigue, overall discomfort, life/work satisfaction, quality of life, and eating behavior. Both the primary and secondary outcomes will be assessed at each assessment point.

DISCUSSION

This study will lean on the use of a sit-stand workstation for 6 months, prompted by an initial psychoeducational session and ongoing motivational prompts. We will aim to contribute to this topic by providing robust data on alternating sitting and standing postures in the workplace.

TRIAL REGISTRATION

The trial was prospectively registered, and the details are at: https://doi.org/10.17605/OSF.IO/JHGPW ; Registered 15 November 2022. OSF Preregistration.

A Privacy-Preserving Desk Sensor for Monitoring Healthy Movement Breaks in Smart Office Environments with the Internet of Things

Smart workplace Internet of Things (IoT) solutions rely on several sensors deployed efficiently in the workplace environment to collect accurate data to meet system goals. A vital issue for these sensor-based IoT solutions is privacy. Ideally, the occupants must be monitored discreetly, and the strategies for maintaining privacy are dependent on the nature of the data required. This paper proposes a new sensor design approach for IoT solutions in the workplace that protects occupants' privacy. We focus on a novel sensor that autonomously detects and captures human movements in the office to monitor a person's sedentary behavior. The sensor guides an eHealth solution that uses continuous feedback about desk behaviors to prompt healthy movement breaks for seated workers. The proposed sensor and its privacy-preserving characteristics can enhance the eHealth solution system's performance. Compared to self-reporting, intrusive, and other data collection techniques, this sensor can collect the information reliably and timely. We also present the data analysis specific to this new sensor that measures two physical distance parameters in real-time and uses their difference to determine human actions. This architecture aims to collect precise data at the sensor design level rather than to protect privacy during the data analysis phase.

Long working hours, sedentary work, noise, night shifts and risk of ischaemic heart disease

OBJECTIVE

Ischaemic heart disease (IHD) is a leading cause of death in Western countries. The aim of this study was to examine the associations between occupational exposure to loud noise, long working hours, shift work, and sedentary work and IHD.

METHODS

This data linkage study included all New Zealanders employed and aged 20-64 years at the time of the 2013 census, followed up for incident IHD between 2013 and 2018 based on hospitalisation, prescription and death records. Occupation and number of working hours were obtained from the census, and exposure to sedentary work, loud noise and night shift work was assessed using New Zealand job exposure matrices. HRs were calculated for males and females using Cox regression adjusted for age, socioeconomic status, smoking and ethnicity.

RESULTS

From the 8 11 470 males and 7 83 207 females employed at the time of the census, 15 012 male (1.9%) and 5595 female IHD cases (0.7%) were identified. For males, there was a modestly higher risk of IHD for the highest category (>90 dBA) of noise exposure (HR 1.19; 95% CI 1.07 to 1.33), while for females exposure prevalence was too low to calculate an HR. Night shift work was associated with IHD for males (HR 1.10; 95% CI 1.05 to 1.14) and females (HR 1.25; 95% CI 1.17 to 1.34). The population attributable fractions for night shift work were 1.8% and 4.6%, respectively. No clear associations with working long hours and sedentary work were observed.

CONCLUSIONS

This study suggests that occupational exposures to high levels of noise and night shift work might be associated with IHD risk.

A New Instrument for Assessing Work-Related Body Mechanics and Strain in the General Population

Clinical pain is often linked to poor body mechanics, with individuals sometimes presenting multiple painful disorders. Such disorders may be influenced by behaviors that affect the general resiliency and health of the musculoskeletal system. We aimed to develop a self-reported scale using the Malmö Diet and Cancer Study questions on work-related body mechanical exposures. An expert panel identified 41 variables having content validity for musculoskeletal problems. Exploratory factor analysis was conducted on a random selection of 50% of the cohort (n = 6,789 adults); the remaining was reserved for confirmatory factor analyses (CFA), item response theory (IRT) item calibration, and differential item functioning investigations. Supported by standard measure development methods and fit criteria, the final unidimensional item bank contains 13 items. Overall CFA statistics (root mean square error of approximation = .09; comparative fit index = .96; Tucker-Lewis index = .96; standardized root mean residuals = .05) indicated excellent single-factor model fit and appropriateness of IRT modeling and calibration. Expert review and item information values (score-precision) guided selection of an 8-item short form with acceptable score-level reliabilities (≥.70) for T-scores = 39-80+. This measure provides reliable assessment of body mechanics strain in adults and can be useful when evaluating different contributions to musculoskeletal problems affecting pain-treatment success in future clinical research. PERSPECTIVE: This article presents the development and psychometric properties of a new measure, "Work-related Body Mechanics and Strain Scale (WR-BMSS)." The scale has 13-items or alternatively an 8-item short form. This measure could potentially help clinicians who seek to assess how musculoskeletal problems may contribute to patient pain and disability.

Office job sitting demand scale: Evidence of construct and predictive validity

Drawing on sedentary behavior and Job Demands-Resources theory, we developed a new scale for assessing office job sitting demand, conceptualized as job demand, and validated it using two independent samples. In Study 1 (N = 252), we developed the items and tested the Office Job Sitting Demand scales' factor structure through exploratory factor analysis. In Study 2 (N = 248), we tested the scales' factorial validity through confirmatory factor analysis. Indicators of measurement invariance showed no differences between participants who engage in leisure-time sport and participants who do not. Moreover, we tested convergent, discriminant, and criterion validity. We found significant positive associations with exhaustion, work pressure, and musculoskeletal complaints. The construct was unrelated to proactive vitality management and relaxation. Our results illustrate the relation between this new job demand in the workplace with employee well-being. Based on our findings, this newly developed instrument is valid and reliable and can be used to assess office job sitting demand to prevent burnout and health complaints.

Occupational sitting and work engagement among university employees

Objective: This study sought to determine the relationship between occupational sitting and work engagement among university employees. Participants: Participants included 103 university employees (age: 48.5 ± 10.4 years, 80% female, 77% staff). Methods: Participants completed an online survey based on the Utrecht Work Engagement Survey (UWES) and the Occupational Sitting and Physical Activity Questionnaire (OSPAQ). The UWES assessed elements of work engagement. The OSPAQ assessed time spent sitting, standing, walking, and in heavy labor during a workday. Results: Compared to staff members, faculty members self-reported less time seated during the workday (373.8 ± 109.7 min/day vs. 321.1 ± 97.3 min/day, p = 0.03). Work engagement was comparable among faculty and staff members (vigor: p = 0.44; absorption: p = 0.68; dedication: p = 0.71). Associations of work engagement with occupational sitting were not significant. Conclusions: These pilot findings suggest that university staff tend to engage in more occupational sitting compared to faculty. Being absorbed and engaged at work is not associated with occupational sitting.

Exploring the use of an under-desk leg swing device during employee aptitude testing and implications on work performance and productivity

BACKGROUND

As modern occupations become more sedentary, desk-bound workers are more at risk of chronic diseases. Active workstations have gained popularity in the workplace, but there remain concerns about their impact on cognitive function.

OBJECTIVE

This study investigated the use of a novel under-desk leg swing device on cognitive ability in the workplace compared to sitting.

METHODS

Cognitive ability was measured using a pre-employment aptitude test (CCAT), and perceived outcomes were analyzed via self-report questionnaires. Using a randomized, repeated measures crossover design, 18 undergraduate students undertook the CCAT while using the under-desk leg swing device and while sitting only (Experiment 1). 9 students returned two to three weeks later to repeat testing (Experiment 2).

RESULTS

In Experiment 1, CCAT scores did not differ significantly between the under-desk leg swing device and sitting (mean difference (MD) = -1.056, standard error (SE) = 1.302,p = 0.429, d = -0.16). Effect sizes of 0.554 were observed for perceived alertness, 0.446 for attention, 0.446 for focus, and 0.564 for enjoyment, but there were no significant differences between the two conditions. CCAT scores were significantly higher in Experiment 2 than in Experiment 1 (MD = 8.444, SE = 2.410,p = 0.008, d = 1.64).

CONCLUSION

Based on Experiment 1, the findings suggest that the use of the under-desk leg swing device promotes movement without detriment to neither workflow nor cognitive ability relevant to employee aptitude compared to sitting.

Innovative seated vertical lumbar traction allows simultaneous computer work while inducing spinal height changes similar to supine lying

BACKGROUND

Lumbar intervertebral disc height loss has been associated with spinal height change (SHC) and low back pain (LBP), including stenosis. Non-invasive methods to improve disc height loss require forms of lying down, which are unconducive to computer work.

OBJECTIVE

Intermittent vertical traction (VT) integrated with seated computer work may provide ergonomic alternatives for increasing SHC to promote LBP relief. The primary aim was to develop and introduce a safe VT prototype and dosage to induce and measure SHC. Prototype comfort and LBP ratings were exploratory secondary aims.

METHODS

Forty-one participants were stadiometry-measured for pre- and post-intervention SHC from seated VT at 35% body weight removed, supine lying (SL), and sitting at a computer (SIT) without VT. Pain ratings were recorded for those self-reporting LBP. VT prototype evaluations were compiled from a 3-question, 7-point Likert-style survey.

RESULTS

SHC increased by 3.9 ± 3.4 mm in VT, 1.7 ± 3.4 mm in SIT, and 4.3 ± 3.1 mm in SL (P< 0.000). Post hoc findings were significant between VT and SIT (P< 0.000), and SL and SIT (P< 0.000). VT and SL LBP ratings both decreased, but not SIT.

CONCLUSION

Intermittent seated VT is a promising alternative for postural relief during seated computer work, producing SHC similar to lying down without compromising workflow.

Multi-Component Intervention to Promote Physical Activity in Japanese Office Workers: A Single-Arm Feasibility Study

This study investigated the feasibility of a multi-component intervention to promote physical activity (PA) among Japanese office workers. It was an 8-week single-arm trial conducted in Japan in 2021, in which 76 employees aged 20 or older, from an insurance company, participated. They received a multi-component PA intervention that comprised individual (lecture, print material, goal setting, and feedback), socio-cultural (team building and supportive atmosphere), physical (poster), and organizational (encouraging message from an executive) strategies. The primary outcome was change in objectively measured moderate-to-vigorous PA (MVPA). A paired t-test was used to compare the changes between weeks 0 and 8. We also conducted a subdomain analysis of PA divided into four domains (working, non-working, commuting working, and remote working). Excluding 26 participants who could not complete valid assessments, the MVPA among participants (n = 50, age 49.6 ± 9.7) significantly increased by +7.3 min/day [95% confidence interval (CI) 0.8 to 13.8]. We also identified significant changes in MVPA by +10.0 min/day [95% CI, 3.7 to 16.3] in working days (n = 40), and by +7.1 min/day [95% CI, 0.4 to 13.7] in remote working days (n = 34). We demonstrated that multi-component PA interventions might improve MVPA among Japanese office workers.

Occupational risk factors for hypertension

The identification and characterization of the modifiable risk factors of hypertension is of great value for public health and clinical medicine to achieve primary prevention. A large amount of literature on the effects of occupational factors on blood pressure and hypertension has been published. In this review, I summarize current evidence regarding the role of occupational factors in hypertension. The results of this review suggest that there is sufficient evidence to support the association between increased risk of hypertension and job stress, shift work, occupational lead exposure, and noise exposure. The association of hypertension with physical inactivity, sedentary behavior, and occupational exposure to mercury, arsenic, cadmium, or carbon disulfide remains inconclusive, although several studies have reported this finding. This review will serve as a step toward future research and provide baseline information for developing strategic interventions to prevent hypertension in the working population.

'Just Right' job design: A conceptual framework for sustainable work in rail driving using the Goldilocks Work Paradigm

Excessive physical demand at work has traditionally been connected with adverse health outcomes, but excessive sitting is now also being recognised as an occupational hazard and emerging work-related risk. Traditional preventive occupational health and ergonomics programs are useful but limited through reliance on individual behaviour change and time-diversion from productive work. A new 'Goldilocks Work Paradigm' aims to optimise health and productivity by using movements of productive tasks. Using rail driving as a specific case of a highly sedentary and inflexible working environment, we construct a conceptual framework for designing better jobs, arguing that a theoretical amalgamation of the new Goldilocks Work Paradigm with System Thinking, Participatory Ergonomics, and a Risk Management Framework, is needed, for establishing a unified, strategic approach-a 'just right' job design model. We extend this by outlining a practical process of designing better jobs with tools that can be used to achieve it.

Oral health outcomes and shift working among male workers: A cross-sectional survey

Working time outside routine daily working hours is known as shift working. Studies have shown adverse effects of shift working such as stress, obesity, and diabetes on the workers' health. The aim of the present study was to compare aspects of oral health in shift workers and non-shift workers of a cement factory in Shahroud, Iran. Study population comprised of 180 male workers of the factory in the year 2015. Convenience sampling was continued until recruiting 180 subjects of shift- and non-shift workers. Data collection included oral health questionnaire, health and safety executive (HSE) questionnaire, and clinical oral examination. The Chi-square test, Pearson correlation coefficient, and generalized Poisson model were employed for statistical evaluation. Mean age of the workers was 39.19 (±9.48); 53% had educational level of less than diploma. Their mean DMFT was 12.89 (±5.75) which correlated with number of years in shift work schedule (Pearson correlation coefficient: 0.41; p<0.001) but not correlated with job stress (Pearson correlation coefficient: -0.11; p = 0.12). Mean number of deep periodontal pockets among the workers was 5.03 (±1.84) that showed correlation with number of years in shift work schedule (Pearson correlation coefficient: 0.33; p<0.001) but no correlation with job stress (Pearson correlation coefficient: -0.03; p = 0.68). Adherence to various oral health behaviors was reported by less than half of the workers. Positive correlation of dental caries and periodontal diseases with shift working partly signals negative impact of working conditions on oral health among this group of workers which calls for modifications in their working environment to facilitate health practices.

TV time, physical activity, sedentary behaviour and cardiometabolic biomarkers in pregnancy-NHANES 2003-2006

OBJECTIVES

This study examined the impacts of individual and combined associations between moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) (accelerometer-derived), as well as MVPA and television (TV) time (self-reported) on cardiometabolic biomarkers during pregnancy.

METHODS

Participants were 332 pregnant women from the 2003-2006 cycles of the National Health and Nutrition Examination Survey (NHANES). Multiple linear regression models were conducted to examine the relationships between individual and combinations of high/low MVPA, ST, and TV time with cardiometabolic biomarkers: body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL), and C-reactive protein (CRP).

RESULTS

Women with high MVPA (≥ 17 min/day) compared to those with low MVPA (< 17 min/day) had significantly lower BMI. Women with low ST (< 503 min/day) compared to those with high ST (≥ 503 min/day) had significantly lower SBP and DBP. Women with low TV (< 3 h/day) compared to those with high TV (≥ 3 h/day) had significantly lower BMI and log-transformed CRP. Women with a combination of low ST/high MVPA had lower SBP and DBP (p_trend < 0.03). Women with a combination of low TV/high MVPA had lower BMI and log-transformed CRP (p_trend < 0.00).

CONCLUSION

We need to consider both physical activity and sedentary time for improved cardiometabolic health during pregnancy.

Spine Posture, Mobility, and Stability of Top Mobile Esports Athletes: A Case Series

Professional esports athletes spend a long time in the same sitting posture during training and competition. Mobile esports may exacerbate potential postural problems because of the closer and unsupported arms and because athletes spend more time in a forward-/flexed-head posture. Prolonged sitting in these postures carries significant health risks and may lead to musculoskeletal problems and injuries. The objective of this retrospective study is to assess the posture, mobility, and stability of the spine for professional mobile esports athletes. We collected spine-assessment data from 48 athletes participating in a top-tier league on a real-time-strategy battle-arena online game. The spinal assessment was conducted using the SpinalMouse® under upright standing and trunk flexion in addition to the Matthiass test. Measurements were converted into Idiag Scores by the SpinalMouse® software. The Idiag Posture, Idiag Mobility, and Idiag Stability scores were 62.50 (IQR: 21), 63.50 (IQR: 19.5), and 54.50 (IQR: 14.5), respectively, and were significantly lower (p < 0.001) than the reference normative value (100). Age was found to have a weak positive correlation with the posture score (ρ = 0.29, p = 0.048). Although career duration appeared to lower the scores, the association was insignificant (p > 0.05). The scores also had no significant association with body height, body mass, body mass index, and esports team (p > 0.05). It was anticipated that mobile-based esports would attenuate the biomechanics of the spine and increase the likelihood of musculoskeletal problems, such as neck and back pain.

The views of general practitioners about using sit-stand desks: An observational study

BACKGROUND

Occupational sitting is associated with negative health outcomes. Sit-stand workstations have been shown to reduce sitting time in office workers, although there is no evidence on whether this change to practice would be acceptable to GPs.

AIM

To investigate GPs views about the use of sit-stand desks within general practice and the potential impact they may have on the nature and quality of consultations with adult patients.

DESIGN & SETTING

Observational study involving GPs located across the United Kingdom.

METHOD

A online survey was emailed to members of the Royal College of General Practitioners and shared on social media. Only GPs working in the UK were eligible. The survey included questions on socio-demographics, GPs views about the use of sit-stand desks within their work, their levels of physical activity, total time spent sitting each day at work and time spent at work.

RESULTS

14,142 surveys were sent by RCGP to their members with 810 GPs responding with a further 33 responding via social media. 60.6% of GPs would like a sit-stand desks in their consultation room, while 19.2% already had one. Most GPs thought sit-stand desks could be used for telephone consultations (91.9%) and administration tasks (92.3%). There was less agreement about whether they could be used during face-to-face consultations (35% agreed), with the potential impact on the doctor-patient relationship raised as the primary concern.

CONCLUSION

The implementation of sit-stand desks had support from GPs, but their possible impact on the doctor-patient relationship should be considered in future research.

A longitudinal linkage study of occupation and ischaemic heart disease in the general and Māori populations of New Zealand

Objectives

Occupation is a poorly characterised risk factor for cardiovascular disease (CVD) with females and indigenous populations under-represented in most research. This study assessed associations between occupation and ischaemic heart disease (IHD) in males and females of the general and Māori (indigenous people of NZ) populations of New Zealand (NZ).

Methods

Two surveys of the NZ adult population (NZ Workforce Survey (NZWS); 2004–2006; n = 3003) and of the Māori population (NZWS Māori; 2009–2010; n = 2107) with detailed occupational histories were linked with routinely collected health data and followed-up until December 2018. Cox regression was used to calculate hazard ratios (HR) for IHD and “ever-worked” in any of the nine major occupational groups or 17 industries. Analyses were controlled for age, deprivation and smoking, and stratified by sex and survey.

Results

‘Plant/machine operators and assemblers’ and ‘elementary occupations’ were positively associated with IHD in female Māori (HR 2.2, 95%CI 1.2–4.1 and HR 2.0, 1.1–3.8, respectively) and among NZWS males who had been employed as ‘plant/machine operators and assemblers’ for 10+ years (HR 1.7, 1.2–2.8). Working in the ‘manufacturing’ industry was also associated with IHD in NZWS females (HR 1.9, 1.1–3.7), whilst inverse associations were observed for ‘technicians and associate professionals’ (HR 0.5, 0.3–0.8) in NZWS males. For ‘clerks’, a positive association was found for NZWS males (HR 1.8, 1.2–2.7), whilst an inverse association was observed for Māori females (HR 0.4, 0.2–0.8).

Conclusion

Associations with IHD differed significantly across occupational groups and were not consistent across males and females or for Māori and the general population, even within the same occupational groups, suggesting that current knowledge regarding the association between occupation and IHD may not be generalisable across different population groups.

Is Sedentary Behavior a Novel Risk Factor for Cardiovascular Disease?

PURPOSE OF REVIEW

Review the most recent evidence on the role of sedentary behavior in the prevention of cardiovascular disease (CVD).

RECENT FINDINGS

Prospective cohort studies continue to suggest a relationship between sedentary behavior and CVD, but the dose-response association, and the implications of sedentary pattern (vs. total volume) and context on CVD risk require further investigation. Most recent evidence suggests that physical activity influences the association between sedentary time and CVD risk, and that replacing sedentary time with other movement behaviors yields cardiometabolic benefits. Short-term intervention studies have further demonstrated that interrupting prolonged sitting with bouts of physical activity can elicit acute improvements on cardiometabolic biomarkers and vascular function relative to prolonged, uninterrupted sitting, albeit limited evidence exists on the long-term effects. More conclusive evidence regarding the implications of sedentary time on CVD risk is warranted before the optimal sedentary behavior reduction prescription for the prevention of CVD can be elucidated.

Proposal of a Comprehensive and Multi-Component Approach to Promote Physical Activity among Japanese Office Workers: A Qualitative Focus Group Interview Study

Office workers spend up to two-thirds of their working hours sitting and are less physically active than other occupational groups. It is necessary to develop an effective approach to promote physical activity among office workers. We conducted a focus group interview with seven Japanese office workers to investigate the current status (topic 1) of, and their opinions on (topic 2), physical activity promotion programs in their workplace. Data were analyzed using qualitative data analysis. We classified the data from topic 1 into individual, socio-cultural, physical, and organizational environments. Most participants indicated that they spent a lot of time sitting and needed programs for a wide range of corresponding employee demands. We classified the data from topic 2 into capability, opportunity, and motivation. Most participants indicated that they wanted evidence-based information, a standing desk, and a conducive workplace environment to enhance physical activity. Thus, we proposed a comprehensive and multi-component approach comprising individual (information delivery), socio-cultural environment (team building, supportive atmosphere), physical environment (standing desk, use of poster), and organizational (incentive, encouraging message from an executive, workplace policy) strategies. Future studies should evaluate the effectiveness of this proposal.

Association of occupational sitting with cardiovascular outcomes and cardiometabolic risk factors: a systematic review with a sex-sensitive/gender-sensitive perspective

OBJECTIVES

Sedentary behaviour is a modifiable risk factor for cardiovascular health. Although long periods of sedentary behaviour take place at work, evidence of the relationship between such occupational sitting and cardiometabolic health risks remains limited. This systematic review aimed to update the evidence on the associations of occupational sitting with cardiovascular outcomes and cardiometabolic risk factors based on longitudinal studies.

DESIGN

Systematic review.

SETTING

Workplace.

POPULATION

Employees aged 18-65 years.

PRIMARY AND SECONDARY OUTCOMES

Primary outcomes were cardiovascular diseases and cardiometabolic risk markers. The secondary outcome was all-cause mortality.

DATA SOURCES

Ten databases, including PubMed, Web of Science and CINAHL (search January 2018, updated February 2019).

DATA EXTRACTION AND SYNTHESIS

Data were screened, extracted and appraised by three independent reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

RESULTS

Studies were markedly heterogeneous in terms of measurement of occupational sitting, cardiometabolic risk factors and cardiovascular morbidity and mortality, so that standards were hardly identifiable and limiting the value of the evidence. The review included 27 high or acceptable quality publications. Of the eight high-quality publications from seven cohorts, three cohort studies found significant associations of occupational sitting with primary outcomes. Additionally, one study described an association with the secondary outcome. Another high-quality publication found an association between occupational sitting and ischaemic heart disease in a subgroup already at risk due to hypertension. For sex/gender analysis, 11 of the 27 high and acceptable quality publications reported sex-stratified results. Five of these found sex differences.

CONCLUSIONS

Evidence regarding the association of occupational sitting with cardiometabolic health risks was limited because of the lack of standardised measurements for occupational sitting. Occupational sitting combined with an overall sedentary lifestyle was associated with an elevated relative risk for several cardiometabolic outcomes. There is an urgent need for standardised measurements of occupational sitting to facilitate meta-analysis. Sex/gender aspects of this relationship require further investigation.

Association Between Occupational Sitting With High Sensitivity C-Reactive Protein: The Jackson Heart Study

Modifiable, behavioral risk factors like occupational sitting may contribute to inflammation, an important cardiovascular risk factor. This study evaluated the association of self-reported occupational sitting with changes in c-reactive protein (CRP) and the role of sex. We examined occupational sitting and baseline CRP levels for 2889 African American participants in the Jackson Heart Study. Four multivariable linear regression models were estimated to determine the association of occupational sitting and CRP. Analyses were conducted in 2020. The mean age was 50.8 years and 61% were female. Participants who reported occupational sitting as “often/always” had CRP levels of 4.9±6.8 mg/L, “sometimes” had levels of 4.8±8.1 mg/L, and “never/seldom” had levels of 4.3±6.8 mg/L. In the unadjusted model, “often/always” engaging in occupational sitting was significantly associated with higher levels of CRP when compared to “never/seldom” ( P < .05). This differed by sex with female participants who reported “often/always” occupational sitting had CRP levels of 6.0±7.6 mg/L compared to only 5.1±6.9 mg/L for “never/seldom.” Neither the overall association nor the female-specific association remained statistically significant in the adjusted models. We found an association between occupational sitting and inflammation, measured by CRP. This association varied by sex but did not remain significant after fully adjusting for covariates.

Leisure but Not Occupational Physical Activity and Sedentary Behavior Associated With Better Health

OBJECTIVE

This study explores relations between occupational and leisure-time physical activity (OPA, LTPA) and sedentary behavior (OSB, LTSB) and several health outcomes.

METHODS

A total 114 full-time workers had their body composition, waist circumference, height, weight, resting heart rate, and resting blood pressure measured. ActivPal monitor measured physical activity behaviors. Stress, mood, and pain were measured with ecological momentary assessment. General linear models were used to examine the relationship between high and low OPA, LTPA, OSB, and LTSB with each health outcome while controlling for covariates.

RESULTS

The high LTPA group had lower body mass index (BMI) (P = 0.04) and better mood (P = 0.007) than the low LTPA group. The high LTSB group had higher systolic blood pressure (P = 0.001), higher diastolic blood pressure (P = 0.01), higher BMI (P = 0.027), higher body fat percentage (P = 0.003), higher waist circumference (P = 0.01), and worse mood (P = 0.032) than the low LTSB group. No differences were found between OPA and OSB groups.

CONCLUSIONS

These findings suggest there may be differential relations between PA and SB accumulated during leisure versus occupational time.

Physical working conditions and subsequent sickness absence: a record linkage follow-up study among 19-39-year-old municipal employees

Purpose

Physical work exposures are associated with sickness absence among older employees. We aimed to examine if they similarly contribute to all-cause sickness absence during early and mid-careers.

Methods

We used questionnaire data on physical work exposures linked to register data on sickness absence from 3542 municipal employees aged 19–39 years. Follow-up for the number of sickness absence days was 12 months. Exposures to physical workload, occupational environmental hazards, and sedentary work were divided into quartiles. In addition, duration of daily exposure to heavy work was included. Negative binomial regression models were used.

Results

Higher exposure to physical workload or hazardous exposures was associated with a higher number of sickness absence days. The age and gender adjusted rate ratios for sickness absence days among the participants whose exposure to physical workload was in the highest exposure quartile were 2.1 (95% CI 1.8‒2.5) compared with those whose exposure was in the lowest quartile. In addition, rate ratios for sickness absence days among participants who reported that they do heavy physical work 1.1‒2.0 h, 2.1‒4.0 h or over 4 h daily were 1.6 (1.3‒1.9), 1.5 (1.3‒1.8) and 1.7 (1.5‒2.1), respectively, compared with those who reported not doing physical work. Further adjustment for lifestyle factors or health characteristics attenuated the associations only slightly.

Conclusion

Exposure to physically demanding work is associated with a higher number of sickness absence days among municipal employees below 40 years of age. Physical working conditions should be considered when aiming to support later work ability.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-021-01791-y.

Ischaemic Heart Disease and Occupational Exposures: A Longitudinal Linkage Study in the General and Māori Populations of New Zealand

OBJECTIVES

This study assessed associations between occupational exposures and ischaemic heart disease (IHD) for males and females in the general and Māori populations (indigenous people of New Zealand).

METHODS

Two surveys of the general adult [New Zealand Workforce Survey (NZWS); 2004-2006; n = 3003] and Māori population (Māori NZWS; 2009-2010; n = 2107), with information on occupational exposures, were linked with administrative health data and followed-up until December 2018. Cox proportional hazards regression (adjusted for age, deprivation, and smoking) was used to assess associations between organizational factors, stress, and dust, chemical and physical exposures, and IHD.

RESULTS

Dust [hazard ratio (HR) 1.6, 95%CI 1.1-2.4], smoke or fumes (HR 1.5, 1.0-2.3), and oils and solvents (HR 1.5, 1.0-2.3) were associated with IHD in NZWS males. A high frequency of awkward or tiring hand positions was associated with IHD in both males and females of the NZWS (HRs 1.8, 1.1-2.8 and 2.4, 1.1-5.0, respectively). Repetitive tasks and working at very high speed were associated with IHD among NZWS females (HRs 3.4, 1.1-10.4 and 2.6, 1.2-5.5, respectively). Māori NZWS females working with vibrating tools and those exposed to a high frequency of loud noise were more likely to experience IHD (HRs 2.3, 1.1-4.8 and 2.1, 1.0-4.4, respectively). Exposure to multiple dust and chemical factors was associated with IHD in the NZWS males, as was exposure to multiple physical factors in males and females of the NZWS.

CONCLUSIONS

Exposures associated with an elevated IHD risk included dust, smoke or fumes, oils and solvents, awkward grip or hand movements, carrying out repetitive tasks, working at very high speed, loud noise, and working with tools that vibrate. Results were not consistently observed for males and females and between the general and Māori populations.

Sedentary behaviour and health in adults: an overview of systematic reviews

The purpose of this overview of systematic reviews was to determine the relationship between different types and patterns of sedentary behaviour and selected health outcomes in adults and older adults. Five electronic databases were last searched in May, 2019, with a 10-year search limit. Included reviews met the a priori population (community-dwelling adults aged 18 years and older), intervention/exposure/comparator (various types and/or patterns of sedentary behaviour), and outcomes criteria. Eighteen systematic reviews were included in the evidence synthesis. High levels of sedentary behaviour are unfavourably associated with cognitive function, depression, function and disability, physical activity levels, and physical health-related quality of life in adults. Reducing or breaking up sedentary behaviour may benefit body composition and markers of cardiometabolic risk. Total sedentary behaviour and TV viewing were most consistently associated with unfavourable health outcomes, while computer and Internet use may be favourably associated with cognitive function for older adults. The quality of evidence within individual reviews (as assessed by review authors) varied from low to high, while the certainty of evidence was low to very low. These findings have important public health implications, suggesting that adults should avoid high levels of sedentary behaviour and break-up periods of prolonged sitting. (PROSPERO registration nos.: CRD42019123121 and CRD42019127157.) Novelty High levels of sedentary behaviour are unfavourably associated with important health outcomes in adults. Reducing or breaking up sedentary behaviour may benefit body composition and markers of cardiometabolic risk. Computer and Internet use may be favourably associated with cognitive function in older adults.

Australian bus drivers' modifiable and contextual risk factors for chronic disease: A workplace study

INTRODUCTION

Little is known about workplace health promotion for bus drivers. Bus drivers are at-risk of chronic disease because they are exposed to the risk factor combination of poor nutrition, low levels of physical activity, high levels of sedentary time and are often overweight or obese. The purpose of this paper is to situate the quantitative baseline data collected from bus drivers within qualitative findings about the socio-cultural context of the workplace.

MATERIALS AND METHODS

Baseline data about physical activity, dietary intake and sedentary hours was collected from 58 drivers employed by a large bus company in southeast Queensland. Ten drivers and seven key workplace informants participated in interviews and discussion groups about driver health behaviours, workplace structure, culture, and resources.

RESULTS

The quantitative results of our study reveal bus drivers have a cluster of poor health behaviours-limited physical activity, lower than recommended consumption of fruit and vegetables and high levels of sitting time during working-hours-which contribute to a high prevalence of overweight and obesity and a heightened risk of chronic disease. The qualitative findings suggest there are individual and structural barriers to improving drivers' modifiable health behaviours. Individual barriers include ingrained poor habits and more pressing life concerns, while structural barriers in the context of the workplace include time constraints, shift work, long days, a lack of work amenities and a general disconnect of drivers with their workplace.

CONCLUSION

In this workplace, health promotion strategies for bus drivers should be prioritised as a means of improving drivers' health. To maximise uptake and effectiveness, these strategies should make use of existing workplace resources and consider the context of workplace health behaviour change. Further research is warranted in a broader sample of Australian bus companies to explore the context of workplace health behavior change so targeted strategies to improve bus drivers' health can be developed.

Effect of bariatric surgery on employment status-a 7 years controlled nationwide registry study

BACKGROUND

Severe obesity is associated with a reduced ability to work. Bariatric surgery is the most effective method to achieve a sustained weight loss. Previous studies have reported conflicting results regarding the effect of bariatric surgery on employment status. To address this, we investigated the effect of bariatric surgery on employment status in the Danish population.

METHODS

In this nationwide study, we identified 5450 subjects who underwent bariatric surgery and 10 900 control subjects matched for age, sex and municipality. From accessible registries, we extracted data regarding employment, absenteeism, sick leave and pension. Using a multistate model, we compared time in occupational states and transitions between these states to determine the effect of bariatric surgery on employment status.

FINDINGS

Before surgery, cases had an absolute risk increase (95% CI)(ARI (CI)) and a relative risk (RR (CI)) of being in full-time employment of -0.12 (-0.14 to -0.10) and 0.84 (0.82 to 0.86) and were more often unemployed or in a subsidised job than the background population. Taking into account the employment status before surgery, the bariatric surgery group increased their probability of being in full-time employment 1-3 years after bariatric surgery. However, this positive effect was not present with a longer duration of follow-up. Being male, above 50 years of age, or employed as a craftsman or office worker were associated with a sustained positive effect of being in full-time employment (ARI (CI) and RR (CI) 0.05 (0.04 to 0.05) and 1.05 (1.04 to 1.06), 0.06 (0.06 to 0.07) and 1.08 (1.07 to 1.09) and 0.05 (0.05 to 0.06) and 1.05 (1.05 to 1.06), respectively).

INTERPRETATION

Compared with a matched control group, those undergoing bariatric surgery did not improve their employment status in the long term. Certain subgroups had a more sustained positive effect.

The physical activity paradox in cardiovascular disease and all-cause mortality: the contemporary Copenhagen General Population Study with 104 046 adults

AIMS

Leisure time physical activity associates with reduced risk of cardiovascular disease and all-cause mortality, while these relationships for occupational physical activity are unclear. We tested the hypothesis that leisure time physical activity associates with reduced major adverse cardiovascular events (MACE) and all-cause mortality risk, while occupational physical activity associates with increased risks.

METHODS AND RESULTS

We studied 104 046 women and men aged 20-100 years in the Copenhagen General Population Study with baseline measurements in 2003-2014 and median 10-year follow-up. Both leisure and occupational physical activity were based on self-report with four response categories. We observed 7913 (7.6%) MACE and 9846 (9.5%) deaths from all causes. Compared to low leisure time physical activity, multivariable adjusted (for lifestyle, health, living conditions, and socioeconomic factors) hazard ratios for MACE were 0.86 (0.78-0.96) for moderate, 0.77 (0.69-0.86) for high, and 0.85 (0.73-0.98) for very high activity; corresponding values for higher occupational physical activity were 1.04 (0.95-1.14), 1.15 (1.04-1.28), and 1.35 (1.14-1.59), respectively. For all-cause mortality, corresponding hazard ratios for higher leisure time physical activity were 0.74 (0.68-0.81), 0.59 (0.54-0.64), and 0.60 (0.52-0.69), and for higher occupational physical activity 1.06 (0.96-1.16), 1.13 (1.01-1.27), and 1.27 (1.05-1.54), respectively. Similar results were found within strata on lifestyle, health, living conditions, and socioeconomic factors, and when excluding individuals dying within the first 5 years of follow-up. Levels of the two domains of physical activity did not interact on risk of MACE (P = 0.40) or all-cause mortality (P = 0.31).

CONCLUSION

Higher leisure time physical activity associates with reduced MACE and all-cause mortality risk, while higher occupational physical activity associates with increased risks, independent of each other.

Cardiorespiratory Fitness Is Associated with a Reduced Cardiovascular Risk in Occupational Groups with Different Working Conditions: A Cross-Sectional Study among Police Officers and Office Workers

Several studies reported a high prevalence of cardiovascular risk factors among police officers and office workers, and adequate cardiorespiratory fitness was reported to have protective effects in reducing cardiovascular risk. Therefore, the present study aimed to evaluate the effects of cardiorespiratory fitness on reducing cardiovascular risk factors in these occupational groups. This cross-sectional study enrolled 101 male participants (55 police officers and 46 office workers). Cardiorespiratory fitness was assessed via spiroergometry. Cardiovascular risk factors were also examined, and the 10-year cardiovascular risk and heart/vascular age were reported using the Framingham risk score. In both groups, higher cardiorespiratory fitness was associated with lower cardiovascular risk factors. Police officers and office workers with higher cardiorespiratory fitness demonstrated significantly lower values in BMI, waist circumference, body fat percentage, diastolic resting blood pressure, heart rate, triglycerides and total cholesterol values, and 10-year cardiovascular risk and heart/vascular age (all factors p < 0.0077, age adjusted). Police officers and office workers mostly presented low levels of cardiorespiratory fitness: 60% of police officers and 58% of office workers were considered “not fit and obese”. Despite different working conditions, both occupational groups had a high rate of low cardiorespiratory fitness levels and showed no differences in their cardiovascular risk profiles. In both groups, cardiorespiratory fitness reduced cardiovascular risk factors, but there was no difference in the influence of cardiorespiratory fitness on cardiovascular risk factors.

Relationship Between the Physical Environment and Physical Activity Levels in Preschool Children: A Systematic Review

PURPOSE OF REVIEW

The aim of this study was to understand the influence of the physical environment on the physical activity (PA) behavior of preschool children (aged 2 to 6 years), in order to provide an overview of these influences from the perspective of the ecological model.

RECENT FINDINGS

PA is of great importance for the prevention of obesity and cardiovascular diseases since childhood. The physical environment has a direct relationship with the different domains, where people can spend their time being physically active. Nonetheless, despite the importance of the physical environment to engagement in PA, very few reviews have focused on this relationship in the context of the growing problem of physical inactivity among preschool children. Studies that had analyzed the school domain had found that greater availability of a wider variety of portable play equipment, presence of certain fixed playground equipment, and presence of open spaces had favored PA levels. Furthermore, different studies had shown that the natural environment and the presence of hills were important for children's PA. Thus, despite the associations with PA we were able to identify in this review, new studies will still be needed to link the physical environment with PA levels, especially regarding transportation and leisure time. In conclusion, promoting studies on this subject from an early age will allow us to obtain information that could allow the adaptation, design, and construction of healthier homes, neighborhoods, and schools that promote children's health.