Sit to Stand: Maximizing Effectiveness of Ergonomic Interventions in an Office Environment
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Transcript of Sit to Stand: Maximizing Effectiveness of Ergonomic Interventions in an Office Environment
Wayne S. Maynard, CSP, CPE, ALCMProduct Director-WC, Ergonomics & Tribology
To Sit or To Stand: Maximizing Effectiveness of Ergonomic Interventions in an Office Environment
July 10, 2013
Acknowledgements:Michelle Robertson, Ph.D., CPE
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Agenda• Background discussion of practical issues of
office ergonomics and employee safety• Current research on training and maximizing
effectiveness of interventions; sit/stand workstations (Robertson et al., 2013)
• Guidelines and research for alternating between sitting and standing…and walking
• NIOSH “Take-a-Stand” project• Discussion of safety positions; treadmill desks
and fitness balls in the workplace
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Office Ergonomics and Safety: Perceptions
• How tough can it be?• We’re different than industry…• Furniture will solve all problems • Furniture is the “cause” of all problems• Computer workstation assessments should
take care of everything• Training people once is enough• Ergonomics is too expensive..• Taking a “break” means unproductive time• Others
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Strongly agree Agree Disagree Strongly Disagree
I am aware of and understand ergonomic principles and proper practices
0
20
40
60
80
Perc
ent
I am aware of and understand ergonomic principles and proper practices
Yes No
Have you ever made changes to your workstation or work habits based on ergonomic training?
0
10
20
30
40
50
60
Perc
ent
Have you ever made changes to your workstation or work habits based on ergonomic training?
Survey Findings* – Ergonomics Training
*Not a scientific survey
Unpublished Liberty Mutual Study (2004)
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0-2 Hours Between 2 and 4 Hours
Between 4 and 6 Hours
Between 6 and 8 hours
More than 8 hours
On average, how much time do you spend each day keying/mousing?
0
10
20
30
40
Perc
ent
On average, how much time do you spend each day keying/mousing?
Never 1-2 times 3-4 times 5-6 times 7-8 times 8+ times
On a typical workday during the past month, about how frequently did you take short rest/recovery breaks from
computer work?
0
10
20
30
40
50
Perc
ent
On a typical workday during the past month, about how frequently did you take short rest/recovery breaks from
computer work?
Findings – Rest Breaks
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Yes No
In the last 3 months, have you experienced physical discomfort while performnig your job or physical discomfort
you feel related to your job?
0
10
20
30
40
50
60
70
Perc
ent
In the last 3 months, have you experienced physical discomfort while performnig your job or physical discomfort
you feel related to your job?
Findings – Employee Comfort
Yes No
Did you report it to your manager and supervisor?
0
20
40
60
80
100
Perc
ent
Did you report it to your manager and supervisor?
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Conclusions• Many employees do not understand
ergonomics or how if affects their work• There appears to be a disconnect between
ergonomic assessment of a computer workstation and risk factors associated with the entire job; task approach versus job design approach
• Ergo workstation assessments are perceived to be the “ergonomics program”
• Employees seem reluctant to report discomfort to managers and supervisors
• Supervisors may not know what to do when discomfort is reported
Published: Robertson, Ciriello, & Garabet, Applied Ergonomics 44 (2013) 73-85
Extended Laboratory Intervention Study; Training and Sit/Stand Workstation Design
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Research Questions
• Will musculoskeletal and visual discomfort be minimal as a function of training and workspace adjustability in the Trained group?
• Will performance be higher for the Trained group?• Will office ergonomics knowledge and intent to
arrange office workstation set-ups increase for the Trained group?
• Will the alternation between sitting and standing computing postures and the amount of time standing be higher for the Trained group?
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Pre-experimental DayBlock 1 DayBlock 2 DayBlock 3 DayBlock 4 DayBlock 5
Minimally Trained Control Group
Day 1
Day 2
Day 3
Day 4
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
Day 8
Day 9
Day 10
Day 11
Day 12
Day 13
Day 14
Day 15
ErgonomicsTrained Experimental Group
Pre-experimental Task Orientation
4 days
Free Choice
Free Choice 5 Minute Mandatory Standing
20 Minute Mandatory Standing
Free Choice
Day 1
Day 2
Day 3
Day 4
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
Day8
Day9
Day 10
Day 11
Day 12
Day 13
Day 14
Day15
“Ergo Reminders”Ergonomics
Training
Study Design: Randomized Control Trial
Randomized schedule of 3 cognitive demand levels
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Methods: Participants and Tasks
• Participants:– 22 healthy females– Basic administration computing skills– No significant difference between groups for age; BMI (p>.05)
• Experimental task and cognitive demand levels:– Simulated customer service representative job– Based on a job analysis the following were determined:
• Task Complexity (cognitive demands)• Quality control and proficiency
– 7 hour day; 15 days
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Ergonomic Training & Experimental Set-up
Trained Group received two-phase ergonomic training
• Phase I:– 1.5 hr. workshop
• Slide and video presentation
• Case studies & de-briefing• Hands-on practice periods
• Phase II:– Practice period & standing– Ergonomics reminders
• Minimally Trained Group received:– Brief, standard orientation of
work setting– Manufacturer pamphlet of chair
adjustments
Participant Workstation
Data Collection
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Office Ergonomics Training: Instructional Systems Design (1.5 hrs)
Recognizing work-related musculoskeletal disorders and risk factors
Understanding the importance of varying work postures
Knowing how to rearrange the workstation to maximize the “comfort zone”,
Recognizing and understanding visual issues in the office environment and reducing visual discomfort
Understanding computing habits (rest breaks) and knowing how in to change work-rest patterns
Knowing how to use the various workspaces for individual and group work
Being aware of the company’s existing health and ergonomic programs
Training Objectives
Knowing how to obtain ergonomic accessories through the company’s programs
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Methods: Data Collection and Outcomes • Musculoskeletal symptoms:
• Scale Range: 0-10 anchored by 8 descriptors » No Pain/Discomfort, Just Noticeable Pain/Discomfort, Very
Little Pain/Discomfort, ….Extreme Pain/discomfort• Visual discomfort/pain rating:
– Yes/No response – 6 symptoms (blurry, difficulty focusing, itching, aching, sensitive, &
burning)• Performance Data:
• Quantity– Number of faxes completed daily
• Quality Control– Daily accuracy score
• Administered:– Baseline– Hourly; 7 sessions per day– 15 days
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Number of reported musculoskeletal discomfort for Top 7 significant body parts across all days
1 2 3 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 150
20
40
60
80
100
120
140
Minimally Trained Ergonomics Trained
Experimental Days
Sym
ptom
Rep
orts
Orientation Days
Number of Symptom Reports for 7 Significant Body Regions by Groups
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Top 7 Sig. Body Parts: Back lower neck right & left; Back upper neck left & right; Back left & right shoulder, Back lower back
All p<.05; Significant Tests Between Groups; Mann-Whitney & Median Tests
Reported Musculoskeletal Discomfort for Top 7 Body Parts all Daily Sessions
0 1 2 3 4 5 6 70
50
100
150
200
250
300
Minimally Trained Ergonomics Trained
Daily Sessions
Sym
ptom
Rep
orts
* p<.05 **p<.01
**
**
**
**
****
**
Number of Symptom Reports for 7 Significant Body Regions by Groups
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Visual Discomfort
050
100150200250300350
Num
ber o
f Rep
orts
Types of Eye Symptoms
Eye Symptoms Across all Days and Sessions
No Training
Ergonomic Training
*p<.05 for Blurry & Difficulty focusing
*
*
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Performance Results: Quantity and Quality
• No significant difference found between groups for the number of faxes completed
• Significant difference found between groups for accuracy across all 15 days – Trained group exhibited higher quality scores
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Behavioral changes: Varying computing postures of sitting and standing
Minimally Trained group did not stand at all during the experiment
1 2 3 4 5 6 7 8 9 10 11 12 13 14 150
20
40
60
80
100
120
140
Average Time Participants Stood per Day by Groups
Minimally Trained Ergonomic Trained
Day
Ave
rage
Tim
e (m
in)
Mandatory Standing ET Group
*
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Behavioral changes: Varying computing postures of sitting and standing
Minimally Trained group did not stand at all during the experiment
1 2 3 4 5 6 7 8 9 10 11 12 13 14 150
1
2
3
4
5
6
7
Number of Times Participants Stood per Day by GroupsMinimally Trained Ergonomic Trained
Day
Num
ber o
f Tim
es S
tood
per
Day
Mandatory Standing ET Group
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Research Findings Summary• Significantly greater reporting of musculoskeletal
symptoms for the Minimally group compared to the Trained group
• Display of musculoskeletal symptoms was minimal for the Trained group
• Workload was equal across groups; no significant difference between groups for number of faxes completed
• Performance accuracy (quality control) was significantly higher for the Trained group
• Significant changes in behaviors for the Trained group as reflected in standing more often and longer
• Greater sense of control over the work environment given the increase in ergonomic knowledge for the Trained group
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Take-away: Designing office ergonomics and safety programs• Systems-based approach
– Comprehensive training – On-going, long-term management commitment.
• Providing flexible work equipment, while important, is not sufficient
• Interesting relationship between MSDs and Visual symptoms– Leveraging the concept of environmental control
• allows employees to knowledgeably exert control over their physical environment
– Employees gain a higher sense of control over their workspace
• all levels of the company, part of a process that can have a positive impact on health, safety and performance
Treadmill Desks and Fitness Balls as Chairs
Sitting versus StandingSit/Stand WorkstationsWalking While Working
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Sitting versus Standing
• Sitting– Less fatiguing
(20% less energy)– Less reach (<15”)– Lower
strengths/exertable forces
– Visually intensive work
– Precision work
• Standing– More fatiguing– Longer reach
(>15”)– Higher strengths
/exertable forces– Frequent
downward forces (packing jobs)
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To Sit or To Stand
• Prolonged sitting associated with high incidence of back, neck and shoulder complaints. Alleged issues; weight gain, overall health, however…
• Prolonged standing associated with greater strain on circulatory system, legs and feet
• Prolonged sitting is bad, prolonged standing is bad
Ergonomic job design includes tasks that allow frequent changes in working posture, including standing, sitting, walking etc.
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Sitting to StandingBreak Research (Galinsky, Swanson, Sauter)• Take conventional 15 minute morning and
afternoon rest breaks. Do not work through breaks
• Also take supplementary 5 minute rest breaks every hour i.e. try to get up and get away from the computer 5 minutes every hour
• Micro-breaks better than long duration breaks• Change posture; vary positions between
sitting and standing• Vary tasks, computing and non-computing
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Project Participant Demographics by Group(Nico Pronk, Ph.D.,Marconi Conference, Holland, Michigan June 9-10, 2012)
Intervention Group• N = 24• Age = 38.4 yrs• Gender = 96% female• BMI = 22.8 kg/m2
• VO2max = 35.6 ml/kg/min (good/excellent)
• Physical activity = 474.6 min/wk• General health excellent or good:
79%• Job role
– Administrative support: 8.3%– Customer service: 12.5%– Account management: 12.5%– Health coach: 54.2%– Manager: 4.2%– Other: 8.3%
Comparison Group• N = 10• Age = 44.2 yrs• Gender = 80% female• BMI = 22.8 kg/m2
• VO2max = 34.0 ml/kg/min (excellent)
• Physical activity = 305.5 min/wk• General health excellent or
good: 100% • Job role
– Administrative support: --%– Customer service: --%– Account management: 10%– Health coach: 60%– Manager: 20%– Other: 10%
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Walking While Working-Treadmill Desks• Pros
– Reduce sedentariness in the workplace; potential to reduce employee obesity and health care costs (Thompson & Levine, 2011)
• Cons– 4 hours of training will be necessary to prevent a
significant drop in employee productivity (Thompson & Levine, 2011)
– Computer task performance was lower when walking. Active workstations may be less suitable for mouse-intensive work and susceptible users (Straker, Levine & Campbell, 2009).
– Treadmill walking caused a 6% to 11% decrease in measures of fine motor skills and math problem solving. (Bassett, et al., 2009)
The Walking AliveThe future of treadmill desks
By Susan Orlean
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Treadmill Desks and Safety
• MSD impact from performing tasks using these workstations is largely unknown; User limitations? Jobs where not appropriate?
• Potential negative health implications i.e. guidelines/medical clearance requirements before use. They are not for everyone.
• Falls; balance issues, medications, younger versus older workers. In the workplace we must consider everyone.
• Risk/reward i.e. “how much is too much”; day, week, month, year? Guidelines for use in the workplace not clear.
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• ANSI/HFES 100 and BIFMA G1-2013; most current approved office furniture ergo guidelines
• Until there are published studies and guidelines addressing these safety issues; treadmill desks should not be allowed in the workplace
Treadmill Desks and Safety
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Fitness Balls as Chairs• Fitness balls fail chair stability
requirements and test standards for office seating (ANSI/BIFMA X5.1)
• Fitness balls do not meet adjustability requirements for office seating as published in two known computer furniture industry guidelines (next slide)
• Fitness balls may not be appropriate for an aging workforce (WSJ, 2/28/07)
• Fitness balls offer no known physical benefit (McGill et al., 2006)
• They should not be allowed in the workplace
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Office Seating Design Standards
• Establish a process for selecting and obtaining furniture use with computers: a furniture standard– ANSI/HFES 100-2007, (in
revision)• Section 8.3.3. Seating
– BIFMA G1-2013• Section 7: The Work Chair
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Summary• Comprehensive ergonomics training (1.5 hrs) PLUS
reminders and practice period with an intervention such a chair, flexible workspace design, sit/stand workstation can decrease MSD and visual discomfort, increase work quality and overall well being (Robertson et al., 2008, 2009, 2013)
• Ergonomic guidelines for sitting and standing work and sit/stand workstations have been known for years. Build flexibility into sit/stand use through instructions that combine ergonomics (job and task design) and rest/recovery breaks.
• Walking is great but too much is unknown about safety of treadmill desks in workplaces. They should not be allowed until safety concerns have been addressed by researchers.
• Fitness balls as chairs do not belong in the workplace.