Standing at the Workplace Andrew J. Krum November 19, 2002.

Standing at the Standing at the WorkplaceWorkplace

Andrew J. KrumAndrew J. Krum

November 19, 2002November 19, 2002

Who cares about standing?Who cares about standing?

Retail CashiersRetail Cashiers

Ryan (1989): Australia, 90% of shiftRyan (1989): Australia, 90% of shift

High rate of standing fatigue symptomsHigh rate of standing fatigue symptoms

Lift-truck operatorsLift-truck operators

Growing population; 4 hour periodsGrowing population; 4 hour periods


HairdressersHairdressers

Assembly line workersAssembly line workers

Healthcare professionalsHealthcare professionals

Doctors, nurses, hursing home aidesDoctors, nurses, hursing home aides

Estryn-Behar (1990): 84% of women Estryn-Behar (1990): 84% of women

healthcare workers stand 4 hrs/dayhealthcare workers stand 4 hrs/day


Janitorial servicesJanitorial services

Many hard workers in our classrooms and Many hard workers in our classrooms and

officesoffices

Nemecek & Buchberger (1987): 80% of large-Nemecek & Buchberger (1987): 80% of large-

scale laundry workers’ days are standing scale laundry workers’ days are standing


Construction workersConstruction workers

Professors and teachersProfessors and teachers

Restaurant chefs and waitersRestaurant chefs and waiters

Laboratory techs and scientistsLaboratory techs and scientists

Farm laborersFarm laborers


DenmarkDenmark

40% and 12% of workers have back and feet 40% and 12% of workers have back and feet

problems (Orhede et all, 1992)problems (Orhede et all, 1992)

Groth et al. (1988): 1/3 work standing without Groth et al. (1988): 1/3 work standing without

physical strain physical strain


SwitzerlandSwitzerland

39% of workers experience back problems39% of workers experience back problems

23% experience leg problems23% experience leg problems

Buchberger 1993Buchberger 1993

What’s the cost ? What’s the cost ?

Standing has been proven to cause back, Standing has been proven to cause back,

leg, and foot pain; and leads to cumulative leg, and foot pain; and leads to cumulative

musculo-skeletal disorders (MSD’s)musculo-skeletal disorders (MSD’s)

Spengler (1986): 85% of peopleSpengler (1986): 85% of people

What’s the cost ? What’s the cost ?

Estimates for the cost of back injuries at Estimates for the cost of back injuries at

$11.1 Billion per year Webster & Snook $11.1 Billion per year Webster & Snook

(1990)(1990)

Cumulative effects unknownCumulative effects unknown

Insurance, loss productivity, absenteeism, Insurance, loss productivity, absenteeism,

and well-beingand well-being

Vast Market of SolutionsVast Market of Solutions

Floor matsFloor mats

Shoe insoles and solesShoe insoles and soles

They’re everywhereThey’re everywhere

Central theme: keep the body movingCentral theme: keep the body moving


Mat dimensions to considerMat dimensions to consider

ThicknessThickness

CompressibilityCompressibility

Surface frictionSurface friction

Don’t forget temperatureDon’t forget temperature


InsolesInsoles

Provide mobility and cushioningProvide mobility and cushioning

Floor mats that follow the workerFloor mats that follow the worker

Floor MatsFloor Mats

InsolesInsoles

Do these solutions work?Do these solutions work?

Where is the pain?Where is the pain?

FeetFeet

LegsLegs

Lower backLower back

What’s the cause?What’s the cause?

OedemaOedema

Joint inflammationJoint inflammation

Muscle fatigueMuscle fatigue

Objective MeasuresObjective Measures

Foot volume: water displacement, chalk on Foot volume: water displacement, chalk on

paper markingspaper markings

Skin temperatures: circulationSkin temperatures: circulation

Heart-rate: standing versus sittingHeart-rate: standing versus sitting


Electromyographic (EMG) muscle Electromyographic (EMG) muscle

responseresponse

Marras (1994) power spectrums reliableMarras (1994) power spectrums reliable

Lower median frequency = higher fatigueLower median frequency = higher fatigue


Pain-Pressure Threshold (PPT)Pain-Pressure Threshold (PPT)

Pressure points on base of footPressure points on base of foot

Threshold increases as pain increasesThreshold increases as pain increases

Internal spinal fixator (Rohlmann et al., 2001)Internal spinal fixator (Rohlmann et al., 2001)

Difficult to collect dataDifficult to collect data

Focus on back in motionFocus on back in motion

Subjective MeasuresSubjective Measures

Participant ratings of pain and comfort Participant ratings of pain and comfort

levels are easy to applylevels are easy to apply

Can be unreliable; placebo condition Can be unreliable; placebo condition

neededneeded

King (2002); requested precise ratings; King (2002); requested precise ratings;

successfully distinguished conditions successfully distinguished conditions

Advice for StandersAdvice for Standers

Keep mobileKeep mobile

Wear comfortable shoesWear comfortable shoes

Floor mats help the backFloor mats help the back

Take breaks and change positionsTake breaks and change positions

Advice for StandersAdvice for Standers

Elevating one foot Elevating one foot

helpshelps

Research is Research is

promising; need to promising; need to

further investigatefurther investigate

What’s this mean for HF ?What’s this mean for HF ?

Need to learn moreNeed to learn more

ExperimentalExperimental

Collaboration neededCollaboration needed

Determine physical causes and reliable measuresDetermine physical causes and reliable measures

IndustrialIndustrial

Particular work environmental standardsParticular work environmental standards

Lifestyle information about participantsLifestyle information about participants

Thank YouThank You

Standing at the Workplace Andrew J. Krum November 19, 2002.

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