The Ups and Downs of Sit/Stand Workstations: An Observational Case Study

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Copyright © 2016 BSI. All rights reserved.
Ups and Downs of Sit/Stand
Workstations: An Observational
Assessment / Case Study
Paula Lewis, M.S., CPE
Principal Consultant

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Agenda
• Quick review of health effects associated with prolong sitting and standing
• Review of past pilot study
• High-Tech call center case study discussion
• Review results of case study

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What Are We Hearing?
• Prolong Sitting
• Inactivity causes 10% of colon cancer and breast cancer
• One study found: Adults who sat for >11 hours had a 40% increased risk of
dying in the next three years than those who sat for < 4 hours a day
• Disrupts metabolic functioning
• A 2010 editorial in the British Journal of Sports Medicine found that those who sit
for prolonged periods have a higher risk of disease
• Researchers at the American Cancer Society found that even if you exercise
nearly every day, those health benefits can be undone if you spend the rest of
your time on your butt

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• Prolong Sitting
• Scientists at the University of Missouri have found that the act of sitting seems to
shut off the circulation of a fat-absorbing enzyme called lipase
• A study published by the American Journal of Epidemiology showed that sitting
for long stretches, more than six hours a day, can make someone at least 18%
more likely to die from diabetes, heart disease and obesity than those sitting less
than three hours a day

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• Prolong Sitting
• Scientists at the Pennington Biomedical Research Center in Louisiana analyzed the
lifestyles of more than 17,000 men and women over about 13 years
̵ People who sit for most of the day are 54% more likely to die of heart attacks
• Prolonged periods of inactivity—best described as sitting a lot—is unhealthy.
Deadly, even

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What Are We NOT Hearing?
• Health Effects from Prolong Standing
• Heart and circulatory problems and pregnancy difficulties
• Chronic heart and circulatory disorders are linked to prolonged standing at work.
• Prolonged time in an upright posture at work may cause hypertension
comparable to 20 years of aging
• Increase vascular pressure in the lower extremities
̵ Increase in varicose veins

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What Are We NOT Hearing?
• Health Effects from Prolong Standing
• Joint compression – pushes out synovial fluid
which naturally lubricates and cushions the joints
• Postural muscle fatigue - It is more tiring
• Poor circulation and swelling in the feet and legs
• Foot problems
̵ Plantar mid-foot sagging due to improper foot wear

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Other Conditions
• Conditions that can effect comfort and health
• Shorten leg height
• Flat footedness
• Scoliosis
• Lower pelvic cross
• Lateral pelvic shift
• Obesity
• Biomechanical or functional challenges

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Previous Pilot
• Who:
• High Tech Company in the San Francisco Bay
Area
• How:
• Two ergonomist
• Conducted observation survey and interview
• How Many:
• Conducted 58 observations

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Results
• Work Space Observations (58 total)
• Sit / stand work surfaces were the standard
• Everyone had crank adjustable tables (with the ability to go from sitting to
standing)
• 76% of the individuals were observed sitting
̵ Most of the individuals were sitting in tall stools (86%)
̵ Most of the individuals had tall foot rest (95%)

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Brief Summary
• Work Environment
• Majority of the keyboard heights were too high
• People rarely took time to readjust their work surfaces
• Posture
• Slightly better wrist posture when sitting
• No real difference in shoulder posture except with a reduction in shoulder
shrugging when standing
• Improved neck posture when standing
• Reduction in back flexion and rotation when standing

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Pilot Study: Conclusion
• A majority of people still prefer to sit and work
• On an average people stood 25% of the day
• More and more people are requesting sit/stand work stations for their perceived
“health benefits”
• If a system is hard to adjust, people are less likely to adjust it

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High-Tech Call Center: Case Study
• Background
• Who:
̵ Call Center of ~500 employee
̵ High-Tech company in CA
• Majority of the individuals have electric sit/stand work stations
• Only general ergonomic training is provided
̵ Nothing specific to sit/stand work stations
̵ Intranet has information on proper adjustments
• Ergonomic evaluations are provided to everyone who would like one and all new
hires

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Case Study
• Tasks include:
• Answering phone and speaking to customers
• Taking notes
• Looking up information on the computers
• Working with customers with either purchasing products or technical support

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Method
• How
• Single ergonomist over a two day period
• Observational assessment was conducted
̵ Snap shot observation
̵ Individuals were observed once over a two day period
̵ Information gathered
̵ Background
̵ Location
̵ Time of day
̵ Shift

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Method
Workspace Observations
• Configuration (sitting/standing)
• Type of desk
• Keyboard tray
• Foot rest
• Type of chair
• # of monitors
• Size of monitors
• Proper keyboarding height
• Proper monitor height
Behavioral Observations
• Wrist posture during mouse usage
• Wrist posture during keyboarding
• Shoulder posture
• Neck posture
• Posture in their chair
• Back posture
• Contact stress
Observational assessment was broken into two main categories:

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Method
• Definition of Awkward Postures
• Awkward wrist postures. Flexion (>10 degrees), extension (>15 degrees)
• Awkward shoulder posture (flexion, abduction, and rotation greater than 20
degrees)
• Shoulder shrugging
• Awkward neck postures (Extension greater than 5 degrees and flexion &
rotation greater than 20 degrees)
• Awkward back postures greater than 20 degrees flexion
• Back twisting greater than 20 degrees flexion

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Challenges / Limitations
• No statistical analysis was done
• Raw numbers were calculated and results were based upon percentage
• We were unable to take pictures
• There were multiple shifts

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Work Environment
• What does the work environment look like?
• 98% of the population had standard chairs
• 10% of the population had keyboard trays
̵ 13% of the fixed desks
̵ 9% of electric sit/stand
• < 10% had foot rest
• Almost 50% had 2 or more monitors
• Everyone had telephone headsets

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Results
• Work Environment
• Employees had either fixed height workstations or electric sit/stand
̵ 76% of the 340 observed were electric sit/stand
0
50
100
150
200
250
300
350
400
Fix electric Grand Total

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Results
• Only 7% of the 340 observations - employees were
observed standing
• Electric sit/stands workstations
• 65% were not correctly adjust for proper
keyboarding height
• 56% did not have correct monitor heights

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Results: Keyboard Height
Fixed height work surfaces had a higher percentage of correct keyboarding height
0%
10%
20%
30%
40%
50%
60%
70%
Correct Height Too high Too Low
electric
Fixed

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Results
Working Position by
Time of Day
Observed
Sitting
Observed
Standing Standing % Grand Total
8:00 - 10:30am 72 1 1% 73
10:31am - 1:00pm 84 11 12% 95
1:01pm - 3:00pm 92 9 9% 101
3:01pm - 5:00pm 68 3 4% 71
Grand Total 316 24 7% 340

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Posture & Type of Furniture
Type of
furniture
Shoulder
Shrugging
Back
Flexion
Non Neutral
Neck
Postures
Neck
Extension
Wrist
Extension -
Mouse usage
Wrist
Extension -
Keyboard
Usage
Electric
Sit/Stand
53% 49% 58% 44% 37% 23%
Fixed Height
Table
39% 57% 61% 39% 42% 28%
Other postures were not significantly affected by the type of furniture

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Posture While Sitting and Standing
Position During
Work
Shoulder
Shrugging
Back
Flexion
Non
Neutral
Neck
Postures
Neck
Extension
Wrist
extension -
Mouse usage
Wrist extension
- Keyboard
Usage
Sitting 51% 53% 60% 45% 37% 24%
Standing 29% 21% 29% 17% 54% 25%
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In almost every case, posture was improved when standing
* 316 sitting observations
* 24 standing observations

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Summary
• Compared to the pilot study with hand crank tables – less people were observed
standing with the electric adjustable tables
• Ease of adjustability did not improve standing rates
• Standing improves posture over sitting
• When given the freedom people tend to adjust their work stations too high

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Conclusion
• We can all agree that movement is good
• Neither extreme is the answer
• The best position is the next position
• We differ on how to get there
• Some people will be able to do it by sitting a majority of the day and taking more
micro breaks
• Some will do it by standing and sitting through the day

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Conclusion
• There’s so much going on from a physical, postural, and motor control that as
ergonomist we don’t have visibility to
• Changing of the work station doesn’t necessarily change some of these core
issues
• To battle the health effects of prolong sitting – we still need to get people to stand
even after they have the equipment

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Conclusion
• Don’t expect sit/stand work stations to “fix” all your
ergonomic risks
• Poor posture is still observed in the use of standing
work stations
• Build into your company culture other opportunities
to stand

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Conclusion
• Training and motivation is key to the “use” and
“proper use” of sit/stand work station
• Even with electric sit/stand work stations that
are easily adjustable – people need to be trained
and motivate

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Conclusion
• Many factors effect employee wellness
• Standing work stations alone won’t guarantee
a healthier employee or neutral posture
• There may be a reduction in back discomfort
and posture but it is only one piece of the
overall puzzle

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Additional Research
• Perform some statistical analysis for significance
• Consider conducting observations over time (sample individuals multiple times a day)

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Questions? Thank You!
Paula Lewis, M.S., CPE
paula.lewis@bsigroup.com

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