Sitting Disease: New Evidence and Cost

Effective Strategies for a Healthier Workplace

Josh Kerst, CPE, CIE

Principal Ergonomist, Mayline - Safco

The Value You’ll Get Today – 4C’s

Data that Frames the Problem

Potential Health & Performance Issues

New Alternatives for Active Movement

Case Study Applications (ROI)

Changing Workplace

Dynamics

1

Paul Taylor and the Pew Research Center, The Next America, 2014, BBS Public Affairs, NY, NY.

Multigenerational Workforce Drivers• Labor shortages (not surplus)

• Knowledge base (not physical labor)

• Team dynamics (not hierarchy)

• Technology

• Globalization

The first true digital natives

LIVING MORE SEDENTARY LIVES

Change for the Worse - Sedentary jobs have risen 83% since 1960 and now account for 43%of all U.S. jobs

Chau JY, van der Ploeg HP, Merom D, Chey T, Bauman AE. Cross-sectional associations between occupational and

leisure-time sitting, physical activity and obesity in working adults. Prev Med. 2012;54(3-4):195-200.

How do you feel when you

sit all day?

Hazards of Prolonged

Sitting

New Evidence on Sedentary Risks

• The Maastricht Study - An extra hour of sedentary time was associated with a 22% increased odds for type 2 diabetes and a 39% increased odds for the metabolic syndrome

• Results suggest that sedentary behavior may play a significant role in the development and prevention of type 2 diabetes

van der Berg, J.D., Stehouwer, C.D.A., Bosma, H. et al. Diabetologia (2016) 59: 709.

doi:10.1007/s00125-015-3861-8

The Maastricht Study.

Obesity Trends Among U.S. Adults

Obesity Epidemic

• Obesity has risen due to highly accessible inexpensive energy-dense foods and concurrent physical inactivity.

• Two-thirds of the USA population are overweight (BMI >25kg/m2) and one-third are obese (BMI>30kg/m2),

• Problem attributed to a persistent positive energy balance as small as 100kcal/day.

Swinburn BA, Caterson I, Seidall JC, James WPT. Diet, nutrition and the prevention of

excess weight gain and obesity. Public Health Nutrition. 2004;7(1A):123-146.

New Global Evidence on Sedentary Risks

• Research has repeatedly linked sedentary behavior with increased risk of obesity, cardiovascular diseases, diabetes, and more.

• A study published in the American Journal of Preventive Medicine (August 16, 2016) estimated that prolonged sitting is responsible for 430,000 all-cause deaths over 54 countries, and that sedentary behavior is a leading risk factor for mortality, second only to smoking.

All-Cause Mortality Attributable to Sitting Time

Rezende, Leandro Fórnias Machado et al.

American Journal of Preventive Medicine , August 2016 Volume 51 , Issue 2 , 253 - 26.

New Evidence on Sedentary Risks

• The Maastricht Study - An extra hour of sedentary time was associated with a 22% increased odds for type 2 diabetes and a 39% increased odds for the metabolic syndrome

• Results suggest that sedentary behavior may play a significant role in the development and prevention of type 2 diabetes

van der Berg, J.D., Stehouwer, C.D.A., Bosma, H. et al. Diabetologia (2016) 59: 709. doi:10.1007/s00125-015-3861-8The Maastricht Study.

New Evidence on Sedentary Risks

van der Berg, J.D., Stehouwer, C.D.A., Bosma, H. et al. Diabetologia (2016) 59: 709. doi:10.1007/s00125-015-3861-8The Maastricht Study.

Newton’s 1st Law

It’s fine if you want to sit. Just so it's an informed

decision

• Beware of the risks for Workout – Sit Cycle

– Just like a salad doesn’t undo a cigarette

– Sit less, move more

Deborah Rohm Young et. Al Sedentary Behavior and Cardiovascular Morbidity and Mortality. A Science Advisory From

the American Heart Association, Circulation, August 2016

Basal Metabolic Rate Declines with Age

AGE (IN YEARS)

BA

SE M

ETA

BO

LIC

RA

TE(K

CA

L/KG

HR

)

Decrease in basal metabolic rate with age, an indication of the decline in energy utilization and production

Brownson RC, Boehmer TK, Luke DA. Declining rates of physical activity in the

United States: what are the contributors? Annu Rev Public Health. 2005;26:421-

43.

More Caloric Intake + Less Exercise = Weight Gain

Marc Hamilton, Ph.D. found that sitting shuts down expression of lipoprotein lipase (LPL) in skeletal muscle, preventing muscle cells from importing fat.

Prolonged Sitting and Metabolic Processes

Zderic TW, Hamilton MT. Physical inactivity amplifies the sensitivity of skeletal muscle to

the lipid-induced downregulation of lipoprotein lipase activity. J Appl Physiol.

2006;100:249–257.

Prolonged Sitting and Back Pain

Traditional Sitting is Under Pressure

“Today the AMA adopted policy recognizing the potential risks of prolonged sitting and encouraging employers, employees and others to make available alternatives to sitting… Prolonged sitting, particularly in work settings, can cause health problems and offering employees alternatives to sitting all day will help create a healthier workforce.”

– June 18, 2013

Policy H-440.843 Health Risks of Sitting

The Evolution of Sedentary Time

1. Frame the Problem*Benden, M. Sedentary Behaviors, Outcomes, and Potential Interventions. Is Obesity an Occupational Disease? Applied Ergonomics.

March 16, 2017 - Government of Canada invests in program to

combat sedentary behavior in the workplace. Sit Kicker is a

nationwide initiative focused on encouraging Canadians who

work in office settings to reduce sedentary behavior and "kick

the sit" out of their work habits

Competition for

Top Talent

2

Competition for Talent

• The average tenure for employees, regardless of age is?

www.bls.gov/news.release/tenure.nr0.htm updated December 22, 2016

4.2 Yrs. (Nov, 2016)

Was 4.6 yrs. (Jan, 2014)

Fast Forward 2030: The Future of Work and the Workplace – October 2014

“Experts, leaders and youths all expressed the need for

the workplaces in 2030 to support overall wellbeing.

These demands will impact building and workplace

design. An industry of wellness in buildings is emerging

– with a broad and holistic perspective.”

Focus

Collaboration

Social

Learning

FLOOR PLAN EXAMPLE

Informal interactions that foster relationships among coworkers.

Allows workers to concentrate on a specific task without distractions.

Opportunities for knowledge building, or exploring ways to improve on what’s already happening.

Bringing individuals together to achieve one goal.

Upright SOLUTIONS

Comfort + Active

Movement = Ergonomics 2.0

3

THESCIENCE

Research: Sedentary Time Risk• Prolonged sedentary time was independently associated

with deleterious health outcomes regardless of physical activity.

32Healy GN, Dunstan DW, Salmon J, et al. Television time and continuous metabolic risk in physically active adults. Med Sci

Sports Exerc. 2008;40(4):639–45.

Active Couch Potato

• A person who sits for up to 9-10 hours of their waking day and yet still goes to the gym and performs moderate to vigorous exercise for at least one hour per day.

Healy GN, Dunstan DW, Salmon J, et al. Television time and continuous metabolic risk in physically active adults. Med Sci

Sports Exerc. 2008;40(4):639–45.

If you're 60 and older, every additional hour a day you spend sitting is linked to 50% greater risk of being disabled -- regardless of how much moderate exercise you get.

Beware the Workout – Sit Cycle

*Source - Northwestern University;”Dangers of sitting”, 2014

NEAT• Non

• Exercise

• Activity

• Thermogenesis

37

Obesity Epidemic

Swinburn BA, Caterson I, Seidall JC, James WPT. Diet, nutrition and the prevention of

excess weight gain and obesity. Public Health Nutrition. 2004;7(1A):123-146.

STANDING MATH

• Heart Rate = on average 10 beats per minute higher • Equals a difference of .7 of a calorie per minute• That’s up to about 50 calories/hour• If you stand for 3 hours a day for 5 days, it’s around 750 calorie

s • Over the course of a year, adds up to about 30,000 extra calories• You burn about 3,000 calories to lose a pound of fat

THAT IS 10 POUNDS A YEAR!

Sit-Stand Desks – An Incomplete Solution

• How long is someone able to stand up? Answer: Not long

• Break-in time needed

• Researchers have reported that only between 18% to 20% of workers use standing desk features after 6 weeks of use

• Promotes hunchback & varicose veins

• Creates tightness in hip flexors

39Wilks S, Mortimer M, Nylen P. The introduction of sit-stand

worktables: Aspects of attitudes, compliance and satisfaction.

Appl Ergon. 2006;37:359–365.

Prolonged Standing Risks

• Prolonged standing at work has been shown to be associated with a number of potentially serious health outcomes– musculoskeletal disorders, chronic venous insufficiency,

and carotid atherosclerosis have been identified as common health problems associated with prolonged standing

• Certain interventions are effective in reducing the hazards associated with prolonged standing

• This includes floor mats, footrails, & semi-standing seats

40Waters TR, Dick RB, Evidence of health risks associated with

prolonged standing at work and intervention effectiveness Jan

Rehabil Nurs. 2015 May-Jun;40(3):148-65

41

Objective

• Evaluate the physiological and

biomechanical differences influenced by

different office working postures (seated,

perching, and standing)

Spine Research Institute

42

Motion

• Postural transitions and joint kinematics

Muscle Activity

• Muscle forces and shared activation patterns

Spinal Loads

• Personalized model dependent on

anthropometry, muscle activity, and motion

Discomfort

• Heart rate variability

• Subjective ratings of discomfort

Spine Research Institute

Approach

43

Postural

Transitions

• Movement was generally

found to be higher during

perching and standing for

all parts of the body

• Most of the motions were

found in two directions:

forward/back (Z) and side

to side (X)

Spine Research Institute

Results

44

Spine Research Institute

Hip Motion (# of Shifts > 1cm / min)

X = Lateral

Y = Superior/Inferior

Z = Anterior/Posterior

45

Peak CI

Condition*Time (p = 0.0012)

Coactivation (Lumbar)

46

Spinal Loads

• Coactivation patterns

may be associated to

the compressive and

shear loads of the spine

Spine Research Institute

Results

47

Discomfort –

Heart Rate Variability

• Frequency and time

responses of the variability

of the heart rate may be

linked to discomfort

• A higher LF/HF ratio may

suggest higher discomfort

Spine Research Institute

Results

Cost Competitive

Options

4

Your Best Posture is the Next

One

Best Movement Ratios

Best Movement Times

TRY A WALKIN

GMEETIN

G

Create Flexible “Team Space”• Organizations are restructuring for several reasons, including the rise of

millennial and gen Z workers who grew up playing team sports and have the same expectations at the office

• Cisco was one of the first companies to embrace this trend, creating "Team Space," a platform that delivers intelligence on how teams can work best to win together

• Small teams thus could have an Integrated Workforce Experience (IWE) presence without having to maintain the whole community— much like a storefront that showcases the merchandise of a shopkeeper while the mall owner provides the overall infrastructure, security, and the maps to locate the shop.

• A Team Space menu was added to the GMCC IWE community to allow users to easily locate the various related communities and Team Spaces

• Government Affairs: ~$12,000 annual savings content publishing costs

• Advertising and Digital Marketing: developer time saved at 4 hours or $500 per week for a total savings of $26,000 per year

• Analyst Relations: ~ $10,000 savings expected in content publishing costs

Supporting Research

Get Up, Stand Up: The Effects of a

Non-Sedentary Workspace on

Information Elaboration and Group

Performance –Washington University

(2015)

▪Collaborative team-work in

creative problem-solving projects

▪Increase in group engagement,

decrease in group idea

territoriality

▪Better information elaboration

and better group performance

▪"Seeing that the physical space

in which a group works can alter

how people think about their work

and how they relate with one

another was very exciting…"

Supporting Research

The Value You’ll Get Today – 4C’s

Data that Frames the Problem

Potential Health & Performance Issues

New Alternatives for Active Movement

Case Study Applications (ROI)

Josh Kerst, CPE, CIE734-707-3808

joshkerst@safcoproducts.com

Questions?

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Annu Rev Public Health. 2005;26:421-43.

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leisure-time sitting, physical activity and obesity in working adults. Prev Med. 2012;54(3-4):195-200.

3. Owen N, Healy GN, Matthews CE, Dunstan DW.Too much sitting: the population health science of sedentary behavior.

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3. Changes in Workplace Design

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3. Changes in Workplace Design