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NIOSH Takes a Stand

Posted on by L. Casey Chosewood, MD and Constance C. Franklin, MPA

Over the past year, NIOSH and its Total Worker HealthTM Program have been traveling the country sharing the evidence and benefits of comprehensively integrating health protection with health promotion, including workplace programs that encourage physical activity, weight loss and stress management.   Recently, we launched an internal NIOSH pilot program  to explore the use of sit and stand work stations as part of a workplace health and wellbeing initiative to reduce sedentary work in our workplace.

The pilot program was inspired by emerging research on the impact of sedentary work (Van der Ploe, Chey, et al, 2012) on employee health and by new employer initiatives that aim to decrease sedentary work, such as VHA’s Wellness Program highlighted in a recent NIOSH Science Blog post.  A sit-stand workstation allows the user to intermittently sit or stand while working on the computer, participating in a conference call, or performing other work.  The customizable workstation allows users to easily transition between a seated and standing work position multiple times throughout the day.

Through the pilot program, we’ll gauge satisfaction with sit-stand workstations, monitor and support our employees as they try out this new intervention, and hopefully improve the health of those who choose to participate.  Given that the benefits and risks of sit-stand workstations remain to be determined, we are proceeding cautiously.  The devices are only just beginning to be widely used and while there are many possible benefits, there may also be drawbacks such as risks from excessive standing as well as possible  ergonomic issues that that may arise with the use of any new piece of equipment.  Some of the possible health benefits that have been reported with regular use of sit-stand workstations are listed below.

  • Standing more while at work decreases the amount of time spent in sedentary work
  • Standing more helps relieve pressure on the lower back, buttocks and legs, and may help reduce compression of the spine arising from long periods of sitting
  • Standing more may improve energy levels
  •  Standing more frequently may improve cognition
  • Standing may increase circulation and lead to better blood flow to the brain and other organs
  • Standing more burns more calories than sitting
  • Standing more may assist with energy balance and aid in weight management
  • Standing more may improve bone density over time
  • Standing more may promote better sleep

The program is underway with 34 NIOSH volunteers in Atlanta, Cincinnati, Washington, D.C., Denver, Morgantown and Pittsburgh selected for the program.  The participants agreed to regularly use the units, complete user satisfaction and other surveys, participate in focus groups, and share their experiences with others.  Enthusiasm is high and initial reports are positive.   Here is what some of the users are saying:

“I have had a somewhat chronic back problem (sciatica) that is exacerbated by sitting for long periods of time. I was very interested when I saw one of the sit-stand keyboard/monitor units and I have been fortunate to be using one now for over two weeks.   It took a few days before I began to regulate the sitting and standing in a balanced way.  At first I actually was standing too much and my legs bothered me a bit (I need more arch support in my shoes I think).  However I am now seeing noticeable benefits both at work and in the morning when I first get out of bed.  I feel more energetic and also have noticed no back pain whatsoever.   I still need to work out a couple of things in terms of logistics such as taking phone calls when I am standing but overall it has been  completely positive.  My work involves a lot of time on the keyboard and I tend to fixate and did not stretch/stand nearly enough and that likely explains the high degree of benefit that I am experiencing.”

“I have had the standing workstation since October 30th and I LOVE it!  As a matter of fact if they decide to take it away, they may need to bring security with them. 😉  I was diagnosed with hypersomnia which includes recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep. This is different from feeling tired due to lack of or interrupted sleep at night.  My job is almost all sitting in front of my computer.  Since I have had this workstation, I have had maybe one day when I felt as tired as I used to be and I realized that I had been sitting too long. I stood up and it was much better.  I don’t stand all the time, but probably 5-6 hours of the day.  I find that if I am able to move around more, I have less trouble with the hypersomnia.   Because I am standing so much, I would suggest having shoes for standing (makes a big difference) and get a standing mat ( I have ordered one). At first my feet and back were a little sore since I wearing shoes that were not good for standing and  was not using a mat. “

“I’ve really enjoyed it.  I feel like it has helped with some minor back issues I go thru from time to time.  I would like to eventually get the tray because I think I would even use the station more.  It’s nice to have the option of standing because it can be tiring to sit all day.  Even though the screen will move up and down, there have been several occasions that it would have been helpful if it moved side-ways, which it does not.  All and all, I do like it.”

“I’ve really enjoyed the new workstation. I have been using the sit-stand workstation for about three months. I have lower back and hip pain and being able to easily switch between sitting and standing helps reduce some of the pain I experience from sitting all day!”

You may see comments from the study volunteers in this blog.  They will identify themselves as a NIOSH sit-stand user.  The pilot program will last 12 months and we will update you during the year with additional information.  We would love to hear from others who use these workstations or offer them in their workplace.

L. Casey Chosewood, MD and  Constance C. Franklin, MPA

Dr. Chosewood is the Senior Medical Officer for Total Worker HealthTM at NIOSH

Ms. Franklin is a Public Health Analyst at NIOSH

Posted on by L. Casey Chosewood, MD and Constance C. Franklin, MPA

61 comments on “NIOSH Takes a Stand”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    I am in 100% agreement with the sit stand work strategy, also don’t forget it also increases productivity in an employee from all the increased energy level.

    Excellent Posting! Thanks for sharing what NIOSH is doing to demonstrate Total Worker Health in its own workplace culture.

    Readers may also want to check out a recent article on this topic in the New York Times “Taking a Stand for Office Ergonomics” http://www.nytimes.com/2012/12/02/business/stand-up-desks-gaining-favor-in-the-workplace.html.

    The article reiterates the health implications for workers in sedentary work environments, even for those workers at work who are physically active outside of work. Also, it touches on how history is repeating itself in the information age where sitting was once considered “slacking” at work. Additionally, it mentions how creative capitalism is moving us towards better health.

    Where can I find a table top unit for existing desks like the one shown in the picture? Thanks for any direction you can provide!

    There are many designs available. An internet search for “sit-stand workstation” should provide a variety of options.

    Co-worker found this site while trying to locate a sit -stand work station.

    [http://www.ergodesktop.com/products]

    we are using this unit for employees [http://www.ergodesktop.com/content/kangaroo-0]
    – have had a lot of success with it so far

    The health of employees is important to the performance of a company.
    Alternate work standing and sitting all day is essential for good health.
    I enjoyed the article. Keep writing.
    Greetings.
    Chris Tiffany Lámpara

    I am a proponent of sit/stand workstations. However, in my experience users often do not adjust the keyboard to an appropriate height when standing. When moving from the sitting to standing position, the monitor and keyboard must be adjusted independently. When standing, the keyboard must often be raised to a higher level relative to the monitor to avoid wrist extension. If not, wrist extension will result, as evidenced by the photo in this blog.

    Thanks very much for this insightful contribution. As with the use of any piece of equipment, ergonomic considerations are of vital importance to the health and safety of users and to long-term success. We strongly favor an individualized approach to optimizing the workspace set-up for each user while following general ergonomic principles. This comment correctly notes that maintaining a straight wrist is generally best, and that severe wrist extension places a user at greater risk. NIOSH endorses ergonomic practices that allow the user to work in the most comfortable work posture. NIOSH also recognizes that individuals differ and may have different preferences and requirements for their workstation set up. Maintaining vigilance for any concerns that arise during use and intervening early to address them are also critical.

    very interesting post…
    I think this is a really useful program for workers who spend a lot of time to work in the front of computer

    It seems very interesting. However, there are some thing to be carefull with.
    1 – The possibility to have one’s papers or books used with the computer on the device
    2 – The possibliity to adjust the screen hight even for people with presbyt correcting lenses

    Thanks for reminding us the importance of ergonomic considerations when introducing any new device, furniture or equipment in the workplace. It is critical that each individual’s needs, patterns of use, and underlying issues are accounted for in this process. Fortunately, a variety of models and accessories are available to allow for optimal selection and adjustments so that the large majority of users can have a successful experience. Attachable work surfaces can also help with appropriate document placement and proximity to phones and other devices.

    When moving from the sitting to standing position, the monitor and keyboard must be adjusted independently.
    Thanks for the post “NIOSH Takes a Stand”.

    A nice post and really a good program for the workers to maintaining the health of their body conditions of the workers well planner out thing from NIOSH

    I am currently working with a client who has employees who have inquired about sit/stand workstations or standing workstations. The client is well aware of the health benefits but are concerned about any risks and liabilities involved with allowing office workers to stand. They are specifically worried about an increase in worker’s comp claims around foot or knee problems. What is the current evidence surrounding this? And, what is the preferred practice in office-based worksites? What is the liability of the employer? Should employees sign a waiver? Thanks in advance.

    Thanks for your comments and question. While any intervention has the potential to cause some level of risk, steps can be taken to minimize these while maximizing possible gains. Our NIOSH sit/stand pilot team is not aware of any research showing an increase in injury or in compensation claims related to the voluntary and correct use of sit/stand workstations. However, we do believe that the stations provide many possible benefits. From a human engineering and industrial psychology perspective, these designs give employees more control over their working posture – and the ability to transition easily and quickly between sitting and standing as desired. Providing this choice is an essential part of their success. For most of us, standing upright is our most basic, normal posture – and often more comfortable than sitting (especially for long periods of time). The stations offer the ability to transition between sitting and standing, frequently throughout the day, at will, all while remaining productive on the job.

    While injury or illness can arise from the incorrect use (or overuse) of any type of equipment, important steps can be taken to minimize these risks. With any new interventions, careful planning, orientation and training are paramount. Assure use of the sit/stand workstations is fully voluntary; let participants completely control the frequency and duration of their standing/sitting intervals, and ensure that good ergonomic practices are followed when workers are sitting or standing. Providing assistance with adjustments of the units and offering cushioning on floor surfaces when standing for prolonged periods may also be beneficial.

    I am a proponent of sit/stand workstations. However, in my experience users often do not adjust the keyboard to an appropriate height when standing. When moving from the sitting to standing position, the monitor and keyboard must be adjusted independently. When standing, the keyboard must often be raised to a higher level relative to the monitor to avoid wrist extension. If not, wrist extension will result, as evidenced by the photo in this blog.

    Sit-stand work stations will reduce the stress and increase the physical activity. Adjust your platform , keyboard and desktop according to your standing posture.

    The article reiterates the health implications for workers in sedentary work environments, even for those workers at work who are physically active outside of work. Also, it touches on how history is repeating itself in the information age where sitting was once considered “slacking” at work. Additionally, it mentions how creative capitalism is moving us towards better health.

    I imagined that by standing more frequently, It would be bad for the lower part of the back. I have some back problems and if I keep standing or walking for a long time, my lower back starts to hurt
    Clair

    It seems very interesting. However, there are some thing to be carefull with.
    1 – The possibility to have one’s papers or books used with the computer on the device
    2 – The possibliity to adjust the screen hight even for people with presbyt correcting lenses

    My boss learned this from yoga class, but we implement it at the office — for 5-10 minutes a day we sit against a wall on our backs, legs pointed towards the ceiling (yes, all five employees do it together!) and it is supposed to improve circulation, blood flow to extremities, and blood flow to the brain. We do our pre-lunch emailing upside down… not sure if it works but it sure looks odd!
    Nathan J. Beckham

    Sitting all day long does cause me back pain. The posture is very important and having a 5-10 minutes stand really helps out! This program is very promising!

    Great work done by NIOSH. “The customizable workstation allows users to easily transition between a seated and standing work position multiple times throughout the day.” is really interesting it gives freedom to those worker who continuously work multiple hours in sitting mode.

    Sharad Jain

    Yeah I work a lot at the computer and this is really great news. I think getting up and doing a few things would be good as I now am getting back pain from setting to long.

    Coby

    Excellent work of NIOSH to investigate this phenomenon, the truth is that it is very interesting I have worked extensively with the subject of welfare of women and one of the things that makes women have a flabby belly and buttocks is just sitting flat all looks excellent on me that these issues are addressed in interesting places like this.

    Monica

    Thanks so much for of these insights contribute. As the case with using any pieces of equipment, and comfortable the considerations is vital importance to the health and integrity the users term success. Strongly support this individualized approach to Making the Most of working space set-up for every user whereas the next on ergonomic principles in general. It is noted This review It is true that maintaining carpal straight overall the best, and that extend the Wristwatches puts the stiff user most at risk. NIOSH Endorses the the comfortable practices of which allows the user to work on much more comfortable working attitude. NIOSH too admits that individuals differ and perhaps have a various Favorites and the requirements to assign as many their workstation. Maintaining vigilant for any concerns you arising during usage early intervention to address it is also critical.

    I worked in a [name removed]shop for over a year and they had a ‘standing only’ policy. At the end of an 8 hour shift my back and feet were on fire.
    I often used [name remove] for pain relief when my shift was over. I do not recommend standing at a desk. Because I have a bad back I found standing for long periods extremely uncomfortable.

    It seems very interesting. It is really good to find more information about that. It would be bad for the lower part of the back. I like your post.

    Great work done by NIOSH. It really good to find more informations about that.I enjoyed the article. Thanks for sharing it.

    This sounds like a great scheme. There is a fair bit of equipment that can cater for employees that have to either sit or stand for the majority of their day. From my experience standing at work can be stressful on the body and i’ve always bought anti fatigue mats which help greatly. i would recommend these to all those that do have to stand for excessive periods of time with little movement.

    @John, this might be good for some and others may find this stressful (like you said). For me, I find this really helpful. After I had a cervical injury couple of months ago, having found [product name removed] adjustable sit to stand workstation is such a blessing for me. I cannot afford to not work in front of my computer even after a painful cervical injury since this is how I earn for living. Having the sit to stand working area is very advantageous compared to sitting all through the duration of your work which is very tiring and draining. This is based on my experience.

    As someone who exercises a lot, this whole movement towards getting people to take time during their day to incorporate a little activity that can improve health is remarkable. I totally support it!

    Excellent Posting! Thanks for sharing what NIOSH is doing to demonstrate Total Worker Health in its own workplace culture.

    Health and wellness only begins with proper education, which leads to proper nutrition and a true understanding of what it takes to be healthy. We’re a small consulting firm, but we preach health and wellness every day.

    I really appreciate yo giving awareness reur work, several other steps should be taken on this issue. Because taking care of workers health doesn’t only restricted to health issue, but it also motivate employees which indirectly increases their productivity level, i admire this stand of NIOSH, and also want other to do some more steps for the awareness in health issue at the workplace …
    Alex Edward

    Health and wellness only begins with proper education, which leads to proper nutrition and a true understanding of what it takes to be healthy. We’re a small consulting firm, but we preach health and wellness every day.

    Awesome post here. We need more companies like NOISH that really care about the health and wellbeing of their workers. Thanks guys. All of this can also be achieved by eating healthy and staying healthy.

    The actual health and wellbeing of workers is very important for the general performance of the organization. Various work standing as well as sitting all day long is important for good health and fitness.I just loved this article. Maintain creating. Thank You!

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