July 2020 – JAMA Study, A New Reason For Breaking Up Static Postures

Although our attention’s been elsewhere recently, there’s been a lot of news about the perils of chronic sitting in the workplace over the past few years. Now, there’s new definitive news published by the American Medical Association. On June 18th, 2020, there was a newly published study in the peer-reviewed Journal of the American Medical Association (JAMA) which confirms a clear link between cancer rates in adults and too much sitting. 

The lead author Dr. Susan Gilchrist, said in a statement “Our findings reinforce that it’s important to ‘sit less and move more.

In a CNN article covering the study Too Much Sitting Raises Your Risk For Cancer, Study Finds, Dr. Gilchrist said “Incorporating 30 minutes of movement into your daily life can help reduce your risk of death from cancer. Conversations with my patients always begin with why they don’t have time to exercise,” said Gilchrist, who leads MD Anderson’s Healthy Heart Program.”

“I tell them to consider standing up for 5 minutes every hour at work or taking the stairs instead of the elevator. It might not sound like a lot, but this study tells us even light activity has cancer survival benefits.

The study involved more than 8,000 people between 2009 and 2013 where none of the participants had cancer when the study began. Gilchrist and the researchers found there was a 82% higher risk of dying from cancer for the most sedentary people compared to the least sedentary people. On the bright side, they found that people replacing just 30 minutes of sitting with a light-intensity activity, such as walking, reduced their risk of cancer.

It’s also well-understood, however, how chronic standing is also well-known to be unhealthy, contributing to lower extremity swelling and venous pooling, higher incidence of varicose veins, lower extremity discomfort and fatigue, lower back pain, and general body and mental fatigue.

An recent study published in the journal Ergonomics concluded “Standing is being used to replace sitting by office workers; however, there are health risks associated with prolonged standing. In a laboratory study…prolonged standing discomfort increased (all body areas), reaction time and mental state deteriorated while creative problem-solving improved. Prolonged standing should be undertaken with caution.

Clearly, there needs to be some balance between sitting and standing during our work, however, should the primary issue really be about “sitting versus standing” or about “reducing static postures and encouraging movement“?

One of the fundamentally wrong messages employees may have heard is that standing in one place, rather than sitting in one place, will help one lose extra pounds, ward off negative effects of too much sitting and improve our hearts. When researching it, you quickly find that the Standing Movement’s pundits are really promoting ‘movement’ rather than static postures.

We have many very useful and adjustable choices in the office furniture and equipment marketplace today. Adjustable-height work surfaces (sit/stand), for example, when used with anti-fatigue mats, very definitely should be recognized as very useful pieces of equipment, so long as they are used. When not used, however, they can be a tremendous waste of money and tragic in that they could have helped to prevent discomfort and eventual recordable injuries.

So what are the best ways to ensure proper long term use of the equipment and furniture you’ve purchased and attain maximum value? The answers all come from understanding human behavior and the Novelty Effect.

Is The Value In ‘The Tool’ or In ‘The Use of The Tool’ or Both?

The way in which we conduct ourselves is termed our behavior and helping employees adopt a regimen of periodic movement during their workday is a matter of behavioral change. Movement is important to get blood circulation through the muscles and to stimulate removal of natural waste byproducts from muscles and tissue. Solid research shows that building a variety of movements into each day is a key in reversing the deleterious effects of static postures while sitting or standing.

So what happens, for example, when we deliver a highly-adjustable new office chair or shiny new sit/stand work surface to an employee? Of course, they’ll be excited and revel in its newness for a few weeks but, longer term, do we expect them to abandon their current behaviors developed over years? Perhaps we might give them a product brochure or a website or pay even more money to bring in consultants to give employees some training or a pep talk?

So what happens after the honeymoon novelty phase of having anything new passes and there’s no continual reinforcement?  You already know the answer.

Changing Behavior Requires Behavior Change Principles

For more than a decade, a fundamental understanding within office ergonomics has been how the process of “mitigating risk factors” includes interventions of various types (e.g. using adjustable workstation components, workstation analysis, adjustment, employee training, etc…) which are all singularly purposed to foster good employee behaviors such as working in neutral postures, moving about during your workday and taking microbreaks while working, inter alia.

Yes, each of these interventions are important in setting the stage for the employee to “begin their behavior change journey“, however, it will be an unfulfilled hope and misunderstanding to then expect that behavior change will be automatic and appear on its own after that point in time.

Almost 100 years of Applied Behavioral Analysis data clearly teaches that without operant conditioning and continual reinforcement at the point-of-use, then long term behavior change is at best remote and unlikely in any human experience other than immediate life-threatening scenarios.

Plainly speaking, we cannot get around this most basic of facts and our “Lost Time Case Rates relating to Office Ergonomics” cannot and will not be tamed without embracing this basic precept of human behavior (see study references elsewhere on this site). We are, after all, earnestly working to improve employee behaviors.

The highly effective concept of “crowding out” refers to introducing and positively reinforcing good behaviors rather than focusing the individual on having to always remember to “not do something”. It’s about positive reinforcement versus negative reinforcement. There is only so much time in each day and so over time the poor behaviors abate.

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