Ups and Downs
The Benefits and Challenges of Sit-Stand Workstations
BY MARJORIE WERRELL AND CATHY WHITE
Technology has become a way of life for many people. The television, video games, and tablets are in high use at home. Inactive modes of transit get people from one place to another. More jobs require full-time computer use than ever before. As a result, the population is more sedentary.
Emerging evidence shows that prolonged sitting is hazardous to your health. Excessive sitting has an impact on the body’s metabolic system. Key fat burners shut off when sitting. Blood flow is reduced. Muscles are idle and do not respond as readily to insulin. Research published in the journal Diabetes has linked extensive sitting to a number of health concerns, including obesity, increased blood pressure, high blood sugar, excess body fat around the waist, abnormal cholesterol levels, and increased risk of heart disease and cancer.
Sitting all day also leads to a greater risk for discomfort. Lack of movement can result in more upper body load on the pelvis, which can cause disc damage over time. Users who slump in their chairs may have weakened abdominal and tight hamstring muscles, which can lead to back pain.
According to a paper published in the American Journal of Epidemiology, studies have shown that people sit anywhere from 7.7 to 15 hours per day. While ensuring that exercise is incorporated into maintaining good health, research has found that this may not be enough if the lifestyle is otherwise sedentary. This means that added gym time may not reverse the effects of this much sitting. ON YOUR FEET The obvious solution to offset the hazards of prolonged sitting is to stand and move. The benefits of standing include increased energy, muscle tone, and blood flow, the burning of extra calories, and improved posture. Standing can therefore help keep the body strong and healthy while improving the metabolic system.
But it’s important to recognize that standing all day may not be healthy, either. Standing for long periods can lead to fatigue, low back pain, and leg cramps. The body is not designed to have the same posture or load placed on it continuously. The need for breaks and changes in body positions is apparent.
The challenge in the work environment is how to maintain health without sitting all day or standing all day. There are various ways to incorporate standing into the day, from simple, no-cost work practices to moderately costly engineering controls:
Use a traditional workstation and change work practice. Users may vary posture during the day. They can sit while computing but stand while talking on the phone. Provide a high file cabinet or counter for reading and writing. Encourage employees to hold standing meetings or to walk with colleagues to discuss a project. By incorporating movement throughout the day, employees can maintain both health and alertness.
Use a box. Place the keyboard and mouse on a box close to standing elbow height. This allows for a quick standing posture. Monitor position has to be considered. Ideally, a monitor swing arm that raises high enough for standing work will be used. If a laptop is utilized, it can easily be raised on a box for proper viewing height, and a separate keyboard and mouse can be repositioned on a second box for standing work.
Two workstations. Configure both a sitting workstation and a fixed-height standing workstation. Often, employees will bring their laptop to a fixed-height counter to work in a standing position. The drawback is that the positioning of the screen is too low for proper neutral neck posture. Ideally, as with the box option, a separate keyboard would enhance this positioning when working on a laptop. Some businesses offer a shared standing work station and allow employees to sign up to use it for specified hours, akin to signing out a conference room. If the user can obtain two separate monitors and position one for standing height and the other for sitting, then the keyboard and mouse would only need to be raised and lowered when transitioning from sitting to standing.
Left: This standing workstation is positioned too low, which promotes non-neutral postures (forward head, extended elbows and wrists). Right: The workstation has been adjusted to proper height, promoting neutral postures for the head, shoulder, elbow, and wrist. Photo credit: Marjorie Werrell
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QUICK TRANSITIONS The box and workstation modifications work best if only one monitor is needed at a time. Users who need more screens require a more complex solution. Adjustable sit-to-stand solutions allow the user to instantaneously choose to sit or stand while remaining engaged with the computer:
Sit-stand keyboard trays. For employees who are under 5’5”, sit-stand keyboard trays can be installed to allow for a quick transition from sitting to standing. These trays would need to be utilized with a monitor arm to allow repositioning of the monitor screen.
Tabletop sit-stand units. These units have deluged the marketplace. Some require little assembly; those that telescope and clamp from the rear require more. Units with monitor arms or bars require monitors to be removed from their base and mounted. These units supply a quick, easy, and fairly low-cost sit-stand solution, and they can be easily transported if the employee moves workstations, but they aren’t all created equal. Some features to be aware of include:
  • The depth of the unit might not accommodate the depth of the work surface.
  • Some units have a tendency to shake while typing.
  • Front-mounted units might not establish secure contact to work surfaces that have a beveled edge underneath.
  • Units whose keyboard platform rests on top of the desk require most individuals who are less than 6 feet tall to raise their chairs to reach the proper seated keyboard height.
  • Some units offer a keyboard platform that extends below the desk level.
  • The monitor distances on some units are fixed, which doesn’t allow the screens to be repositioned at a comfortable viewing distance.
  • Some units incorporate a document platform while others do not.
  • The ease of raising and lowering these units varies depending on the number of monitors and the horizontal distance required to reach for the unit.
  • Size, weight, and quantity of monitors need to be considered when ordering to ensure whether a regular or heavy-duty unit is needed.
  • Many units take up a fair amount of real estate on the desk surface.
  • Some units have a swing arm that allows users to move the unit out of the way, freeing up the work surface for reading and writing.
Complete work surface sit-stands. These come in various shapes, depths, and lengths. Corner or side pieces are available. They can be raised and lowered by crank, pneumatic lift, or electric machinery. While these units are more costly than other options, their cost has come down over the last few years. They work well for individuals who still utilize a fair amount of reference material that cannot be accommodated on other sit-stand units. In addition, current work surfaces can be retrofitted with legs whose height can be adjusted electronically.
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Left: Poor, unsupported seated posture. Right: Supported seated posture. Photo credit: Marjorie Werrell
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Treadmill workstations. These alternative standing workstations are beyond the scope of this article. The treadmills in these workstations operate at the one-to-three mile per hour range. They present a safety concern for tripping or falling, and some individuals may find it challenging to concentrate and read while moving. Treadmill workstations are not a replacement for regular physical exercise.
It’s important to recognize that your best position is your next position. A sit-stand workstation is no good if the user doesn’t change positions frequently. Alternating between sitting and standing will increase blood flow, energy, and alertness. It also raises awareness of body posture, allowing for realignment into a neutral position. Users who are new to standing work should be trained on this topic to encourage the correct behaviors when using a sit-stand workstation. New users might also need to slowly adjust to standing work. They can begin by standing for only 10 to 30 minutes at a time, gradually increasing the time they spend on their feet. STAND AND MOVE Research does not conclusively favor a single sit-stand formula. General rules of thumb call for users to alternate between sitting and standing every 30 to 60 minutes. A further recommendation based on research conducted by Cornell University would be to spend 20 minutes sitting, 8 minutes standing, and 2 minutes standing and moving. Moving can include gently stretching and walking. For example, assume an 8-hour work day with a 30-minute lunch. For the 7.5 hours of the working day, this means a total of 5 hours of sitting, 16 sit-to-stand changes, 2 hours of standing, and 30 minutes of moving. These numbers provide a basic framework. A company can further this concept by designing their work so employees can be more active. Following a movement pattern such as this throughout the day should keep employees comfortable, healthy, and productive.
Comfortable, supportive shoes should be worn while standing to maintain good ankle and pelvis alignment. Some users might be interested in an anti-fatigue standing mat to use with their standing workstation. The initial problem with most standing mats is that their weight makes them difficult to move each time the user sits to work. Chairs do not easily roll over these mats. If a worker already has a back issue, moving these mats by bending forward in an awkward posture and lifting or dragging them out of the way is a risk factor that needs to be avoided.
Whether sitting or standing, users should always follow basic ergonomic principles when computing. Do not lean forward at the head or back to view work or type. Keep shoulders relaxed and wrists in a straight, neutral position. Adjust work surface height to match bent elbow height. Position monitors so they are about an arm’s length viewing distance and height at the top portion of the screen is at approximately eye level. And be sure to avoid static postures from sitting or standing for prolonged periods of time. MARJORIE WERRELL, PT, CIE, CPEE, is president of ERGOWORKS Consulting, LLC. She can be reached at (301) 417-2077 or marj@ergoworksconsulting.com. CATHY WHITE, CIH, CSP, CPE, is a Global EH&S project leader at the Dow Chemical Company in Midland, Mich. She can be reached at cmwhite@dow.com. Send feedback to synergist@aiha.org.
RESOURCES American Journal of Epidemiology: “Amount of Time Spent in Sedentary Behaviors in the United States, 2003–2004” (April 2008).
Current Cardiovascular Risk Reports: “Too Little Exercise and Too Much Sitting: Inactivity Physiology and the Need for New Recommendations on Sedentary Behavior” (July 2008).
Diabetes: “Role of Low Energy Expenditure and Sitting in Obesity, Metabolic Syndrome, Type 2 Diabetes, and Cardiovascular Disease” (September 2007).
A sit-stand workstation is no good if the user doesn't change positions frequently.
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