Architecture
Interior Design
Landscape Architecture
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STANDING
ROOM ONLY
Is sitting the new smoking
and what does it mean
for workplaces?
February 2016
Australia
China
Hong Kong
Singapore
United Kingdom
Document Title
SBS Sydney, Australia
Photography by Nicole England
Title Two
Contents
Section
01 Introduction
02 Health impacts of prolonged
sitting (and standing)
03 The key is movement
04 The moving workplace
05 Conclusions and further research
06 References
Front cover image: Medibank Workplace,
Melbourne, Australia.
Photography by Earl Carter
Contact
Steve Coster, Principal
[email protected]
Authors
Agustin Chevez, Senior Researcher
[email protected]
Brett Pollard, Principal
Head of Knowledge and Sustainability
[email protected]
HASSELL
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Australia 3000
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hassellstudio.com
@HASSELL_Studio
HASSELL Limited
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HASSELL
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ANZ Tower, Sydney, Australia
Photography by Earl Carter
01 Introduction
“The maladies that
afflict the clerks . . .
arise from three causes:
First, constant sitting,
secondly the incessant
movement of the hand
and always in the same
direction, thirdly the
strain on the mind…”
While the ‘father’ of Occupational Medicine, Bernardino Ramazzini, first highlighted the
health effects of prolonged sitting over 300 years ago, it’s only recently that terms such
as ‘Sitting is the New Smoking’ 1, 2 have started appearing in the mainstream press.
Analysis using Google Trends3 shows that ‘Sitting vs Standing’ first appeared in Google
searches in 2010, while ‘Sitting is the New Smoking’ only started trending in 2013.
During the same period there have been numerous articles and industry reports
promoting standing desks and sit-to-stand workstations as the solution to the health
effects associated with sitting for long periods.4, 5
This trend also coincides with a huge upswing in interest in the health and wellbeing of
office workers. In response, many organisations have incorporated standing desks and
adjustable workstations in their workplaces. However, recently articles such as “5 Ways
Your Standing Desk is Doing More Harm than Good”6 have started appearing suggesting
that standing desks and sit-to-stand workstations may not, by themselves, be the
‘magic bullet’ to solve the issue of prolonged sitting.
Bernardino Ramazzini
Disease of Workers
De Morbis Artificum Diatriba, 1713
Source: Google Trends
AGL Workplace, Melbourne, Australia
Photography by Earl Carter
HASSELL
© 2016
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Medibank Workplace, Melbourne, Australia
Photography by Earl Carter
02 Health impacts
of prolonged sitting
(and standing)
‘The average office-based employees spend around
80,000 hours seated during their working life”
The average office worker can spend a
considerable period of their day sitting
down. Australian research, published
in 2009, reported that office workers
included in the study were sitting for over
70 percent of the working day.7 Studies
undertaken in the UK and elsewhere have
reported similar figures. All this sitting is
creating numerous health issues with one
study calculating the effects as reducing
a person’s lifespan by two years,8 leading
some to draw the analogy between
smoking and sitting.
Worryingly, the study showed the
increased risk remained even for people
who exercised regularly, suggesting that
exercising at lunchtime or outside work
hours may not completely counteract the
effects of prolonged sitting.
Victorian Health
romotion Foundation
While Ramazzini may have identified
constant sitting as a health issue over 300
years ago, doctors in London in the 1870’s
were reporting on the effects of prolonged
standing amongst female shop workers,
primarily various foot ‘ailments’.10
Researchers have subsequently identified
a range of other serious consequences
from prolonged standing including back
pain, varicose veins, increased stroke risk
and problems during pregnancy. Most
recently, research published in the US
journal Human Factors found long term
muscle fatigue amongst workers who
stood for the majority of their working day
even after rest breaks.11
In 2015, Canadian researchers undertook
a meta-analysis of published academic
research on the effects of sitting and
other sedentary behaviours and found
that it increased the risk of diabetes,
heart disease and cancer.9
02
01
03
Images 01, 02, 03 & 04
Medibank Workplace, Melbourne, Australia
Photography by Earl Carter
Image 05
Suncorp Workplace, Melbourne, Australia
Photography by Dianna Snape
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04
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Standing room only
03 The key is movement
“In the end, the best
posture is the next
posture”
Ergonomics@work
UC Berkeley
If standing and sitting for long periods are
equally problematic and the effects can’t
be completely negated by rest or exercise,
what is the answer? Instead of promoting
standing over sitting or visa versa, leading
ergonomic and health experts are saying
that the best approach is for people to do
both. Their advice is to regularly shift
between sitting and standing combined
with walking. But how often and for how
long?
More recently, research undertaken for
Public Health England by a number of
leading international experts,13 including
Professor Hedge, recommended that
office workers should initially aim for two
hours per day of standing and light
walking and progressively increase this to
four hours per day. They also
recommended that workers should
regularly shift from sitting to standing/
light walking and back again.
The advice on this is still evolving. In 2014,
Professor Alan Hedge of Cornell University
recommended that people should aim to
sit for twenty minutes, stand for eight
minutes, stretch for two minutes and then
repeat this cycle throughout the day.12
While the researchers did not nominate a
specific maximum time before changing
from sitting to standing, they did stress
the importance of gradually introducing
movement to avoid fatigue, discomfort,
musculoskeletal pain and other issues.
Medibank Workplace, Melbourne, Australia
Photography by Earl Carter
HASSELL
© 2016
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04 The moving
workplace
“90% of office workers in Scandinavia now
have access to sit stand workstations,
while the figure in the UK is 1%”
Estimate based on data from
Furniture Industry Research Association (UK)
So how do you create workplaces that
encourage movement? In 2015, UK
researchers published a systematic
review that assessed over 1,000 academic
studies to determine the effectiveness of
various workplace strategies for reducing
sedentary behaviours, primarily prolonged
sitting.
They found the most promising
approaches included providing
information of the health consequences of
sitting, self-monitoring techniques and
changes to the workplace environment.
This means that while initiatives such as
awareness campaigns play a role in
encouraging movement in the workplace,
the design of workplaces also needs to
support and promote movement.
Sit-to-stand Workstations and
standing desks
Sit-to-stand workstations and standing
desks are an important component in
helping people to shift between sitting
and standing. However, questions such as
how many to provide, which type to use
and where they should be located need to
be considered.
In terms of how many workstations to
provide, the WELL Building Standard,15
which focusses on the health and
wellbeing of building occupants,
recommends that at least 60 percent of
workstations should be either height
adjustable standing desks or standard
desks with a height adjustable desktop.
Interestingly, in the Ergonomics: Visual
and Physical section of the standard the
recommendation is for at least 30 percent
of workstations to have the ability to shift
between sitting and standing.
6
Standing room only
While WELL and other standards can
provide some guidance the specific
number or percentage for each workplace
requires detailed consideration of issues
such as the types of work activities being
undertaken, the mobility of workers, what
percentage of the day people are in the
office and whether the workplace has
allocated or unallocated seating.
For example, if the majority of people in a
workplace are highly mobile and spend a
significant portion of the day at meetings
or working remotely then a mixture of
fixed height and sit-to-stand workstations
as well as standing desks may be
appropriate. If the tasks being undertaken
are largely desk based and the workplace
has allocated seating then a higher
percentage of sit-to-stand workstations
would be required. The ultimate goal is to
have everyone in a workplace being more
active and spending less time sitting,
without reducing and potentially
improving work performance.
Budget is also another important
consideration as sit-to-stand
workstations are typically more expensive
than fixed height workstations. On a
recent project designed by HASSELL, it
was decided to select workstations with
legs that can be retrofitted with motors to
make them height adjustable. Initially 30
percent of the desks had motors installed,
with the intention to install motors to 100
percent of the desks over time.
There are a wide variety of sit-to-stand
workstations currently on the market and
the selection of which one to use is highly
dependent on project specific selection
criteria. However, a discussion of
workstations would not be complete
without including active workstations,
such as treadmill desks, bicycle desks and
stepper desks. These regularly feature at
furniture tradeshows and WELL
recommends that three percent of all
workstations in an office should be one of
these types.
However, research on the effectiveness
and impact of active workstations is still
equivocal. One particular issue is whether
work performance is affected by
introducing movement while undertaking
various work related tasks. One recent
US research project that studied the
effect of treadmill desks on cognitive and
typing outcomes showed a decrease in
learning and typing outcomes for people
working on treadmill desks compared to
those sitting.16
However the researchers suggested that
this decrease might be outweighed by the
overall benefits of increasing physical
activity. In other words the jury is still out
on these types of workstations. But
workstations and standing desks are only
one of a number of design strategies to
help get people moving more in
workplaces.
Activity Based Working (ABW)
The nature of work now undertaken in
most workplaces involves a number of
different activities, not all suited to be
undertaken from an individual’s desk.
During the course of an average day
people can spend time in meetings,
working with colleagues on projects, as
well as undertaking individual focussed
work. By analysing the variety of different
activities undertaken within a particular
organisation the most appropriate work
settings can be developed to support the
particular nature of each task being
undertaken. By providing different work
settings this can encourage people to
physically move around the workplace as
they undertake different work tasks.
Suncorp Workplace, Melbourne, Australia
Photography by Dianna Snape
Meeting and collaboration spaces
Stairs
Distributed facilities
Early studies on proxemics suggest that
non-verbal communication influences
behaviour and the way people interact
with each other.17 As such maintaining
same eye height during meetings and
collaborations might be important. This is
because in situations where people are
seated and one person stands up it can
introduce a psychological feeling of
dominance. A standing height table, with
people standing or using stools, enables
people to remain at the same eye height
regardless of whether they are presenting
an idea or listening. This allows people
to equally contribute and respond to
ideas as well as allowing them to stand
and move.
More workplaces are integrating stairs
into their design to increase connectivity
and interaction. Stairs also offer a great
opportunity to increase physically
movement. However research has shown
that just asking people to use the stairs
instead of taking the elevator is not
effective by itself.18 In order for people to
use the stairs they must be highly visible
and conveniently located. The central stair
in the Medibank Melbourne workplace is a
good example of how the design and
placement of stairs can encourage
movement.
Distributing common facilities such as
print rooms, staff breakout spaces and
kitchens also offers opportunities to
encourage people to move more. However
care does need to be taken to not place
these too distant as people will find
workarounds to avoid having to travel too
far or too frequently in order to get to
these facilities.
HASSELL
© 2016
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05 Conclusion and future
research
The average office worker currently spends more than a third of their working life in
an office, most of which is sitting down. The vast weight of research suggests that
this can have serious health consequences. The constant movement currently
recommended by health and ergonomic experts to help prevent these issues means
that workplaces need to support and encourage movement. Along with
management initiatives and programs, the design of workplaces including the use
of sit-to-stand workstations and standing desks, has an important role to play in
supporting movement. However, like all fields of research, the body of knowledge on
movement in the workplace is constantly evolving.
One area that warrants further exploration is the potential conflict between the
recommendations for regular movement and research on the impact of
interruptions on workplace effectiveness. A study undertaken by the University of
California Irvine has shown that it takes an average of 23 minutes for people to
return to a task after being interrupted.19 Related to this is research that suggests
that people are most individually productive when they are able to concentrate
without interruption.20 ‘The Flow’ or ‘The Zone’ is described as when you are so
immersed in an activity that you lose track of time and one of the conditions for
entering a “Flow’ state is the absence of distractions. Given the number of physical
interruptions and digital distractions that already occur in the typical workplace,
will adding regular movement create even further interruptions or will the health
benefits outweigh them?
Another area requiring more research is whether different work activities are more
effectively undertaken sitting, standing or moving. The previously mentioned
research into the effects of treadmill desks on cognition are part of a growing field
of research. Walking meetings have been promoted as being shorter and more
effective than sitting meetings, while researchers at Stanford University have
conducted a series of experiments that showed people were more creative whilst
walking.21 Other studies have shown that tasks requiring fine motor skills and
concentration are better undertaken sitting down.22
With the all insights and guidance being developed on how people can be healthier
and more effective in the workplace another issue arises. How do people deal with
all this information and remember to move or work in the most effective position.
This is where wearable technology such as the Apple Watch potentially has a
significant role to play. Tim Cook, CEO of Apple recently said “if I sit for too long, it
will actually tap me on the wrist to remind me to get up to move…” Wearables offer
the ability to monitor movement, heart rate, blood pressure and potentially stress
levels in real time and provide their wearers with immediate feedback. How long will
it be before wearables have the ability to recognise what activities people are doing
and assess how effectively they are being done and then offer guidance on how and
where to do them better? Although a survey undertaken in the US in 2014 revealed
that half of people who had purchased a wearable device stopped wearing them
within 12 months.23 Time and further research will tell whether wearable technology
is a novelty or a real aid to help people be healthier and more effective at work.
8
Standing room only
Hub workplace, Adelaide, Australia
Photography by Nathan Dyer
SBS, Sydney, Australia
Photography by Nicole England
06 References
1. Berry, S. (2013). Sitting is the new
smoking. The Sydney Morning Herald.
Retrieved from http://www.smh.com.
au/lifestyle/life/sitting-is-the-newsmoking-20130529-2nca0.html
2. Weller, C. (2013). Is sitting the new
smoking? A workday of inactivity could
offset any Benefits of Exercise.
Medical Daily. Retrieved from http://
www.medicaldaily.com/sitting-newsmoking-workday-inactivity-couldoffset-any-benefits-exercise-248119
3. Google Trends. https://www.google.
com.au/trends/ Accessed November
2015.
4. Lee, S.M. (2012). Standing desk eases
pain from sitting. SFGate. Retrieved
from http://www.sfgate.com/health/
article/Standing-desk-eases-painfrom-sitting-3770838.php
5. Stromberg, J. (2014). Five Health
Benefits of Standing Desks.
Smithsonian.com Retrieved from
http://www.smithsonianmag.com/
science-nature/five-health-benefitsstanding-desks-180950259/?no-ist
9. Biswas, A. Oh, P. Faulkner, G. Bajaj, R.
Silver, M. Mitchell, M. Alte, D. (2015)
Sedentary Time and its Association
with Risk for Disease Incidence,
Mortality and Hospitalisation in
Adults: A Systematic Review and
Meta-Analysis, Annals of Internal
Medicine 2015;162(2):123-132.
doi:10.7326/M14-1651
10.O’Neill, R (2005) Standing Problem,
Hazards Magazine, 91 August 2005.
Retrieved from http://www.hazards.
org/standing/
11.Garcia, M. Laubli, T. Martin, B. (2015)
Long-Term Muscle Fatigue after
Standing Work. Human Factors: The
Journal of the Human Factors and
Ergonomics Society;
DOI:10.1177/0018720815590293
12.Hedge, A. (2014). Hedge’s 3S’s Ideal
Work Pattern. Retrieved from http://
ergo.human.cornell.edu/
CUESitStandPrograms.html
16.Larson MJ, LeCheminant JD, Hill K,
Carbine K, Masterson T, Christenson E
(2015) Cognitive and Typing Outcomes
Measured Simultaneously with Slow
Treadmill Walking or Sitting:
Implications for Treadmill Desks. PLoS
ONE 10(4): e0121309. doi:10.1371/
journal.pone.0121309
17.Hall, E.T. (1966). The Hidden
Dimension. Anchor Books.
18.Dugdill, L. Brettle, A. Hulme, C.
McCluskey, C. Long, A. (2008)
Workplace physical activity
interventions: a systematic review,
International Journal of Workplace
Health Management, Vol. 1 Iss: 1,
pp.20 - 40
19.Mark, G., Gudith, D., & Klocke, U. (2008,
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more speed and stress. Proceedings of
the SIGCHI conference on Human
Factors in Computing Systems (pp.
107-110). ACM
13.Buckley, J. Hedge, A. (et al) (2015), The
20.Csikszentmihalyi, M.(1990). Flow: The
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psychology of optimal experience.
change towards better health and
Harper Perennial, New York.
productivity. Commissioned by Public
6. Miller, A.M. (2015). 5 Ways Your
Health England and the Active Working 21.Oppezzo, M. Schwartz, D. (2014) Give
Standing Desk Is Doing More Harm
your ideas some legs: The positive
Community Interest Company.
Than Good. US News. Retrieved from
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Retrieved from http://bjsm.bmj.com/
http://health.usnews.com/healthJournal of Experimental Psychology:
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articles/2015/02/17/4-ways-your40(4), Jul 2014, 1142-1152. http://dx.
standing-desk-is-doing-more-harm14.Gardner, B. Smith, L. Lorencatto, F.
doi.org/10.1037/a0036577
than-good
Hamer, M. Biddle, S (2015) How to
22.Larson MJ, LeCheminant JD, Hill K,
reduce sitting time? A review of
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Carbine K, Masterson T, Christenson E
behaviour change strategies used in
P. Healy, G Keegal, T. Owen, N. Winkler,
(2015) Cognitive and Typing Outcomes
sedentary behaviour reduction
E. (2009) Stand Up Australia –
Measured Simultaneously with Slow
interventions among adults, Health
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