It’s summer in New Jersey, which means I’m trying to adjust to a staggering degree of humidity. Stepping outside at all is like wrapping myself in a layer of wet wool, and sticking my head in a steamer basket.
I’m trying to balance things out with some exceptionally dry reading. The documents I’ve been combing through are at the intersection of academic research and government policy. Woo! They are papers that even the authors likely complain about reading. Either I have the worst summer vacation ideas, or it’s time for me to get a real job.
As you can probably glean from my recent articles about NIOSH’s assessments of standing risks, and Dutch OR assistants, I’ve been reading up on the occupational hazards of standing at work, and recommendations for minimizing the risks. Various governments have weighed in, although their publications vary greatly in terms of usefulness.
Canada and Malaysia, which are two countries I’ve never grouped together before, both offered surprisingly useful information on standing and working. The Canadian Centre for Occupational Health and Safety (CCOHS) has a concise and user-friendly fact sheet about working in a standing position. And Malaysia’s Department of Occupational Safety and Health (DOSH) offers useful guidelines on occupational safety and health for standing at work.
Bizarrely, the U.S.’s Occupational Safety & Health Administration (OSHA) only mentions prolonged standing in the context of teenage drive-thru workers. Strangely, prolonged standing is not listed as a risk for those involved in cooking, food prep, or service. And adult workers seemed to be presumed immune.
This is article is my attempt to summarize very boring, government-sponsored, information into a slightly-less-boring format that is, at any rate, shorter.
How Is This Related to Sitting Disabilities?
I spent a lot of time answering the question, “So this matters…why?” when doing this research. Admittedly the connection between occupational safety guidelines and sitting disabilities is indirect, but my hope is that this information is useful when discussing accommodations with employers.
I’ve mainly worked in traditional office jobs, which, physically speaking, do not have much in common with the industrial or manufacturing jobs that most of this occupational safety data addresses. This might be why my HR department seemed unaware that standing for 8+ hours a day might not be the best choice for my overall health. Had I brought data on the actual risks, they might have been more willing to discuss alternatives.
What Are the Health Consequences of Standing Jobs?
- Sore feet
- Varicose veins & chronic venous insufficiency
- Low back pain (including spine and disc problems)
- Swelling of the legs (edema)
- Fatigue
- Degeneration of tendons and ligaments
- Neck and shoulder pain
What Factors Make Standing Jobs Worse?
- Staying in uncomfortable postures for long periods of time (e.g., hunched over, neck or elbows bent at an awkward angle).
- Inability to take frequent, short breaks, or move around to relieve discomfort. (The Malaysian guidelines use 10 minutes as the rule-of-thumb for the maximum amount of time a worker should be expected to stand without moving or resting the legs.)
- Standing on a hard floor and/or wearing poor shoes.
- Using a workstation that can’t be adjusted to the worker’s height.
- Doing a job that requires frequent awkward movements (e.g., reaching above the head, or keeping tools out of arm’s reach.)
- Wearing heavy clothing (e.g., heavy aprons, or cold-weather gear).
- Individual health conditions, such as obesity, pregnancy, previous injuries, arthritis, or bone diseases.
What Interventions Help?
I was not privy to any of the behind-the-scenes conversations that went into creating these guidelines. But an important, unstated criteria for all of them seems to be, “What interventions are cheap, quick, and easy for employers to roll out?” The interventions listed in all these sources may not be the absolute best options for improving workers’ health, but they are the most practical for employers to adopt.
Noticeably absent from these lists are measures like improved training for workers and managers, and re-designed machinery that takes human needs into account.
Of course, many workers may not mind some quick-and-easy options either.
- When possible, let workers use a chair or sit-stand stool. (This is obviously only helpful if an employee is able to both sit and stand.)
- Include a footstool, grate, or low railing in each workstation for workers to rest their feet on.
- Use pliable flooring materials like cork, rubber, or carpeting, or anti-fatigue mats.
- Rotate workers frequently among different types of tasks. The goal is to minimize worker fatigue by preventing too much strain to any particular body part.
- Encourage workers to take frequent breaks.
- Make sure the workstation fits the worker. This means that the work surface is adjustable or appropriate for the worker’s height. Frequently needed tools should be kept close at hand. Work should be done close to the body, and should not require stooping or awkward postures.
- For close or detail work, workers may need elbow or wrist rests. Proper lighting is essential.
Workplace Culture, Psychosocial Factors, and Pain
How Much Do Employers Care?
It’s easy to see how the layout of a particular workstation or the physical demands of a job could lead directly to health problems. But the fuzzier elements of workplace culture and management can also have an effect.
The Malaysian guidelines lay out a clear system for workplaces to evaluate the risks to employees and work to minimize them. This is an important and useful tool, no doubt. However, while reading through the guidelines, it struck me that unless an employer was truly committed to the health of their employees, it would be easy to sweep legitimate problems under the rug and still make the company look good on paper.
In a perfect world, companies would review their employees’ health records before assigning them to a task, and would try to make sure workers were not exposed to unnecessary risks. They would also encourage employees to report pain and injuries, and use that feedback to improve working conditions. They would realize that frequent injuries or a drop in workers’ productivity was likely due to working conditions, and they would try to address the source of the problem without blaming the worker.
I only have anecdotal data to back this up, but it seems to me that many, maybe most, employers would obey the letter of the law but not the spirit. In the U.S., workplace injuries (specifically in meatpacking plants) are often under reported. This is partly due to the manipulation of data by canny employers, who offload many of the risks onto contractors or disadvantaged employees (who are less likely to pursue legal recourse).
They also (to put it charitably), do not encourage workers to report injuries, and are less than helpful when they do. And some companies (looking at you, Amazon) barely pretend to care about worker injuries.
Psychosocial Factors: Do They Matter?
The Malaysia guidelines also briefly mention psychosocial factors as important concerns. To quote the guidelines:
There is increasing evidence that psychosocial factors related to the job and work environment play a role in the development of work related musculoskeletal disorders. Finding suggest perceptions of intensified workload, monotonous work, limited job control, low social support are associated with various work related musculoskeletal disorders. Psychosocial factors should be taken into consideration when performing risk assessment at a workplace.
Alas, sources for this assertion are not given.
I’ve seen echoes of this sentiment in other documents, and it always gets my hackles raised. Blaming psychosocial factors for musculoskeletal concerns seems, to me, a convenient way to blame workers’ health conditions on their own poor attitudes.
I’ve seen a few examples of studies, particularly about back pain, that do show an association between psychosocial factors and pain. However, the associations tend to be relatively modest, and the reason for the connection is still not well understood. I confess this isn’t a great specialty of mine, and it’s possible that data exists that would get me to change my mind. But so far, I haven’t seen it.
I’m speculating here, but it seems more reasonable to assume that people who are in pain would naturally be more likely to complain about poor working conditions. In any case, I have yet to be convinced that psychosocial factors really are important to the development of injury.
Conclusion
I don’t have any powerful thoughts to leave you with, so instead, here’s a picture of a moose.
