Risks associated with sedentary work practices Speaker’s Name: Janice Batt Stream: White Collar

Safe Work Australia

Australia’s Biggest Killers?

The Couch

Exposure to sedentary behaviour is common in Australia and is linked with an increased risk of premature mortality, morbidity and detrimental work outcomes

Sedentary Behaviour Any waking behaviour characterized by an energy expenditure less than or equal to 1.5 METS while in a sitting or reclining posture: Sitting Reading Driving Watching TV Using a computer

Emerging WHS Issues Program Developed methodology with National Research and Evaluation Reference Group (RERG) We conduct horizon scanning and network to identify potential WHS issues of national significance Assess issue against pre-developed guiding definitions and assess the risk against criteria of “new” and “increasing” Consult with Members, commission expert intel and develop policy solutions.

Working Environment 1900’s Today

The impact of sedentary work is not new Bernardino Ramazzini C1700 All sedentary workers ... suffer from the itch, are a bad colour, and in poor condition ... for when the body is not kept moving the blood becomes tainted, its waste matter lodges in the skin, and the condition of the whole body deteriorates.

How can we be sure of the evidence? Systematic Reviews and publications in multiple prestigious journals Boyle, T., Fritschi, L., Heyworth, J., & Bull, F. (2011). Long-term sedentary work and the risk of subsite-specific colorectal cancer. American journal of epidemiology, 173(10), 1183-1191 Hordern, M. D., Dunstan, D. W., Prins, J. B., Baker, M. K., Singh, M. A. F., & Coombes, J. S. (2012). Exercise prescription for patients with type 2 diabetes and pre-diabetes: a position statement from Exercise and Sport Science Australia. Journal of Science and Medicine in Sport, 15(1), 25-3 Dunstan, D. W., Kingwell, B. A., Larsen, R., Healy, G. N., Cerin, E., Hamilton, M. T., ... & Owen, N. (2012). Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes care, 35(5), 976-983 Dunstan, D. W., Howard, B., Healy, G. N., & Owen, N. (2012). Too much sitting–a health hazard. Diabetes research and clinical practice, 97(3), 368-376 Straker, Leon, Healy, G, Atherton, R, & Dunstan, D. (2014). Excessive occupational sitting is not a "safe system of work": time for doctors to get chatting with patients. Medical Journal of Australia, 201(3), 138-140 Stamatakis, E., Hamer, M., & Dunstan, D. W. (2011). Screen-Based Entertainment Time, All-Cause Mortality, and Cardiovascular Events Population-Based Study With Ongoing Mortality and Hospital Events Follow-Up. Journal of the American College of Cardiology, 57(3), 292-299.

How does excessive occupational sitting cause harm?

Beware the Active Couch Potato

How much occupational sitting is too much?

WORK HEALTH AND SAFETY RISKS Risk Management Management commitment duty holder leadership 4 Step approach Step 1 - identify hazards – find out what could cause harm Step 2 - assess risks if necessary – understand the nature of the harm that could be caused by the hazard, how serious the harm could be and the likelihood of it happening Step 3 - control risks implement the most effective control measure that is reasonably practicable in the circumstances Step 4 - review control measures to ensure they are working as planned. Australian legislation provides a clear duty of care for employers, related designers/manufacturers/ importers/suppliers and employees to ensure a safe system of work. Workplaces will need to assess sedentary exposure to determine whether excessive exposure exists for each group of workers. Excessive occupational sedentary exposure will in many situations meet the criteria of being a hazard that can be controlled with reasonable practicality. Consultation consult with workers and others at all stages HOW TO MANAGE WORK HEALTH AND SAFETY RISKS  Code of Practice

WORK HEALTH AND SAFETY RISKS Hierarchy of Controls The hierarchy of controls (WHS Act) The hierarchy of controls is not prescribed in the WHS Act however, section 3(1) (a) includes the object that protection of workers and others from harm to their health safety and welfare is through ‘the elimination or minimisation of risks arising from work’. Section 3(2) extends the object of WHS Act to risk management as described in section 3(1) (a) by applying the overriding principle ’that workers and other persons should, so far as is reasonably practicable, be given the highest level of protection against harm to their health, safety and welfare from hazards and risks arising from work’. It is consistent with the WHS Act (s3(1)(a)) to mandate the elimination and minimisation of the risk by adopting a formula. The hierarchy of controls is such a formula. The model WHS Regulations (Chapter 3 Part 3.1) describes the risk management duty to identify hazards, manage the risk using the hierarchy of controls, maintain and review the control measures. Section 36 sets out the hierarchy of control measures to be implemented to minimise risks to health and safety if it is not reasonably practicable for a duty holder to eliminate risks to health and safety. Administrative controls must be implemented if a risk remains after implementing risk control measures. A duty holder may use a combination of controls to minimise a risk so far as is reasonably practicable if a single control is not sufficient for the purpose. The mode Code of Practice - How to manage health and safety risks further explain how to apply the hierarchy of controls by grouping the control measures into levels of effectiveness HOW TO MANAGE WORK HEALTH AND SAFETY RISKS  Code of Practice

How the hazard of sedentary work can be reduced by substitution and interruption of sitting time. The evidence from health outcomes and potential mechanisms clearly supports the need for two aims to minimise the risk of harm associated with occupational sitting exposure:  to reduce the overall accumulation of occupational sitting when this is high by substitution, and to interrupt prolonged bouts of occupational sitting. Here is an outline of a sedentary work day timeline – from starting the work shift in the morning through to end of the work shift. In the first line sitting is only interrupted with walking at morning, lunch and afternoon breaks. In the second line two periods of sitting are substituted with standing which reduces the overall accumulation of sedentary time –but does nothing to interrupt prolonged bouts of sitting. In the third line sitting regularly interrupted with walking reduces the number of prolonged bouts of sitting but doesn’t reduce the overall accumulation. In the fourth line alternating sitting with standing every 30 minutes addresses both aims by substituting half of the sitting work time standing and providing an interruption to prolonged sitting. In the fifth and final line, the ultimate aim of alternating sitting and standing and including some brief walks (to the toilet, to get a cup of tea etc) creates both maximum task variety and is the best way to minimise harm from occupational sitting.

Australia’s Physical Activity and Sedentary Behaviour Guidelines – June 2014 www.health.gov.au

Evidence on the metabolic effects of standing is mixed but suggest beneficial effects.

M Healthy and safe by design Workplace hazards are eliminated or minimised by design. Structures, plant and substances are designed to eliminate or minimise hazards and risks before they are introduced into the workplace. Work, work processes and systems of work are designed and managed to eliminate or minimise hazards and risks.

Action Areas Work Design Design & management of work, work processes and systems of work to eliminate or minimise hazards and risks Design of structures, plant and substances to eliminate or minimise hazards and risks before they are introduced into the workplace Work Design

Principles of Good Work Design

Key Messages Musculoskeletal and metabolic experimental and epidemiological evidence supports the benefits of keeping sedentary tasks to no longer than 20-30 minutes Prolonged sedentary behaviour can be interrupted with either the substitution of sitting with a productive or non-productive non-sedentary task, or a brief non-sedentary activity. Examples of substitution tasks to interrupt sedentary tasks include: switching to work on a computer at a standing or walking workstation, standing to read a document, having a standing or walking meeting, stand for some of a public transport commute. Examples of brief activities which can act as breaks include: standing while talking on the phone, walking to deliver a message to a colleague rather than emailing, walking to get a drink or visit the bathroom. Good job design can use substitution and breaks to minimise the harm from occupational sedentary exposure.