1. STAND UP TO WORK Elizabeth J Garland MD, MS
Department of Environmental Medicine and Public Health
Icahn School of Medicine at Mount Sinai
November 2016

2. Learning Objectives
By the end of the session, the audience will be able to identify:
Health benefits of minimizing sedentary behavior
Benefits of the adjustable workstation (AWS)
Components of the Stand Up to Work Study (SUTW)
Baseline behavior of Perkins+Will (P+W) office workers

3. Background Historical changes in the work culture
How much sitting time is too much?
The health consequences

4. Benefits of Movement Physical Active metabolism
Increased blood flow to brain and muscles
Reduction of blood clots (DVTs)
Change in body habitus
Cognitive/Emotional
Improved alertness/accuracy
Increased productivity/innovation
More endorphins
Opportunity for social interactions

5. Adjustable Work Stations (AWS)
Associated with improvements in:
musculoskeletal pain
employee well-being
caloric expenditure
Growing movement in the workforce

6. “The White House is Requesting $700K for Standing Desks”

7. Study Objective To assess the impact of AWS on:
Employee health and wellness
Stress
Sedentary behavior
Sustainability of observed behavioral changes

8. Methodology Two groups at P+W: Target group: on the fifth floor
Standard conditions: on the fourth and sixth floors

9. Methodology
Micro-polls: 3-questions via or text message three times a day for one week in October, January, and May
Two validated web-based surveys: a 10-minute questionnaire via in October, January, and May
Training module: One-hour session at P+W about office ergonomics and well-being (CEU credit 1.0)
Data was collected from October 2015 to June 2016

10. Web-based Surveys Working Sitting Questionnaire:
Time spent sitting in various activities on a working vs non working day
Health and Work Questionnaire, scaled from 1-10
Muscle pain
Relationships with co-workers, family
Stress level
Levels of efficiency and productivity

11. Results N=67 P+W participants 27% 20-29 year olds; 35% 30-39 year olds
60% males; 40% females
100% non-smokers
78% work 5 days per week

12. Quantitative Results Micro-Poll

13. Quantitative Results Web-based Survey*
AWS Installation

14. Quantitative Results Web-based Survey

15. Before AWS Installation

16. AWS In Use

17. Strongly Disagree + Disagree
Qualitative Results
Strongly Agree + Agree
N (%)
Neutral
Strongly Disagree + Disagree
AWS was convenient to use.
22 (95.7 )
1 (4.3 )
0 (0 )
AWS encouraged me to stand up more often than I used to do.
19 (82.6)
2 (8.7)
My work productivity improved with the OPTION of standing.
15 (65.3)
5 (21.7)
3 (13.0)
I felt discomfort in my legs & feet due to standing at the AWS.
8 (34.8)
4 (17.4)
11 (47.8)
Overall I recommend the AWS for our worksite.
20 (87.0)
Table 1. Adjustable Workstation Participant Responses to Various Questions (N=23): Likert-Scale Collapsed into 3 Options
As can be seen from the table, most respondents found the workstation convenient (95.7%); more frequent standing up (82.6%); and self-perceived improved productivity (65.3%). A few participants expressed some discomfort in their legs due to increased standing. Overall, a majority of the respondents (87%) would recommend the adjustable workstation for their worksite.

18. Qualitative Results Mean ranking of Specific Benefits Gained by Alternating Between Seated and Standing Position (N=23)
Average Rating
Response Count
Less leg discomfort
3.50 8
Happier
3.41 17
Less lower back discomfort
3.27 11
More focused
3.08 12
More productive
3.07 14
Uncertain
3.00 7
Less stressed/ more comfortable
2.93
Less upper back, shoulder or neck discomfort
2.86
Energized
2.50 20
Table 2. Mean Ranking of Specific Benefits Gained by Alternating Between a Seated and Standing Position ( N = 23) Most important benefits selected related to physical comfort, including being energized; less upper back, shoulder and neck discomfort; as well as less stress and feeling more comfortable.

19. Qualitative Results Mean ranking of Specific Barriers Experienced by Alternating Between Seated and Standing Position (N=21)
Average Rating
Response Count
Less Happy
4.50 2
Less productive
3.92 12
More stressed/ less comfortable
3.71 7
More leg discomfort
3.00 9
More upper back, shoulder or neck discomfort 5
Fatigued
2.92
Less focused
2.57
I forgot to use
2.40 20
Inconvenient footwear
1.64 11
Table 3. Mean Ranking of Specific Barriers Experienced by Alternating Between a Seated and Standing Position (N = 21) Most important barriers included inconvenient footwear; forgetting to use the adjustable workstation; and being less focused. Physical symptoms such as fatigue; upper back, shoulder or leg discomfort; and ankle swelling were ranked less importantly.

20. Qualitative Results POSITIVE Physical: Moved more outside of work
Felt stronger and more limber
Felt less pain in muscles, joints and back
Had more energy
 Mental:
More aware of standing posture
Had more positive outlook
 Behavioral/Environmental:
Inspired to create standing workstation at home
NEGATIVE
Physical:
Discomfort in the lower extremities
Minor back pain when in same position for long period of time
Fatigue
Mental:
Less focused on work-related tasks
Behavioral/Environmental:
None
Impact of Adjustable Workstation Outside the Workplace: Open-Ended Responses
A question (Q 25) about the impact of the AWS outside the workplace yielded 13 open-ended responses. Six respondents stated that they encountered no impact and 4 found this question not applicable. The 13 responses were coded thematically as: 1) physical 2) mental and 3) behavioral/environmental.

21. Sample Open Ended Responses at Survey End Eliciting Any Comments About the AWS
“I love it. I'm surprised by how much I enjoy having the option of standing. It has made my post-lunch energy slump disappear...and I'm more focused when using it. I recommend future desks have settings that remember the most comfortable heights...to avoid guessing each time the desk is raised or lowered. Please let us keep them!”
“I found it hard to draw and do detailed tasks while standing.”
“I found that I concentrate better while sitting.”
“I enjoyed having options and being able to change my workstation to a degree.”

22. Study Contributors Center for Active Design Mount Sinai Perkins+Will
Steelcase

23. Acknowledgements P + W Hakim Hasan John Haymaker, PhD Steelcase
Mount Sinai
John Doucette, PhD
Mary Foley, EdD
Krishna Baumet, MD
Sadie Sanchez, MD
Dominique Peters
Elyse Mallin
CfAD
Abigail Claflin
P + W
Hakim Hasan
John Haymaker, PhD
Steelcase
James Brewer