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05/08/2021

Move more and stand less! Addressing the risks of prolonged constrained standing

The dangers of sitting for long periods when working is fairly well established, but the risks associated with prolonged standing are also significant for workers in certain sectors. Prolonged standing can lead to musculoskeletal disorders (MSDs) and other health problems, so it is vital to understand the risk factors to ensure effective interventions and prevention strategies.

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Image by cottonbro from Pexels

Prolonged standing is defined as standing continuously for more than 1 hour or for more than 4 hours in a day. It can also involve prolonged constrained standing on the spot and not being able to enjoy temporary relief by walking or sitting.

One in five workers in the EU report spending most of their working day standing up[1] and this is particularly the case in the services, healthcare, industry and teaching sectors, among others. Many workers who stand for long periods are low-paid and there is evidence that temporary workers are more exposed to standing at work[2]. Constrained standing is especially reported in jobs where women predominate, such as hairdressing, production line work and cashier work[3].

Risk factors and health effects of prolonged standing

When it comes to MSDs, research shows a clear link between the time workers stand and symptoms related to lower back and lower limb complaints. Standing for at least 25% of the working day coincides with experiencing MSDs for three quarters of men and over two thirds (69%) of women. The risk will also depend on other factors such as the standing posture needed to do the job, if a foot pedal has to be operated, as in some factory work or train driving, or any twisting, reaching or manual handling involved.

It’s important to distinguish between prolonged static standing (standing on the spot) and dynamic standing, meaning there is a possibility to move about. Besides a difference in the mechanic load on musculoskeletal structures, there is a substantial physiological difference between static and dynamic standing in particular when it comes to blood flow. Being able to move about one’s workstation, even in only one square metre, can prevent the negative effects on the body’s blood flow propulsion mechanisms.

Prolonged standing can lead to: discomfort and fatigue in lower limbs; musculoskeletal pain of the lower back and feet; chronic venous insufficiency; low blood pressure; and arthritis in the knees and hips, to name just some of the health effects. And it should be noted that as the duration of prolonged standing increases, so does the risk of complaints. For workers with an existing health problem, such as sciatica related to a back problem or painful joints due to rheumatism, prolonged standing can provoke the associated pain and exacerbate the condition.

Interventions and prevention strategies

The most important advice is to avoid prolonged standing wherever possible. Workers need to be able to vary postures between standing, sitting and moving. Actions to avoid prolonged standing should follow the usual hierarchy of prevention measures, taking a systematic approach and using risk assessment. The starting point is an ergonomic workstation and workspace and organising work to limit standing.

Work can be made more dynamic in a number of ways: by providing workstations that allow for sitting, perching and dynamic standing; through work/task reorganisation to limit standing – plan work to allow for breaks from continuous standing at least every 20-30 minutes and not exceeding 1 hour of continuous standing without a break; and by allowing workers discretion to take breaks from standing when they need to.

Employers should also consider additional measures to reduce risks if standing cannot be avoided, such as cushioned insoles in shoes and anti-fatigue mats; promoting healthy behaviours and ensuring that measures are put in place and can be reported on. It is also important to encourage consultation and active worker involvement for all aspects of a prevention strategy. This will help to ensure that all risk factors are identified and assessed in order to address them together in a comprehensive way.

Small measures can have a big impact

Many jobs currently involve prolonged standing entirely unnecessarily and there are many simple and inexpensive steps that even small companies with limited resources can take to avoid and improve standing work. For example, introducing regular breaks and time for exercise, adjusting workplace, job rotation, and providing proper equipment (simply wearing the correct shoes or providing a chair can make a huge difference).

Don’t forget our motto, ‘our next posture is the best posture!’ So, ‘sit when you need to, stand when you want to and walk or move when you can.’ You can find out more about prolonged sitting and standing by visiting the sedentary work priority area on the Healthy Workplaces Lighten the Load campaign website. And make sure you follow the campaign on Facebook, Twitter and LinkedIn to keep up-to-date with the latest news and events.