For many workers, standing all day is simply part of the job. So are the sore feet and heavy legs they come home with at the end of every workday. Those aches and pains may disappear with a good night’s rest but, over time, prolonged standing can lead to serious health problems, according to experts.
Workers who stand every day can develop low back pain, stiffness in the neck and shoulders, swelling of the lower legs, pooling of blood and varicose veins. Standing also increases the risk of carotid atherosclerosis, or hardening of the arteries, as well as the risk of musculoskeletal disorders such as carpal tunnel syndrome.
As with any fixed position, standing causes muscles to flex, exerting pressure on tissues and blood vessels and obstructing blood circulation, says Dhananjai Borwankar, technical specialist with the Canadian Centre for Occupational Health and Safety (CCOHS) in Hamilton.
“Nutrients and oxygen needed by tissues can’t get in. Waste products can’t get out. So muscles and other supporting structures in those areas that need blood tend to get fatigued a lot quicker,” he says.
As a result, it’s important to find ways to increase workers’ physical movement during the day. One good way is to rearrange tasks to provide opportunities to walk more, says Borwankar. For example, a person operating an industrial press could be required to walk to another area every so often to get more raw materials.
“That could be almost like a work break. They’re still working, but they’re varying their tasks so they get a little bit of movement. They’re not fixed,” he says.
When workers can’t get away from their stations, they should try to move on the spot, says Mike Harnett, director of operations at WorkSMART Ergonomics in Vancouver. Even taking a very short break — which may last a few seconds, perhaps a minute or two — to get away from the stationary position will make a difference.
When standing and leaning over a workstation, for instance, a person simply needs to stop and do a back extension in the opposite direction. This balances out the postural demands on the body.
“It’s better to have several micro-breaks during the day than two long breaks,” she says. “If you have to sit or stand for more than an hour, that’s too long. You need to incorporate a micro-break at that point.”
On some assembly lines, Harnett says, people work shoulder to shoulder. This makes it impossible to move or stretch and change posture. Employers need to understand the importance of making sure each worker has some space on either side to allow them to move when there’s a break in activity.
When there’s not much opportunity to move during work hours, using allotted breaks or lunchtimes to go for short walks outside is a good way to improve circulation, says David Mijatovic, ergonomist in musculoskeletal disorder prevention at the Occupational Health Clinics for Ontario Workers in Toronto. Elevating the legs also helps, by lying down or putting them up on a chair.
Mijatovic also recommends workers get into the habit of taking a walk after getting home. Walking serves as a corrective to the inactivity of the day and has lasting health benefits.
“It’s not easy, but you have to look at it as part of your workday and get home and walk. It’s something that can last you for the ages,” he says. “Walking is great, and it’s convenient. Something dynamic — that’s the key word.”
Adjusting workstations according to workers’ different heights, especially on assembly lines, also helps reduce some of the strain of standing, Harnett says. The height of the workstation is set to suit the tallest person. Then, platforms are brought in to raise the shorter people up. The end result is everyone is working at the same angle.
“You don’t have some bending over and wrecking their back, and other people reaching up with their arms and wrecking their neck and shoulders,” she says.
The type of work should also help determine the height of a workstation, says Borwankar. For example, if a person is handling small components, as in electronics manufacturing, the desk should be higher than usual to allow the worker to see the items without having to stoop.
With heavier work, however, a lower surface is better, he adds. It allows a worker to use gravity to apply more force.
Moreover, the workstation should be organized to avoid awkward and frequent reaching, Borwankar says. Keep commonly used items close by and less needed items farther away.
“You want to avoid reaching above the shoulder or reaching behind your shoulder line — if you were to make a horizontal line through your shoulders. You don’t want to reach behind you,” he says.
Sit or stand
Some employers put a seat rest in each workstation, allowing for a real change in position, Borwankar says. If attached to a wall, a worker can easily flip it down when there’s a break in production. There should be enough space for knees and feet.
“Prolonged sitting in one position is bad, too. So if you can mix them, it’s the best of the situation,” he says.
Adding a footrest or foot rail is another effective ergonomic modification, he adds. The worker can take pressure off one leg, then the other, and the legs get some rest.
For workers on assembly lines, who often have little chance to move or sit, Harnett recommends a “sit-stand” stool be incorporated at each station. The stool, which has a tilted seat pan, is designed for perching, rather than sitting. It keeps the back in an upright posture and takes weight off the lower body.
“Seventy per cent of body weight is resting on your hips and down through your legs. So, if we can take some of that weight off, it’s going to go a long way to keeping the lower limbs healthy and to take a lot of stress off the back,” she says.
Floors made of corkwood or rubber are much easier on the body than those made of cement or metal, Borwankar says. In many warehouses, cement floors are covered with anti-fatigue matting, which reduces muscular fatigue. Carpeting should be thick enough to provide some shock absorption or cushioning. But if too thick or soft, it can actually increase leg fatigue.
Proper shoes can also reduce the bad effects of prolonged standing. Borwankar suggests workers shop for shoes after they have been standing for a while. By trying footwear on when feet are swollen, they can make sure their shoes fit properly all day long.
Wearing high heels, of course, should be avoided, he says, but completely flat shoes are not a good alternative — shoes should provide good arch support. They should also allow for the movement of the toes. Laces are preferable to Velcro straps because they allow a person to adjust the tightness of the whole shoe.
Putting insulating insoles into shoes will provide support and also help keep feet warm — especially important if the floor is cement, metal or some other hard surface, Harnett says.
“And if they’re standing on concrete without insoles, their feet will collapse a bit sooner. So you want good compressible insoles,” he points out.
Jim Wright, national representative with United Food and Commercial Workers Canada, says proper shoes can be so expensive that the union often tries to negotiate them into contracts, requiring an employer either to supply them or pay an amount of money towards them.
“It should be up to the employer to supply that type of footwear, in a situation where a person has to deal with prolonged standing in one place,” he says.
Wright believes employers need to pay more attention to the ill-health effects of prolonged standing. They tend to neglect the problem, he says, because other health and safety issues, such as accidents, are always in the forefront.
“Yet, repetitive strain and musculoskeletal injuries from repetitive work are the vast majority of the claims that are being dealt with through the workers’ compensation boards across the country,” he says.
The tendency to underestimate the damage that prolonged standing can cause makes it more important for workers to speak up. If they have a problem with their workstation, for instance, they need to raise it with someone who can take action, Mijatovic says, preferably a health and safety committee.
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