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Bodies at Work

By Amanda Kolson Hurley
From treadmill desks to $1,000 chairs, the marketplace for health-conscious office furniture is booming. But what do you really need to invest in? Johns Hopkins specialists in occupational and environmental health weigh in on the latest trends so that you may set up a work environment that fosters both physical well-being and productivity.
If sitting is the new smoking, I have a pack-a-day habit. 
Like most Americans, I lead a sedentary life. I’m a writer, and in the run-up to a big deadline, I might sit at my desk for 12 or 14 hours a day. I belong to the growing cohort of home workers, so my morning commute is a mere seven steps from bedroom to office. How convenient—and yet how bad for my body, hunched over a laptop again when it could be ambling down the street or even standing upright in a packed subway car. Sure, I intend to take yoga breaks, to get up and stretch. Then a new email pops up. And then another ... 
In an era of instant communication and rocketing productivity, there’s still no hack that can change our mortal nature. We are flesh and blood, prone to all that entails, whatever we do for a living. “We all bring our bodies to work,” says Dr. Francesca Litow, co-director of the Occupational and Environmental Medicine Training Program in the Johns Hopkins Bloomberg School of Public Health. 
Work isn’t easy on our bodies, and it’s not only people with physically strenuous jobs who pay the price. According to the U.S. Bureau of Labor Statistics, musculoskeletal disorders—including repetitive-strain disorders—accounted for 33 percent of occupational injuries and illnesses requiring days off work in 2013. Recent news stories have made us hyperaware of the danger posed by what seems like the most innocuous workday activity: sitting down. 
This January, a widely reported study published in the Annals of Internal Medicine found that the amount of time a person sits during the day is associated with a higher risk of heart disease, diabetes, cancer, and death, even if the person gets regular exercise (although that can lessen the effects). The researchers looked at 47 previous studies on sitting and mortality to reach their conclusions. American workers are understandably alarmed, and many of us are rethinking our daily routines. We’re buying standing desks or hitting the gym with a stack of reports—anything to avoid more time parked in a chair. 
Litow says that we should try not to panic. Usually, people who are experiencing discomfort on the job—or who are hoping to avoid it—can improve their health in their work environment by making small, targeted changes. Most of these are cheap or free. “You can certainly find a $1,000 chair,” Litow says. “You can also find a much less expensive chair that is fine.” 
In fact, some of the products being marketed to make us healthier, such as treadmill desks or sitting balls, have their own significant drawbacks. Here are the evidence-based strategies that Hopkins experts recommend for staying healthy at work without chasing fads or spending a small fortune. 

Sit for Shorter Periods

“Sitting Is Killing You,” blared a recent headline in Time magazine. Well, thanks for the death warrant. Coverage of the sitting “epidemic” can sound hysterical, but there’s no question that we are sitting too much, and for too long without shifting posture. Sitting for more than an hour causes changes in how the body produces the enzyme lipase and how it metabolizes glucose, leading to the deposit of fat in tissues. Sitting down also burns about 20 percent fewer calories than standing up. 
This might prompt you to ask if standing is the answer. In a word: No. “Standing all day is not a piece of cake, either,” says James Bukowski, director of Occupational and Environmental Safety at Johns Hopkins Medicine.  It increases circulation, which is a good thing, but it also puts more pressure on our back, feet, and joints, and it raises the risk of developing varicose veins.
Sitting less doesn’t necessarily mean standing more—after all, you burn more calories when you’re on the move, even if it’s just swinging by the break room for a water refill. Litow and Bukowski recommend taking frequent mini-breaks, getting up from your chair to stretch and walk around every 15 minutes or so. “The worst case is that you sit for your entire work shift,” Litow says. Bukowski suggests setting a timer to go off, and there are multiple apps, such as Stand Up! for the iPhone, Time Out for Mac, and Breaker for Windows, that allow you to do that. 
But maybe you want or need to stand for part of the day. Sit-stand desks have surged in popularity in recent years. One Cadillac model, released just this year, nudges you to stand at intervals, moving up and down slightly when you’ve been seated long enough. At a cool $2,990, it’s an investment, like other top-of-the-line products in this category. Bukowski says you don’t have to shell out for a sit-stand desk, and more affordable models like the Ergotron WorkFit and the Varidesk work fine. Some research has found that users end up not standing all that much, another reason not to spend a lot of money.
The amount a person sits during the day is associated with a higher risk of heart disease, cancer, and death. 

Sit the Right Way  

Even if you’re a sit-stand convert, that doesn’t cancel out the need to sit correctly for the periods when you are in your chair. Perhaps the most important thing you can do to avoid strain is to make sure your work chair is fully adjustable, with a pneumatic height lever; that it offers lumbar support for your lower back; that it has a separate chair back and seat pan; and that it is comfortable to sit on, with a “waterfall” front (curved down, so there’s nothing hard pressing against the back of your thighs). 
And just possessing the chair isn’t enough—you have to actually adjust it, or get someone who’s knowledgeable about workplace health and safety to do it for you. People often don’t realize how much they can adjust their chairs and other equipment (“You don’t get operating manuals,” Bukowski notes), or they become passive about it.   
Another crucial thing is foot position. Tucking your feet under your chair can hamper circulation, and if your feet don’t reach the floor, you probably need to adjust your chair. When she is called to do a workstation assessment, Litow says she always begins by placing the person’s feet on the floor. 

Stay Neutral  

The goal of ergonomics, which is the study of people at work, is to reduce stress and eliminate injuries caused by bad posture, overused muscles, and repeated tasks. “The first thing we’re looking for, ground zero, is that you want to make sure you’re in alignment,” says Bukowski, who has been doing ergonomics surveys at Johns Hopkins for almost 20 years. Awkward, misaligned postures can take small and surprising forms. Maybe you talk on the phone a lot, jamming it between your ear and one shoulder. (Consider using a headset.) Maybe you have a box or computer tower under your desk and sit with your legs to one side of it. (Move it somewhere else.)
The Occupational Health and Safety Administration has a detailed checklist for anyone who wishes to perform a self-assessment. The short version: Maintaining a neutral posture is key, Bukowski and Litow say. If you’re seated, sit back in your chair and face forward, with your lower back supported. The angle between your torso and legs should be between 100 and 110 degrees. When you’re typing, your elbows should bend at approximate right angles and your shoulders should be relaxed. “The only thing you should try to keep straight [is] your wrists,” Bukowski says. 
Illustration of a worker sitting at a desk
Repetitive flexing and extending of your wrists increases the pressure on the carpal nerve tunnel. The link between hand and wrist movements and carpal tunnel syndrome is still not clear, but it can contribute to other problems, like cramping and tendonitis. “Awkward postures and typing can increase your risk for developing CTS, but it will not affect everyone equally,” Bukowski says. “It’s worth noting that increases in body fluid retention increase your risk of carpal tunnel syndrome. For example, it’s well-established that pregnancy is strongly related to developing CTS.”
“The first thing we’re looking for, ground zero, is that you want to make sure you’re in alignment.”
Despite all the discussion of whether and how to sit, the proper setup of your computer monitor has a big effect on posture, too. Seated or standing, you want to be able to touch your monitor without much effort, and the top of it should be at or slightly below eye level. If you use two monitors, the midpoint between them should be right in front of you so there’s no extended rotation of the neck to view either one. Bukowski observes that people who wear bifocals often tilt their heads back to look at their computer screen, which can cause strain. He recommends getting a special pair of “computer glasses” (an optometrist can make the right lenses). 

Establish an Action Zone, and Keep It Clean 

Keep the items you use regularly—your keyboard, mouse, and phone, for starters—in an “action zone” within easy reach. Litow says she sometimes finds herself playing interior designer, organizing people’s desks so go-to items are close at hand. Equipment you use less often can be kept farther away, even much farther. Consider putting the printer on the other side of the room so you’re forced to get up and walk to it, Bukowski advises. 
Laptops aren’t designed for long-duration use. Their screens are too low, and the keyboards are too small, which promotes deviation of the wrist. If you use a laptop, get a docking station with a separate monitor and keyboard. An ergonomic keyboard isn’t essential, unless you have a hand or wrist condition, but it’s a good idea. 
Once your action zone is established, keep it clean. Bacteria and viruses can live on work surfaces. Wipe them down, especially if you share a desk or your phone. It should go without saying to wash your hands before you eat and after you go to the bathroom, especially during cold and flu season. And stay home when you’re sick. 
Laptops aren’t designed for long-duration use. Their screens are too low, and the keyboards are too small.

Check Your Building 

Finally, if you’re experiencing frequent headaches at work or stubborn upper respiratory problems (nasal congestion, a cough), the building could be a factor. There may be a problem with the heating, air conditioning, and ventilation system. “Often when people say they don’t feel well at work … the cause of that is [that] the ventilation system was designed for one setup, then over time the office [was] redesigned,” Litow says. If the interior space has been reconfigured without appropriate changes to the HVAC, there may be too few air exchanges (or, less commonly, too many). Tell your manager or HR about your symptoms. 
Of course, that’s not an option if you work from home. A home office is not a respite from the problems outlined above—in some ways, it’s more of a Wild West since it’s not subject to the usual workplace safety regulations. People who work from home should buy the right furniture and equipment, change their air filters regularly, and not fall into the “just for a little while” trap. We tell ourselves we’re going to work for a few minutes, sitting on the couch or lying in bed with an iPad, and then we lose track of time.  
Which reminds me: I’ve been sitting here for a while. Time to get up, walk around, and change the air filter.  
man sitting and working
Ray Zapanta

Given the increased interest in staying healthy at work, lots of products are being marketed to that end. Not all of them are worth the time or money. Here are the ones that Hopkins experts say to think twice about or skip altogether.

Sitting balls. “We don’t recommend ball chairs at all,” Bukowski says. There’s a risk of injury (people fall off), and some models have no lumbar support. Research suggests they have few advantages over a conventional chair. However, Litow acknowledges that some people really like them, and you can put them in cradles so they don’t escape. 
Treadmill desks. Bukowski calls these “the pet rocks of office ergonomics.” They’re expensive and take up a lot of space, and there are many tasks you can’t perform well on a treadmill (try moving data between two spreadsheets while walking in place). A sensible compromise: When you have a conference call or want to listen to a webinar, hit the treadmill at the gym. 
$1,000 chairs. Unless you really want to drop a lot of money on a chair (say, a Herman Miller Aeron), there are plenty of less expensive, equally serviceable options. 
The “chair-free office.” Designers in the Netherlands have taken the office layout to the next level with a concept for a chairless office. It looks like a carnival funhouse, minus the fun. Maintaining a neutral posture in this room of irregular blocks would be challenging, to say the least. 

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