Complications of prolonged standing

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The complications of prolonged standing are conditions that may arise after standing, walking, or running for prolonged periods. Many of the complications come from prolonged standing (more than 60% of a work day) that is repeated several times a week. Many jobs require prolonged standing, such as "retail staff, baristas, bartenders, assembly line workers, security staff, engineers, catering staff, library assistants, hair stylists and laboratory technicians". [1] The basic physiological change that occurs in the body during prolonged standing or sudden stand from supine position is that there will be increased pooling of blood in the legs. This decreases the venous return, and so there will be decreased cardiac output, which ultimately causes systolic blood pressure to fall (hypotension). This hypotension may lead the subject to faint or to have other symptoms of hypotension. Standing requires about 10% more energy than sitting. [2] [ better source needed ]

Contents

Prevalence

There are no exact measures of how prevalent the complications are. However, European studies report that between one third and one half of all workers spend at least four hours per Working time (for an average workday of eight hours) standing or walking. [3] One estimate from the United Kingdom stated that over 11 million people stand for long periods of time without rest. [1]

Complications

Slouching

Proper posture is often referred to as a "neutral spine"; slouching is an improper posture or a "nonneutral spine".

Slouching is often described as improper posture, movement or rigidity of the spine, especially the cervical and thoracic regions, in relation to other parts of the body.

Varicose veins

Varicose veins are veins that have become enlarged and twisted, especially within the legs, ankles and feet of an affected individual. [4]

When standing, gravity pulls the blood downwards to the lower part of the body. Body mechanisms, such as vasoconstriction and valves of the veins, assist in pumping blood upwards. [5] As blood is pumped through the body, the valves within the veins prevent the blood from flowing backwards. After extensive, prolonged standing, these valves can become weak and eventually fail. When this happens, blood is no longer being prevented from flowing backward. Gravity will pull the blood back into an individual's legs, ankles and feet. This forces the veins to expand or "balloon" to accommodate this extra blood.

The valves of the veins work best in concert with accompanying muscle contractions that force the blood to continue moving up the leg. Standing with some muscles constantly strained weakens these muscles and therefore the strength of the contractions. Varicose veins have also been associated with chronic heart and circulatory disorders and hypertension as well as complications related to pregnancy.

Prolonged standing increases the risk for hospitalization from varicose veins. [6] Among the working age population one out of five hospitalizations from varicose veins are as a result of prolonged standing. Prolonged standing leads to impeded blood flow and stasis in the veins in the lower limbs, which can cause varicose veins.

Cardiovascular disorders

Standing for prolonged periods can lead to certain cardiovascular disorders. In a study by Krause et al. (2000) [7] the authors examined the relationship between standing at work and the progression of carotid atherosclerosis in men. Standing for long periods can change the distribution of blood in the extremities. This in turn causes the blood to pool and reduces the circulating blood plasma volume leading to hemodynamic changes that impact the body. The authors reported that long periods of standing at work were significantly associated with atherosclerotic progression. This study provides evidence that hemodynamic changes from standing can influence the progressions of carotid atherosclerosis. The authors also found that men with carotid stenosis or ischemic heart disease were at greater risk for the progression of atherosclerosis . Atherosclerosis can lead to coronary artery disease, carotid artery disease, peripheral artery disease, and aneurysms. [8]

Joint compression

Standing places significant pressure on the joint of the hips, knees, ankle and feet but without any significant movement of it. [9] This reduces the normal lubrication and cushioning of synovial joints, causing them to tear. The combined effect of pressure and tearing can cause extensive amounts of pain and make it difficult to move or walk. [3]

Muscle fatigue

Muscles kept in a constant stress position quickly become exhausted and can result in pain and swelling in the lower back, legs, ankles and feet. [10] [11]

The Occupational Safety and Health Administration (OSHA) has stated that muscle fatigue and musculoskeletal disorders account for "33% of all worker injury and illness". [12] Considerable research has been conducted as to the extent of muscle injuries and all have concluded that these are expected but can be reduced with breaks and the availability of chairs.[ citation needed ]

Research has shown that the body experiences muscle fatigue after standing for five hours; this fatigue persists for more than 30 minutes after the end of the work day according to electronic measurements of fatigue. [13] The perception of fatigue is subjective and does not necessarily correlate with the experimental indicators of fatigue.

Pregnancy

Walking or standing more than six hours per day has been linked with pre-term births, low birth weights as well as high blood pressure for the mother. [14]

Researchers have found that working more than 25 hours a week has been "associated with slower rates of fetal growth". They also found that, on average, there are no "negative effects of working up to 36 weeks into pregnancy". [15]

Productivity

A systematic review from Karakolis and Callaghan [16] found that sit-stand workstations did not reduce worker productivity. Three of the reviewed studies found increased productivity when workers used sit stand stations, four reported no impact on the productivity of workers, and one reported mixed results.

Intervention

There is no real prevention for standing, but there are ways to mitigate time spent standing in the workplace. Experts suggest to move around and change positions throughout the day. It is best not to sit in one position for more than 20 minutes, or to stand in one position for more than 8 minutes. [17]

If prolonged sitting in the workplace is required or desired, individuals should gradually transition to significant periods of standing. [18] When transitioning from sitting to standing, individuals might experience musculoskeletal discomfort or fatigue while the body adapts.

Companies should design workstations that are conducive to good health. Workstations should allow workers to choose between several working positions and to move easily between them. [19] Additionally, workers should be able to adjust the height of their workstations to fit their body size. Other helpful aspects of workstations are footrests, elbow rests, and seats so workers can sit when they need to.

Footwear

The choice of footwear can change the impact of prolonged standing. Shoes should support the foot, have shock-absorbing cushions, fit the foot well, and be comfortable. [19] Shoes should not be flat, have heels higher than 5 cm, or change the shape of the foot. There are also special insoles for shoes that can be used when soft mats or chairs are not available. Additionally the floors in a work area should not be metal or concrete. It is best to have cork or rubber covered floors. Floors should not be slippery.

Training and education are important components of avoiding complications from standing. Employees trained in ergonomics experience less muscle discomfort and more productivity while using sit-stand work stations than workers not trained. [20]

Floor mats

Floor mat or anti-fatigue mats are used to prevent the complication associated with prolonged standing. A study by the University of Loughborough conducted by George Havenith and Lucy E. Dorman has shown "(dis)comfort sensations did show statistically significant improvements related to mat use." [21] Proper floor mats can also be used to reduce stress on feet and knees. Anti-fatigue matting is recommended and launderable matting is preferred.[ citation needed ] A study investigating the effects of 4 different standing conditions on assembly workers showed that using mats and shoes with in-soles was perceived as more comfortable for the workers than without while standing on hard floors. [22]

See also

Related Research Articles

<span class="mw-page-title-main">Varicose veins</span> Medical condition in which superficial veins become large and twisted

Varicose veins, also known as varicoses, are a medical condition in which superficial veins become enlarged and twisted. Although usually just a cosmetic ailment, in some cases they cause fatigue, pain, itching, and nighttime leg cramps. These veins typically develop in the legs, just under the skin. Their complications can include bleeding, skin ulcers, and superficial thrombophlebitis. Varices in the scrotum are known as a varicocele, while those around the anus are known as hemorrhoids. The physical, social, and psychological effects of varicose veins can lower their bearers' quality of life.

<span class="mw-page-title-main">Vein</span> Blood vessels that carry blood towards the heart

Veins are blood vessels in the circulatory system of humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are those of the pulmonary and fetal circulations which carry oxygenated blood to the heart. In the systemic circulation, arteries carry oxygenated blood away from the heart, and veins return deoxygenated blood to the heart, in the deep veins.

<span class="mw-page-title-main">Atherosclerosis</span> Inflammatory disease involving buildup of lesions in the walls of arteries

Atherosclerosis is a pattern of the disease arteriosclerosis, characterized by development of abnormalities called lesions in walls of arteries. This is a chronic inflammatory disease involving many different cell types, and driven by elevated levels of cholesterol in the blood. These lesions may lead to narrowing of the arterial walls due to buildup of atheromatous plaques. At onset there are usually no symptoms, but if they develop, symptoms generally begin around middle age. In severe cases, it can result in coronary artery disease, stroke, peripheral artery disease, or kidney disorders, depending on which body part(s) the affected arteries are located in the body.

<span class="mw-page-title-main">Sitting</span> Resting position of human body weight, primarily supported by buttocks in contact with objects

Sitting is a basic action and resting position in which the body weight is supported primarily by the bony ischial tuberosities with the buttocks in contact with the ground or a horizontal surface such as a chair seat, instead of by the lower limbs as in standing, squatting or kneeling. When sitting, the torso is more or less upright, although sometimes it can lean against other objects for a more relaxed posture.

<span class="mw-page-title-main">Mat</span> Protective or cushioning floor covering

A mat is a hard floor covering that generally is placed on a floor or other flat surface. Mats serve a range of purposes including:

<span class="mw-page-title-main">Vascular surgery</span> Medical specialty of the blood/lymph vessels

Vascular surgery is a surgical subspecialty in which vascular diseases involving the arteries, veins, or lymphatic vessels, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The specialty evolved from general and cardiovascular surgery where it refined the management of just the vessels, no longer treating the heart or other organs. Modern vascular surgery includes open surgery techniques, endovascular techniques and medical management of vascular diseases - unlike the parent specialities. The vascular surgeon is trained in the diagnosis and management of diseases affecting all parts of the vascular system excluding the coronaries and intracranial vasculature. Vascular surgeons also are called to assist other physicians to carry out surgery near vessels, or to salvage vascular injuries that include hemorrhage control, dissection, occlusion or simply for safe exposure of vascular structures.

<span class="mw-page-title-main">Atheroma</span> Accumulation of degenerative material in the inner layer of artery walls

An atheroma, or atheromatous plaque, is an abnormal accumulation of material in the inner layer of an arterial wall.

<span class="mw-page-title-main">Sedentary lifestyle</span> Type of lifestyle involving little or no physical activity

Sedentary lifestyle is a lifestyle type, in which one is physically inactive and does little or no physical movement and/or exercise. A person living a sedentary lifestyle is often sitting or lying down while engaged in an activity like socializing, watching TV, playing video games, reading or using a mobile phone or computer for much of the day. A sedentary lifestyle contributes to poor health quality, diseases as well as many preventable causes of death.

<span class="mw-page-title-main">Common carotid artery</span> One of the two arteries that supply the head and neck with blood

In anatomy, the left and right common carotid arteries (carotids) are arteries that supply the head and neck with oxygenated blood; they divide in the neck to form the external and internal carotid arteries.

<span class="mw-page-title-main">Office chair</span> Chair designed for use at an office

An office chair, or desk chair, is a type of chair that is designed for use at a desk in an office. It is usually a swivel chair, with a set of wheels for mobility and adjustable height. Modern office chairs typically use a single, distinctive load bearing leg, which is positioned underneath the chair seat. Near the floor this leg spreads out into several smaller feet, which are often wheeled and called casters. Office chairs were developed around the mid-19th century as more workers spent their shifts sitting at a desk, leading to the adoption of several features not found on other chairs.

<span class="mw-page-title-main">Compression stockings</span> Compression garment

Compression stockings are a specialized hosiery designed to help prevent the occurrence of, and guard against further progression of, venous disorders such as edema, phlebitis and thrombosis. Compression stockings are elastic compression garments worn around the leg, compressing the limb. This reduces the diameter of distended veins and increases venous blood flow velocity and valve effectiveness. Compression therapy helps decrease venous pressure, prevents venous stasis and impairments of venous walls, and relieves heavy and aching legs.

<span class="mw-page-title-main">Musculoskeletal disorder</span> Pain in the muscular or skeletal systems

Musculoskeletal disorders (MSDs) are injuries or pain in the human musculoskeletal system, including the joints, ligaments, muscles, nerves, tendons, and structures that support limbs, neck and back. MSDs can arise from a sudden exertion, or they can arise from making the same motions repeatedly, or from repeated exposure to force, vibration, or awkward posture. Injuries and pain in the musculoskeletal system caused by acute traumatic events like a car accident or fall are not considered musculoskeletal disorders. MSDs can affect many different parts of the body including upper and lower back, neck, shoulders and extremities. Examples of MSDs include carpal tunnel syndrome, epicondylitis, tendinitis, back pain, tension neck syndrome, and hand-arm vibration syndrome.

<span class="mw-page-title-main">Manual handling of loads</span> Use of the human body to lift, lower, carry or transfer loads

Manual handling of loads (MHL) or manual material handling (MMH) involves the use of the human body to lift, lower, carry or transfer loads. The average person is exposed to manual lifting of loads in the work place, in recreational atmospheres, and even in the home. To properly protect one from injuring themselves, it can help to understand general body mechanics.

Active sitting is the practice of enabling or encouraging individuals to engage in physical activity while seated. It is also commonly known as dynamic sitting. The underlying notion highlights the advantages of incorporating flexibility and movement while sitting, as it can positively impact the human body and allow the completion of certain tasks that require sitting. "Active sitting, consisting of modified chairs or stability balls, allows the body to stay dynamic while seated." One of the earliest forms of active sitting is the common rocking chair which allows forward and backward swaying motion.

<span class="mw-page-title-main">Chronic venous insufficiency</span> Pooling of blood in the veins

Chronic venous insufficiency (CVI) is a medical condition in which blood pools in the veins, straining the walls of the vein. The most common cause of CVI is superficial venous reflux which is a treatable condition. As functional venous valves are required to provide for efficient blood return from the lower extremities, this condition typically affects the legs. If the impaired vein function causes significant symptoms, such as swelling and ulcer formation, it is referred to as chronic venous disease. It is sometimes called chronic peripheral venous insufficiency and should not be confused with post-thrombotic syndrome in which the deep veins have been damaged by previous deep vein thrombosis.

<span class="mw-page-title-main">Calf (leg)</span> Back part of lower leg

The calf is the back portion of the lower leg in human anatomy. The muscles within the calf correspond to the posterior compartment of the leg. The two largest muscles within this compartment are known together as the calf muscle and attach to the heel via the Achilles tendon. Several other, smaller muscles attach to the knee, the ankle, and via long tendons to the toes.

<span class="mw-page-title-main">Ergonomics</span> Designing systems to suit their users

Ergonomics, also known as human factors or human factors engineering (HFE), is the application of psychological and physiological principles to the engineering and design of products, processes, and systems. Primary goals of human factors engineering are to reduce human error, increase productivity and system availability, and enhance safety, health and comfort with a specific focus on the interaction between the human and equipment.

<span class="mw-page-title-main">Superficial vein thrombosis</span> Medical condition

Superficial vein thrombosis (SVT) is a blood clot formed in a superficial vein, a vein near the surface of the body. Usually there is thrombophlebitis, which is an inflammatory reaction around a thrombosed vein, presenting as a painful induration with redness. SVT itself has limited significance when compared to a deep vein thrombosis (DVT), which occurs deeper in the body at the deep venous system level. However, SVT can lead to serious complications, and is therefore no longer regarded as a benign condition. If the blood clot is too near the saphenofemoral junction there is a higher risk of pulmonary embolism, a potentially life-threatening complication.

Musicians can experience a number of health problems related to the practice and performance of music. The differences in career paths, occupations and performance scenarios are some of the determinants of a wide range of possible health effects.

<span class="mw-page-title-main">Ergonomic hazard</span> Physical conditions that may pose a risk of injury

Ergonomic hazards are physical conditions that may pose a risk of injury to the musculoskeletal system due to poor ergonomics. These hazards include awkward or static postures, high forces, repetitive motion, or short intervals between activities. The risk of injury is often magnified when multiple factors are present.

References

  1. 1 2 Watson, Kevin. "MSc". Standing for Long Periods. Retrieved 1 October 2015.
  2. ↑ Cornell University. "Sitting and Standing at Work".
  3. 1 2 Prolonged Standing: taking the load off, Version 2.0. From: Workers Health and Safety Center.
  4. ↑ Mayo Clinic Staff. "Diseases and Conditions: Varicose veins". Mayo Clinic . Retrieved December 22, 2015.
  5. ↑ "Society of Interventional Radiology- Patient center". SIRweb.org. Retrieved 23 February 2017.
  6. ↑ Tuchsen, F (2005). "Prolonged standing at work and hospitalization due to varicose veins: a 12 year prospective study of the Danish population". Occup Environ Med. 62 (12): 847–850. doi:10.1136/oem.2005.020537. PMC   1740939 . PMID   16299093.
  7. ↑ Krause, N (2000). "Standing at work and progression of carotid atherosclerosis". Scandinavian Journal of Work, Environment & Health. 26 (3): 227–236. doi: 10.5271/sjweh.536 . hdl: 2027.42/55329 . PMID   10901115.
  8. ↑ "Arteriosclerosis / Atherosclerosis - Symptoms and causes". Mayo Clinic .
  9. ↑ "Standing - Hazards Magazine". Hazards.org. Retrieved 23 February 2017.
  10. ↑ "Standing for Long Periods". SafeWorkers.co.uk. Retrieved 23 February 2017.
  11. ↑ Waters, Thomas R.; Dick, Robert B. (1 May 2015). "Evidence of Health Risks Associated with Prolonged Standing at Work and Intervention Effectiveness". Rehabil Nurs. 40 (3): 148–165. doi:10.1002/rnj.166. PMC   4591921 . PMID   25041875.
  12. ↑ "Safety and Health Topics - Ergonomics - Occupational Safety and Health Administration". OSHA.gov. Retrieved 23 February 2017.
  13. ↑ Garcia, M (2015). "Longterm muscle fatigue after standing work". Human Factors. 57 (7): 1162–1173. doi:10.1177/0018720815590293. PMID   26048874. S2CID   2725600.
  14. ↑ "Prolonged Standing During Pregnancy May Result In Stunted Fetal Growth". MedicalNewsToday.com. 29 June 2012. Retrieved 23 February 2017.
  15. ↑ "Standing for Long Hours During Pregnancy May Slow Babies' Growth". LiveScience.com. 30 May 2013. Retrieved 23 February 2017.
  16. ↑ Karakolis, T (2014). "The impact of sitstand office workstations on worker discomfort and productivity: a review". Applied Ergonomics. 45 (3): 799–806. doi:10.1016/j.apergo.2013.10.001. PMID   24157240. S2CID   30170218.
  17. ↑ "Yes sitting at work is bad, but is standing actually better? - The Boston Globe". BostonGlobe.com. Retrieved 23 February 2017.
  18. ↑ Buckley, J.P. (2015). "The sedentary office: a growing case for change toward better health and productivity. Expert statement commissioned by Public Health England and the Active Working Community Interest Company". Br J Sports Med. 49 (21): 1357–62. doi:10.1136/bjsports-2015-094618. PMID   26034192. S2CID   131237.
  19. 1 2 Safety, Government of Canada, Canadian Centre for Occupational Health and (2019-01-23). "Working in a Standing Position - Basic Information : OSH Answers". CCOHS.ca. Retrieved 23 February 2017.{{cite web}}: CS1 maint: multiple names: authors list (link)
  20. ↑ Robertson, M.M. (January 2013). "Office ergonomics training and a sitstand workstation: Effects on musculoskeletal and visual symptoms and performance of office workers". Applied Ergonomics. 44 (1): 73–85. doi:10.1016/j.apergo.2012.05.001. PMID   22727324.
  21. ↑ Havenith, George; Dorman, Lucy E. (2007-01-01). "The effect of COBA anti fatigue floor matting on worker comfort during standing work".{{cite journal}}: Cite journal requires |journal= (help)
  22. ↑ King, P. M (2002). "A comparison of the effects of floor mats and shoe in-soles on standing fatigue". Applied Ergonomics. 33 (5): 477–84. doi:10.1016/s0003-6870(02)00027-3. PMID   12236657.

Best shoes for walking and standing all day

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