Study on prolonged standing and heart disease: Setting the record straight

Tackling three common misconceptions about the implications of IWH's prolonged standing study

Published: November 3, 2017

The recent study on prolonged standing and the risk of heart disease led by Institute for Work & Health Senior Scientist Dr. Peter Smith has received much media coverage since it appeared online in August 2017. While the researchers were encouraged to see this level of interest, some of the coverage and online commentary seemed to have missed the point. So, for the record, Smith and his team would like to tackle a few misconceptions:

Misconception #1: Office workers should now be confused about whether they should sit or stand, and about whether sit/stand stations are a good idea. They shouldn’t be, says Smith. The study’s main finding was about workers who are required to stand for long periods (i.e. five hours or more) throughout their work shift, without opportunities to sit. Extending this to any worker who stands (e.g. an office worker using a sit-stand desk) is not correct. This is because office workers who stand at these types of workstations likely have the option to sit down when they get tired or when they feel pain in their legs and back.

This study was about people in jobs where sitting is not an option—retail workers, assembly line workers, bank tellers, hotel front-desk clerks and grocery store cashiers, for example. It’s understandable why office workers have dominated the discussion; they make up nearly 40 per cent of the labour force, while the standing occupations account for about 10 per cent. But it bears repeating: this study was not about office workers who have the ability to sit or stand at their desks; nor was it about the value of sit/stand workstations.

Misconception #2: We no longer have to worry about the negative health effects of prolonged sitting, thanks to this study. Not so fast, says Smith. There was nothing in this study to refute the research on the health consequences of a sedentary lifestyle. Much of that research is about sitting too much throughout the day—at work, while commuting and at home. This study only focused on prolonged sitting and prolonged standing at work.

And even within the study, another finding about prolonged sitting at work got lost in the coverage. Yes, prolonged standing occupations were linked with twice the risk of heart disease as prolonged sitting jobs. However, prolonged sitting jobs were still linked, among men, with a 40 per cent higher risk of heart disease compared to jobs that involve a mix of standing, sitting and walking.

Misconception #3: This was just one contrarian study, so we can ignore it. When it comes to acting on research, it’s certainly better to base decisions on systematic reviews or meta-analyses, which synthesize a body of evidence. That said, this is not the only study on the risks of prolonged standing at work, Smith notes.

For example, a literature review by the U.S. National Institute for Occupational Safety and Health (doi:10.1002/rnj.166) in 2015 found “ample evidence” of adverse risks of prolonged standing. These include low-back pain, leg pain, and chronic venous disorders such as varicose veins and chronic venous insufficiency, which is a condition of the veins that makes it difficult for blood to return to the heart, resulting in blood pooling in the veins.

For those who don’t have the subscription to access that article, a fact sheet by the Canadian Centre for Occupational Health and Safety (CCOHS), a source of health and safety information for workplaces, points to many of the same health concerns.