Is sitting the new smoking?
The press is awash with reports highlighting just how bad it is for people to spend prolonged time sitting down. Research suggests that the ill-health effects of prolonged sitting can be as bad as smoking.
The average person in the UK spends a staggering 8.9 hours every day sitting down. Some of this time might be at work, and some in a car or on the sofa in front of the TV. For many workers in the UK, 80% of their working day is spent sitting or performing sedentary tasks.
Such inactivity can reduce lifespan. A recent Australian study has shown that the human lifespan is reduced by 22 minutes for every hour of sitting. Other studies have shown that prolonged periods of inactivity not only increase the risk of obesity but also cause an astonishing list of other conditions. These include heart disease, diabetes, colon cancer, muscular and back issues, deep-vein thrombosis, brittle bones, depression and even dementia.
The World Health Organisation has identified physical inactivity as the fourth biggest killer in the world, which is a stunning statistic.
A study of bus drivers and conductors carried out by Transport for London in the 1950s provided stark evidence of the dangers of spending too much time sitting down. It found that drivers, who spent more of their time sitting, were 1.5 times as likely to develop heart disease as conductors, who stood more often.
The effects of a sedentary life and work style have been known for some time, but only now is it being realised that the serious health effects of sitting are perhaps on a par with those from smoking.
What, then, are the implications and obligations for companies and other organisations in relation to the health of their employees? Are there any legal requirements? What action, if any, should they take?
The legal case for action
The common law duty of care developed in the courts during the 20th century, in particular through the case of Donoghue v Stevenson in 1932. Breach of this duty can lead to compensation claims for negligence for injuries and ill health sustained at work.
For any claim to succeed there must be evidence to link a work activity with an injury or incidence of ill health and legal concepts such as “reasonable foreseeability” will be important.
For a long time, civil claims for diseases derived from exposure to asbestos or cigarette smoke failed because there was insufficient evidence to prove a causal link between the exposure and the disease. Perhaps, with the accumulation of scientific evidence of the ill-health effects of sitting, we are reaching the stage where employers may be liable in civil claims for compensation for ill health brought about by sedentary work, including sitting?
The Health and Safety at Work, etc Act 1974 contains general requirements for the protection of employees and others but does not include specific duties to alleviate the ill-health effects of sitting.
The dramatic effects on health from prolonged sitting have thus far not been especially recognised by the Health and Safety Executive. In its publication HSG57 Seating at Work it takes the view that sitting is often preferred to standing and makes the following comment.
“People find it more comfortable to sit rather than stand whilst working, unless the type of work requires constant stretching or twisting to reach or lift objects. Employers therefore need to ensure that work is organised to allow people to be seated wherever possible.
In circumstances where sitting is not possible, for instance where work has to be done over a large area or where constant handling of heavy objects cannot be avoided, standing may be preferable. In this case, employers need to ensure that workers take adequate rest breaks and that suitable comfortable seating is provided during those breaks.”
It does recognise to some extent that discomfort from sitting or standing can occur, and provides this advice.
“Standing or sitting for long periods can lead to discomfort and may result in long-term health problems, so it is important that workers have the opportunity to change position, stand up and move around.
If possible, the workstation and seating design should allow for free movement. If this is not possible, an employer can provide opportunities for movement by giving employees a variety of tasks or introducing task rotation, or by ensuring that employees take adequate rest breaks away from the workstation.”
Many people sitting at work will be working at a computer screen and will be governed by the Health and Safety (Display Screen Equipment) Regulations 1992. The Regulations do not currently recognise that sitting for long periods may be bad for health. They do specify the quality and type of seat to be used and do require breaks from the screen when discomfort occurs.
What action should employers take?
It is easy to be blasé or play down the increasing evidence about the ill-health effects of sitting. That is exactly what happened in relation to the effects of cigarette smoke, until it was too late for millions of smokers and those passively exposed to cigarette smoke.
It may now be time for employers to take seriously the mounting evidence and take action to protect their employees. As always, the starting point should be a risk assessment to evaluate those tasks that involve prolonged significant sitting and whether action should be taken to make work less sedentary. This is likely to be a complex matter, bearing in mind many people like sitting and others have disabilities or health issues which may limit how much physical activity they can undertake.
A review of prolonged sitting will show what action should be taken which may include the following.
- Work rotation and the introduction of non- or less sedentary tasks. This may include breaks from display screen equipment work to include tasks which involve more standing and more physical activity.
- The introduction of “standing desks” where workers stand instead of sit at their workstations. An innovation from the USA include “treadmill” desks where the worker is actually exercising while working but these are probably not a solution for many UK workplaces, especially when such desks cost up to £3000.
- The introduction of well-being workplace schemes such as gyms, gym membership, and education about the benefits of exercise.
- Incentive schemes which reward well-being behaviour at work and at home such as partaking in exercise, good diet and weight management.
Conclusion
It seems a long time ago since Dame Carol Black published her review of the health of Britain’s working age population in 2008, Working for a Healthier Tomorrow. Her review sought to promote health and well-being in the workplace as this would not only benefit Britain’s workforce but also employers, as they would incur fewer of the costs associated with ill health in the workforce. She recommended a shift in attitudes about health in the workplace. She also recommended a model for the early intervention on health issues in the workplace.
In light of her report the evidence of the ill-health effects of sitting at work has a special significance, and should be a stimulus for action by employers. Perhaps the evidence about the effects of sitting will be the catalyst for change and action by employers and maybe they need to think and act in a radical non-conformist manner?
The danger is that, like smoking, the evidence will be ignored for the next 20 years, potentially leading to early death for thousands of workers who spend their working day sitting.