Associations of occupational standing with musculoskeletal symptoms: a systematic review with meta-analysis

Abstract

Objective: Given the high exposure to occupational standing in specific occupations, and recent initiatives to encourage intermittent standing among white-collar workers, a better understanding of the potential health consequences of occupational standing is required.We aimed to review and quantify the epidemiological evidence on associations of occupational standing with musculoskeletal symptoms.Design: A systematic review was performed. Data from included articles were extracted and described, and meta-analyses conducted when data were sufficiently homogenous. Conclusions: The evidence suggests that 'excessive' occupational standing is associated with the occurrence of low-back and (inconclusively) lower extremity symptoms, but there may not be such an association with upper extremity symptoms. Only limited evidence from high quality, longitudinal studies using objectively measured standing was found.  The association of occupational standing with musculoskeletal symptoms is yet unclear, with no current systematic review quantifying this association. WHAT ARE THE NEW FINDINGS: We systematically reviewed literature and identified substantial evidence (50 articles from n=88,158 participants) describing associations of occupational standing with low-back, lower extremity and upper extremity symptoms. We found evidence (including pooled data from a meta-analysis) for associations between occupational standing and the occurrence of low-back and (inconclusively) lower extremity symptoms, however not for upper extremity symptoms. We found only limited evidence from high quality, longitudinal studies using objectively measured standing was found. Such information is needed to provide more definitive evidence to inform good work design for both blue-and white-collar workers.4

Does a Classroom Standing Desk Intervention Modify Standing and Sitting Behaviour and Musculoskeletal Symptoms during School Time and Physical Activity during Waking Time?

“…This suggests that spending more time standing at school may not cause additional lower limb discomfort, even though these joints take more load in standing and prolonged occupational standing is associated with lower limb and back discomfort [33]. Weight shifting or the use of the fidget bar could have contributed to this.…”

“…However, only a few studies have explored the effects of standing desks on musculoskeletal discomfort in children and results from these studies were inconsistent [31,32]. Given that research that has examined the association of occupational standing with musculoskeletal symptoms in adults has found that prolonged standing in adults is associated with the development of low back pain [33], it is important to examine the relationship between standing and musculoskeletal symptoms in children. If standing desks prove to be effective in increasing standing time and decreasing sitting time in children, while not causing excessive musculoskeletal discomfort, schools would have more reasons to implement these desks in classrooms.…”

Frequent Exertion and Frequent Standing at Work, by Industry and Occupation Group — United States, 2015

“…Recent studies have emphasized health risks associated with excessive sitting during the workday ( 8 ); however, excessive standing on the job also has been linked to adverse health outcomes ( 9 ). A systematic review of peer-reviewed articles on musculoskeletal symptoms and occupational standing as the main exposure variable found that occupational standing is associated with low back pain; however, associations with lower and upper extremity symptoms were inconclusive ( 9 ).…”

“…A systematic review of peer-reviewed articles on musculoskeletal symptoms and occupational standing as the main exposure variable found that occupational standing is associated with low back pain; however, associations with lower and upper extremity symptoms were inconclusive ( 9 ). More research is needed to understand how to balance time spent sitting and standing while at work.…”

Evidence to design ‘just right’ work using active workstations is currently limited

“…For example, the risk of back pain with prolonged standing, as shown in recent reviews of laboratory10 and field11 evidence.…”