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Prolonged Standing at Work

Posted on by Robert B. Dick, PhD


standingThe National Retail Federation forecasts that retailers and merchants will hire between 730,000 and 790,000 seasonal workers this holiday season.[i] Many of these workers, such as sales associates and cashiers, have little, if any, opportunity to sit during their work shift. Increasingly, workers across a variety of occupations are required to stand for long periods of time without being able to walk or sit during their work shift. For example, in operating rooms, nurses and doctors must stand for many hours during surgical procedures. In retail, sales associates spend a considerable amount of their work time standing without the ability to sit down.  Female associates who wear high heel shoes are at increased risk of developing musculoskeletal pain conditions.[ii] [iii]

NIOSH conducted a review of the literature to examine the risks of prolonged standing in the workplace. “Evidence of Health Risks Associated with Prolonged Standing at Work and Intervention Effectiveness” was published in Rehabilitation Nursing earlier in the year.[iv]  Based on the research reviewed, there appears to be ample evidence that prolonged standing in the work place leads to a number of negative health outcomes. The studies consistently reported increased reports of low back pain, physical fatigue, muscle pain, leg swelling, tiredness, and body part discomfort due to prolonged standing. There is significant evidence that prolonged standing at work (primarily in one place) increases risk of low back pain, cardiovascular problems, and pregnancy outcomes.

Interventions such as floor mats, shoe inserts, adjustable chairs, sit–stand workstations, and compression stockings have been used by employees to reduce the pain, discomfort and fatigue from prolonged standing. In reviewing the studies examining the effectiveness of interventions, we concluded that dynamic movement appeared to be the best solution for reducing risk of these health problems due to prolonged standing. The ability for workers to “have movement” during work, such as walking around, or being able to easily shift from standing to sitting or leaning posture during the work shift seemed to be a common suggestion in nearly all of the literature but needs more research.

A reliable characterization of prolonged standing is needed based on a standard workday (i.e continuously standing for over one hour or standing for over 4 hours per day). Various groups, such as the Association for peri-operative Registered Nurses (AORN) and the Dutch researchers, have suggested time limits for prolonged standing, which they believe would be effective. Perhaps the solution can be found in how work is organized. Jobs should be designed to allow the employee to have control over their own bodies, such that they are able to assume different sit/stand postures and move as they need throughout their work shift.

Has your workplace addressed the issue of prolonged standing? What has worked? Please share your experiences in the comment section below.

Robert B. Dick, PhD, Captain USPHS (Ret.)  is a visiting scientist in the NIOSH Division of Applied Research and Technology.


This blog is in memory of Thomas Waters, PhD. Dr. Waters, a preeminent scientist who worked at NIOSH for 24 years, passed away in November. He made important contributions to research on work-related musculoskeletal disorders and was a co-author of the study summarized here.




[i] National Retail Federation Accessed 11/21/2014

[ii] Mika A, Clark BC, Oleksy Ł. The influence of high and low heeled shoes on EMG timing characteristics of the lumbar and hip extensor complex during trunk forward flexion and return task.   Man Ther. 2013 Dec;18(6):506-11. doi: 10.1016/j.math.2013.03.004.


[iii] Mika A, Oleksy L, Mika P, Marchewka A, Clark BC. The effect of walking in high- and low-heeled shoes on erector spinae activity and pelvis kinematics during gait. Am J Phys Med Rehabil. 2012 May;91(5):425-34. doi: 10.1097/PHM.0b013e3182465e57.

[iv] Waters, T and Dick,R. “Evidence of Health Risks Associated with Prolonged Standing at Work and Intervention Effectiveness “Rehabilitation Nursing 2014, 0, 1–18.

Posted on by Robert B. Dick, PhD

6 comments on “Prolonged Standing at Work”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    The work of Karen Messing and her colleagues has contributed a lot to making this hazard better understood and more recognised. (See the chapter in “Pain and prejudice. What scientists can learn about work from the people who do it.) Thanks for your work, and acknowledging Tom’s contribution. How does one get a copy?

    I’m wondering how this research and the relatively recent research about prolonged *sitting* mesh together. Being able to move around and neither sitting nor standing in one place seems to be the best, as is alluded to in this article. But workplaces are many and varied. It’s hard to individualize your employees’ work area across an entire facility. “Happy mediums” are extremely hard to find!

    Concerning this research, I’m particularly curious about the notion that standing for too long can lead to cardiovascular problems. Surprising conclusion.

    in my work as occupational medicine doctor, I see daily lots of workplaces where long standing is imposed either by firm policy or the place of work conditions ( lack of space in a store or the necessity to adopt a fixed position in front of a machine).The legislation in my cointry allows me to make reccomendations ( medical or ergonomic) based on the ,anamnesis,psysical exam and suplimentary medical tests. For example ,the employee that presents subjectiv and objectiv modifications in his state of health, that can be atributed to prolonged standing is either exchanged from his workplace (rotation) or he could beneficiate of 10 min every dwo hours of sitting or lying down in Trendelemburg in a separate room. If the disease can be atributed to profession, I signal it to abilitated control organisms and if the case corfirms that employee benefits of 4 to 12 salaries (depending on the disease),pait recuperatory treatment and so on.

    now a days most of the businesses specially in city centre and on the shop floors most of the employees are standing almost all day with out sitting….

    It’s fact but, it’s not all time standing all time. My job is keep on sitting 7 hours but meanwhile we have lunch and so on things we need.

    It will be interesting to conduct a study on the correlation between formation of plantar calcaneal spur and duration and frequency of prolonged standing among workers.

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