Bernadino Ramazzini became interested in occupational diseases while still a medical student in Parma. He carefully observed the diseases experienced by different workers. He noted that although some were caused by occupational exposure to chemical or physical agents many occupational illnesses were due to prolonged postures, sudden movements or lack of motion. He observed that sedentary tailors were more likely to succumb to disease than flighty messengers. 

Ramazzini made his shrewd observations in the early Enlightenment period. Now, a sedentary lifestyle has become the norm, especially in the workplace. A recent groundbreaking study, following in Ramazzini’s footsteps, has shed light on the health risks associated with prolonged occupational sitting. This research was conducted over two decades in Taiwan. It explores the silent but substantial impact of sitting for extended periods at work. The study also examines how modest increments in physical activity can counteract the detrimental effects of prolonged sitting.

The Silent Threat of the Modern Workplace

In recent years, the mantra “sitting is the new smoking” has echoed through the both corridors of public health and the echochambers of social media. In keeping with this, public health offcials and social media influencers urge us to reevaluate our sedentary habits via our mobile deives. The 2020 World Health Organization guidelines took a definitive stance (no pun) against prolonged sedentary behaviour. The guidelines highlighted its adverse health consequences. Yet, the specific dangers of occupational sitting, especially when combies with low levels of physical activity, remained relatively underexplored until now.

The Sitting Study Cohort

The study analysed the health outcomes of 481,688 participants. It revealed a stark contrast between the health of those who sit extensively at work and their more active counterparts. Individuals entrenched in sedentary occupations faced a 16% increase in all-cause mortality risk. In addition, they had a staggering 34% rise in cardiovascular disease mortality when compared to those whose jobs involve more standing or movement.

However, there’s a potential silver lining. Alternating between sitting and standing at work, or incorporating just 15 to 30 minutes of additional leisure-time physical activity (LTPA) daily, can significantly mitigate against these risks. This finding introduces a new narrative. The idea that small, consistent changes in our daily routines can combat the health risks posed by a sedentary job.

Get Up, Stand Up. Stand Up for Your…. Health

The conversation around occupational health is slowly evolving. Standing desks and walking meetings are becoming more commonplace. This study does provide some validation for these trends which have often, reasonably, been thought of as faddish. It also highlights the necessity for a broader cultural shift in our workplaces and working practices. To some extent, it’s a call to action for employers and employees to embrace more dynamic work environments where movement is integrated into the fabric of our workdays.

The Role of Personal Activity Intelligence (PAI)

One of the most compelling aspects of the study is the introduction of the PAI metric. This is a personalised measure of physical activity. PAI considers the intensity and duration of exercise. Every time your heart rate increases you earn PAI points. The higher your heart rate goes up, the faster you accumulate PAI points. According to the study, achieving a PAI score greater than 100 was a robust strategy for counteracting the health risks associated with prolonged sitting. Indeed, Norwegian University of Science and Technology research suggests that people who achieve a PAI score of over 100 every week live an average of 8 years longer than those who don’t. PAI, therefore, offers a more tailored approach to health that goes beyond bland and generic recommendations. How do you achieve a PAI of over 100? Well, slightly annoyingly, there’s an app involved. However, it doesn’t take much to get a score of over 100. 2 hours of exercise at 80% of your maximum heart rate per week will get a PAI score of over 100. The beauty of PAI is that is adjusts to your fitness levels. The fitter you are, the harder, or longer you have to workto achieve your PAI. 

Moving More, Sitting Less

The implications of this research are clear. In combating the hazards of that come as the collateral damage of our sedentary modern life, every step counts. Whether it’s taking a brief walking break, choosing a stand-up desk, or dedicating a proportion of our free time to physical activity, these actions can collectively mitigate some the health risks posed by prolonged sitting.

In essence, this study serves as a reminder that our health is in our hands (and feet). We have choice, agency, in how we move our bodies at work. It challenges us to rethink our daily routines, to find balance in movement, and to prioritise movement in the workplace and beyond. Ramazzini exhorted people in sedentary professions to take physical exercise…. and so to counteract the harm done by many days of sedentary life.” Today, as we continue to tackle the demands of modern work and living, be mindful that movement is not merely a part of life, it’s essential to living well.

Dr J Hugh Coyne

Private GP

Coyne Medical