Systematic Review of the Influence of Physical Work Environment on Office Workers' Physical Activity Behavior.

BACKGROUND: Many American workers spend over 7 hours a day at work in primarily sedentary office work. Physical activity is a key aspect of optimizing health and preventing disease; yet, 80% of American adults do not meet the recommended guidelines for physical activity. In this systematic review, the relationship between physical work environment and physical activity among office workers was explored. METHODS: Of the 321 studies screened, 26 studies met the eligibility criteria and were included for evaluation in this systematic review. RESULTS: Of the 26 studies, four were cross-sectional studies, 14 were quasi-experimental studies, and eight were randomized control trials. Physical activity during the workday was measured using self-report surveys and electromechanical devices such as accelerometers. Physical work environments examined by the studies included different types of desks (n = 16), office arrangements (n = 5), and building design (n = 5). In nine studies, office environments and building work environments designed to promote activity using active design principles such as stairs and flexible workspaces were associated with increased physical activity. Sit-stand desks reduced overall sitting time, but had a minimal effect on physical activity. CONCLUSION/APPLICATION TO PRACTICE: Offices and buildings designed for activity had the largest impact on physical activity among office workers. To increase physical activity in office workers, focus should be placed on opportunities to increase incidental movement that can increase physical activity throughout the workday. Occupational health nurses should advocate workspace designs that can increase physical activity in workers.

Impact of California Safe Patient Handling Legislation: Health Care Workers' Perspectives.

BACKGROUND: Musculoskeletal injuries from patient handling are significant problems among health care workers. In California, legislation requiring hospitals to implement safe patient handling (SPH) programs was enacted in 2011. This qualitative study explored workers' experiences and perceptions about the law, their hospital's SPH policies and programs, patient handling practices, and work environment. METHODS: Three focus groups were conducted with 21 participants (19 nurses and 2 patient handling specialists) recruited from 12 hospitals located in the San Francisco Bay Area and San Joaquin Valley. Qualitative content analysis was used for data analysis. RESULTS: Multiple themes emerged from diverse experiences and perceptions. Positive perceptions included empowerment to advocate for safety, increased awareness of SPH policies and programs, increased provision of patient handling equipment and training, increased lift use, and improvement in safety culture. Perceived concerns included continuing barriers to safe practices and lift use such as difficulty securing assistance, limited availability of lift teams, understaffing, limited nursing employee input in the safety committee, blaming of individuals for injury, increased workload, and continuing injury concerns. Participants indicated the need for effective training, sufficient staffing, and management support for injured workers. CONCLUSIONS/APPLICATION TO PRACTICE: This study identified improvements in hospitals' SPH programs and practices since the passage of California's SPH law, as well as continuing challenges and barriers to safe practices and injury prevention. The findings provide useful information to understanding the positive impacts of the SPH law but also notes the potential limitations of this legislation in the view of health care workers.