PREMUS 2025: 12th International Scientific Conference on the Prevention of Work-Related Musculoskeletal Disorders
Too much standing, too little sitting? Associations between closeness to the EU-OSHA guideline for occupational physical activity and need for recovery among eldercare workers
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Introduction: Occupational physical activity (OPA) plays a complex role in recovery and health, where both too much and too little activity can be detrimental. To promote sustainable work, the European Agency for Safety and Health at Work (EU-OSHA) recommends a balanced OPA composition for jobs involving prolonged standing – such as in eldercare – of approximately 60% sitting, 30% standing, and 10% moving. This study examines whether eldercare workers whose OPA compositions align more closely with EU-OSHA recommendations report less need for recovery than those with less aligned compositions.
Methods: We analyzed data from 212 eldercare workers (188 [88.7%] women, 46.5 [SD 12.3] years of age) in three Swedish municipalities. Of these, 79 (37.3%) worked in nursing homes, and 133 (62.7%) in homecare services. Physical behaviors were assessed using a thigh-worn accelerometer worn for seven days, and working hours were identified using a self-report diary. Time spent sitting, standing, and moving at work was determined using the ActiPass software. The Aitchison distance between each worker‘s OPA composition and the EU-OSHA recommendation was calculated and expressed in terms of a closeness index ranging from 0 (composition furthest from the recommendation, [1:1:98] to 100 (ideal alignment with the recommendation, [60:30:10]). Need for recovery was assessed using the short version of the Dutch Need for Recovery Scale. The association between the closeness index and need for recovery was examined in linear mixed models, adjusting for age, sex, and sector (nursing home vs. homecare), while accounting for the hierarchical structure of the data.
Results: Eldercare workers spent on average, 47.4% of their working time sitting, 39.4% standing and 13.2% moving. The mean closeness index was 87.3 (SD 7.3). We found a negative association between the closeness index and need for recovery, for both unadjusted (β=-0.89; CI=[-1.4:-0.37]; p<0.01) and adjusted models (β=-0.95; CI=[-1.77:-0.14]; p<0.02).
Discussion: Our findings suggest that eldercare workers with OPA compositions closer to the EU-OSHA recommendation experience less need for recovery than those having more diverging compositions. This supports previous evidence indicating that an imbalance in OPA—in the present case excessive standing or moving—can contribute to fatigue and increased recovery needs. Workers were relatively close to the EU-OSHA recommended composition of behaviors, yet even small deviations were, on average, associated with higher recovery needs. However, understanding what constitutes a ‘high’ or ‘low’ closeness index in relation to health and well-being remains limited.
Conclusion: Our results show that structuring work tasks to promote a balanced mix of sitting, standing, and moving is important to prevent high recovery needs in eldercare settings. Further research is needed to understand the validity of the EU-OSHA guidelines for predicting physical behaviors that promote health. Also, in addition to the overall composition, the pattern of alternations between these behaviors should be considered to understand the extent to which different time patterns of OPA are associated with health outcomes.
