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Although the word ergonomics joined the English language less than 100 years ago, the idea of ergonomics goes back over 2,000 years. Hippocrates himself weighed in on how a surgeon should set up his workspace and arrange his instruments, but his concern seems to have been only with creating an efficient workflow. By the Middle Ages it became clear that over time some forms of work harmed workers, a problem so acute that Ramazzini published his Diseases of Workers (De Morbis Artificum Diatriba) in an effort to protect workers from their work. Thus, the tension between efficient and healthful work environments has been understood for over three centuries, but the relative importance of these two interests has seesawed back and forth over time.

While the conflicting requirements of efficiency and health were clear, the Western capitalist world immediately prized efficiency over the health of workers. So it was that the “Taylor method” devised by Winslow Taylor was able to triple the amount of coal a man could shovel by reducing the size of shovels1, but little thought was given to the effect this change might have on the men doing the shoveling. (It was clear, however, that the increase in output wouldn’t affect the men’s wages2.) Similarly, it was discovered that bricklayers could lay bricks three times as fast when the process was streamlined, but again little attention was accorded the how this affected the bricklayers. Ultimately it was left to Russian researchers to push back and emphasized the importance of protecting the human machines involved in production3, proclaiming in 1921 “The ultimate ideal of the labor problem is not in Taylorism, but is in such organization of the labor process that would yield a maximum of efficiency coupled with a minimum of health hazards, absence of fatigue and a guarantee of the sound health and all-round personal development of the working people.”

While this debate from a century ago is ever with us, there have been notable successes: For example, the science of ergonomics has made impressive inroads into preventing repetitive stress injuries by understand their cause and redesigning tools and workflow to protect workers. And by understanding how humans interact with machines ergonomists have redesigned many machines to be safer. For example, by simply making the instrument panel of an airplane easier to scan for critical information plane crashes were reduced. This idea has been applied to the dashboards of cars, making driving less distracting, and safer.

Avoiding the disastrous plane and car crashes is an obvious priority, and ergonomic researchers engaged fully with these problems and substantially reduced crashes. Unfortunately, less dramatic problems haven’t attracted the same sort of ergonomic scrutiny. A striking example is the office chair. Although the average American sits for over 8 hours each day, the office chair hasn’t changed in half a century. New models appear every year, as marketing requires, but the basic design enforces the same “90-90-90” sitting position (knees, hips, and ankles at 90 degrees) advocated in the 1800’s. There is little evidence that this position is optimal, and human anatomy suggests that a more open hip angle is a far more physiologic, and comfortable, way to sit because it encourages the lumbar spine to express its normal lordosis. This central diagram in this illustration from Galen Cranz book The Chair shows that the psoas muscle, which connects the lower spine to the femur, naturally pulls the lower spine into its lordotic curve. By contrast, sitting with the hips at 90 degrees, as in the left-hand diagram, forces the low back to round, a position that not only looks uncomfortable, but is uncomfortable.

Sitting with the hips at 90 degrees, as in the left-hand diagram, forces the low back to round, a position that not only looks uncomfortable, but is uncomfortable.

Yet surprisingly ergonomic textbooks, and companies manufacturing our office chairs, continue to espouse the 90-90-90” posture despite an epidemic of back pain and a plethora of proposals for other options: yoga balls, standing desks, treadmill desks, reclining desks, and more. Over $1B worth of standing desks were sold in the US last year, without any research showing that they are actually helpful. Those condemned to sitting at desks, 25% of America’s work force, are obviously searching for a solution beyond the 90-90-90 office chair. But inexplicably the ergonomic world seems to be ignoring this clamor.

Or, maybe it’s not so inexplicable. The ergonomic community and the office chair industry have a long and cozy association. The “Big chair” lobby has decades of advertising invested in the 90-90-90 posture, and especially in the concept of “lumbar support”. It would be embarrassing, and expensive, to walk back all this “scientific certainty” as well as the sunk costs of decades of marketing.

And there’s this: overwhelming epidemiological research shows that passive sitting has created a public health crisis. Sitting passively for 8 hours a day shortens our lives by as much as two years4. Surely the office chair industry and the ergonomic community are aware of these inconvenient facts. But we hear… crickets.

What’s to be done? In the long run the ergonomic community will need to expand its focus to include total health, not just avoiding repetitive stress injuries and increasing production. Perhaps the “guarantee of the sound health and all-round personal development of the working people” that researchers advocated 100 years ago should finally be the goal.

In the short run, we’ll all have to make our own best choices. Don’t take how you sit for granted. If you work from home, set up your office with an eye not only to efficiency, but to health as well. And if you work in an office, ask if your employer provides better sitting options than a standard “ergonomic” office chair. And if your employer gives you only bad choices, well, you may have to bring your own chair to work. It might even be an active chair.



3First Conference on Scientific Organization of Labour

4Sedentary behaviour and life expectancy in the USA: a cause-deleted life table analysis

Turner Osler

Turner is the CEO and Founder of QOR360. Dr. Osler is an academic trauma surgeon turned research epidemiologist who has published over 300 peer-reviewed medical papers and book chapters. As a physician who’s suffered from a tyranny of conventional chairs for most of his life, Dr. Osler’s quest for a healthier way to sit led him to develop a healthier chair.

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