Standing Up for Cashiers' Rights
Five years ago, customers at the Universe Club food chain complained to the Na'amat women's organization and the Labor Ministry that cashiers, some of whom were older women, were not permitted to sit during their eight-hour shift.
Peter Magnus, the chief labor inspector, appointed a panel of experts to determine whether working for long periods while standing could damage health. The panel found that standing during a shift was not detrimental to workers' health.
Dr. Avi Weiner, head of the preventive occupational medicine institute at Haifa's Rambam Medical Center, was a member of the panel. Shortly thereafter, he was asked by the SuperPharm chain for his opinion on the same matter. Universe Club also turned to him for advice. Weiner, whose institute provides paid consultations, wrote that working for long periods while standing at a cash register does not impair health.
Weiner's opinion was widely publicized yesterday by SuperPharm, which is in a struggle with the Histadrut labor federation and social organizations over the right of workers to more comfortable and dignified working conditions, including the right to sit.
Weiner's attitude has angered a number of doctors, including other experts in occupational medicine, who believe orthopedic damage must be distinguished from damage to blood vessels. From an orthopedic point of view, long periods of standing may be no more damaging than long periods of sitting. "Some people stand incorrectly and some people sit incorrectly. In both cases, it is recommended to change position from time to time," a senior physician at Be'er Sheva's Soroka Medical Center explained. "But with regard to blood vessels, there is no doubt that prolonged standing causes damage."
"Standing for long hours causes blood to pool in the veins of the legs and it can't reach the heart," said Professor Joseph Ribak, director of the national institute of occupational and environmental medicine of Tel Aviv University. "The pooling of blood can cause leg pain, swelling, weakening of the vascular walls, lower back pain, and more."
A survey of research on the Internet revealed a plethora of problems that can be caused by standing for long hours: arthritis in the knees, foot infection, flat feet, and high blood pressure. A study carried out in the U.S. a few years ago found that standing for long periods is especially dangerous for pregnant women. A correlation was found between standing for six hours or more and early labor, low birth weight of babies and maternal high blood pressure.
A guide produced by the British government's health and safety institute recommends supermarket cashiers not stand for more than 3.5 hours and that they not stand when activities are repetitive or require detailed reading. Working while standing was recommended when bending was involved, for example in bagging purchases, or in lifting weights of more than five kilograms. One study evaluating the effect of rest on people who stand at work recommended a ratio of 1:3 between standing and sitting or resting, i.e., workers who stand should rest for 15 minutes every hour.
Other doctors state that, although standing at work may not be harmful to younger workers, it can be detrimental in cases where blood vessels are impaired from birth or by age.
Weiner stresses the importance of distinguishing between discomfort from standing for long periods and damage to health. He notes that standing for long periods does cause lower back and leg pain, swelling and muscle fatigue, but "there is no connection between this and damage to health. Not everything that's uncomfortable is damaging to health," he says. "Standing does not cause weakening of the veins. This is a myth."
To prevent discomfort, at Universe Club he suggested workers stand on pliable air-filled rugs to reduce fatigue, and that they wear sport shoes. Cashiers' shifts were also shortened on his recommendation from eight to six hours, with two breaks of 15 minutes each.
Peter Magnus believes Weiner is wrong. "The committee didn't say it was healthier to stand, just that it couldn't show cumulative damage to health from standing. Even if there is no proven health damage - why should the cashier suffer? She should be taught how to stand correctly and given the choice of sitting."