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Health hazards of sitting at work

Health hazards of sitting at work

Today’s worker spends more time than ever in a seated positon. The Bureau of Labor Statistics reports that U.S. adults spend between eight and nine hours each day in seated and sedentary positions, mostly at work.

We all know that a sedentary lifestyle contributes to obesity, but the health risks of spending too much time sitting may surprise you. According to the Centers for Disease Control and Prevention (CDC), prolonged sitting time is a risk factor for negative health outcomes including cardiovascular disease, diabetes, cancer and premature death.

What about standing instead of sitting? Standing is not the answer. Research shows that prolonged periods of standing work comes with its own human health risks, including circulatory issues and musculoskeletal aches and pains.

However, taking breaks and avoiding prolonged sitting time can significantly reduce the risks associated with too much sitting. One option that has gained traction and has had positive results is the sit-stand workstation. These devices can be elevated or lowered to an appropriate height so that an employee can work either standing or sitting, and employees can change from a standing or seated position at any time during the work day without interrupting their work flow or process.

Research supports a sit-stand paradigm:

A recent study by the CDC found the installation of a sit-stand device was effective at increasing non-sitting time, reducing upper back and neck pain, and improving mood states. Furthermore, the removal of the sit-stand device largely negated all observed improvements within a two-week period.

A 2009 study found that discomfort complaints were significantly reduced among workers using the sit-stand paradigm, and that those workers showed no significant loss of data entry efficiency. The study concluded that implementing a sit-stand workstation is an effective workplace health intervention for reducing adverse effects of occupational “sedentariness” without negatively impacting productivity.

Beyond worker health, employers may be interested in potential costs savings associated with a sit-stand option for workers. A 2011 study reported on Ergoweb compared the musculoskeletal disorders (MSDs) cost data on two similar employee groups – one  group could adjust their work stations and the other group could not. When comparing all cost (personal and worker compensation costs) the researches saw a three-fold increase in the cost for the employees in the non-adjustable group. When considering only the work related MSD costs, they experienced a 20X increase in costs for the non-adjustable group versus the user-adjustable Group ($74,300 per 100 workers vs. $3,500 per 100 workers, respectively).

But how can a company encourage workers to change their habits and adopt a sit-stand strategy? In a 2012 article, ergonomist Gene Kay, MS, CEA summarized the options an organization should consider:

  • Go Big: everyone gets sit-to-stand furniture and coaching & instruction on how/when to use it. This has the highest initial cost but has been shown to produce very good results.
  • Go Flexible: reduce your overall real estate footprint by deploying shared sit-to-stand workstations that two or more workers will use in combination with work from home, alternate shifts and periodic joint work in conference rooms etc. This can significantly reduce your real estate costs and produce excellent results with gains in productivity, retention, and engagement.
  • Go Alternate: Leave the primary seated station unchanged and identify alternate stand-up areas for other tasks. This could be a small raised portion of the fixed cube for stand up work (paper work, secondary computer tasks, etc.). Central printers and recycling can encourage users to get up and walk, as can, walking to more distant bathrooms and using stairs instead of elevators. This can produce some moderate results with a moderate budget.
  • Go Small: If the previous options don’t fit your budget or work demands, then only deploy sit-to-stand for those with a qualifying medical need — look for specific physician recommendations for conditions such as degenerative disc disorder, etc. This produces the least overall return on investment, but will help in individual cases

What else can you do?

If you’re not able or can’t afford to implement a sit-stand workstation, consider two simple options:

  • Encourage the use of pedometers, and reward employees who achieve a target step count.
  • Remind workers to take breaks. Some companies install software on the employee’s computer timed to remind them to stand up and walk around. Research has indicated that these prompts deliver positive results.

If your company needs help addressing any aspect of worker health, contact Ministry Medical Group Employer Solutions. We assist with:

  • Reducing worker compensation claims
  • Reducing lost work time
  • Reducing costs to the company and the employee related to health care costs and related health insurance
  • Improving employee health status and morale

 For more information, call (715) 346-5243 or visit our website


Author: Deb Kearns, OT, Industrial Rehabilitation Services Coordinator, Ministry Medical Group Employer Solutions

Are you at risk for sleep apnea?

Are you at risk for sleep apnea?

Everyone has brief pauses in his or her breathing pattern, such as the short pause that occurs after a deep sigh. Obstructive sleep apnea (OSA) occurs when the throat muscles and tongue relax and sag during sleep, blocking the opening of the airway.

Breathing becomes labored, loud, and stops until the brain signals the need for oxygen, waking the person and keeping them from getting deep sleep.

Sleep apnea is just one of 84 reported sleep disorders. About 24 percent of men and 9 percent of women have the breathing symptoms of obstructive sleep apnea with or without daytime sleepiness. Between 80 and 90 percent of adults with obstructive sleep apnea remain undiagnosed.

If you suspect that you or a loved one has obstructive sleep apnea, call your primary care physician.

Risk factors

  • Are you male?
  • Are you overweight with a body mass index (BMI) of 25 or above?Approximately two-thirds of children diagnosed with sleep apnea are overweight or obese.
  • Are you older than 40?
  • Do you have large tonsils?
  • Is your neck size larger than 17 inches if you are a man; 16 inches, if you are woman?
  • Are you a post-menopausal woman or a middle-aged man?
  • Are you a minority?
  • Does a family member have OSA?

There are treatments for sleep apnea

Over-the-counter remedies may reduce snoring but may cover up the presence of sleep apnea.

Behavioral changes. Losing body weight will benefit many people who suffer with sleep apnea. Sleeping on the side rather than the back, may also lessen symptoms.

Oral appliances. Oral appliances, similar to mouth guards used for sports can stabilize and reposition the jaw, tongue and palate to keep airways open. A trained professional must fit the appliance.

Continuous positive airway pressure (CPAP). A CPAP device delivers a steady stream of pressurized air through a mask as the patient sleeps. The airflow keeps the airway open, prevents breathing pauses and restores normal oxygen levels. CPAP is common treatment for moderate or severe apnea, but may also be used in mild cases.

Surgery. In severe cases or in situations where there is an anatomic deformity, surgery may be the best treatment option. Two of the most common surgeries to treat sleep apnea are uvulopalatopharyngoplasty (UPPP), a trimming of the soft palate, sometimes including removal of the tonsils and uvula and adenotonsillectomy, the surgical removal of the tonsils and adenoids.

If you or people you live with suspect that you have sleep apnea, don’t wait. Contact your primary healthcare clinician today. Sleep apnea is a potentially life-threatening condition. If you don’t have a primary care clinician contact the Ministry Medical Group clinic nearest to you.

Affinity Health System Sleep Disorders Labs are state-of-the-art full service sleep labs, which test patients for sleep disorders such as sleep apnea.

Ministry Health Care offers treatment options for such disorders such as sleep apnea.


Recipe: pureed bean brownies

Recipe: pureed bean brownies

Labor Day is around the corner. If you are looking for a delicious, healthy brownie recipe, no need to look any further. We made a few changes to a favorite recipe transforming it into a lighter, healthier option. Here are a few tips and tricks as well as the delicious recipe.

  • Use low fat cream cheese or whipped cream cheese. Use skim or low fat milk in recipes.
  • Use less sugar than noted in the recipe without much change in taste or texture. (if a recipe calls for 1 cup sugar use ¾ cup).
  • Use pureed beets to replace some of the sugar. You can use 2/3 of a cup of finely grated raw beets and cut the sugar by a quarter of a cup.
  • Use high quality chocolate and pure vanilla extract. High quality ingredients tend to be more flavorful and allow you to cut calories somewhere else without sacrificing taste.
  • To reduce the fat in a recipe, try using pureed fruit or using pureed soft or silken tofu and use it in a one to one ratio to replace half of the fat called for in a favorite cake or brownie recipe. Tofu has a neutral taste and will take on the flavors of other ingredients such as chocolate.
  • Use pureed white beans to replace half of the fat used in baked goods.
  • Use two egg whites for one egg or use a quarter cup of egg substitute for one egg in your baking. You could try skipping out on eggs altogether and use a powdered egg substitute.
  • Use mini chocolate chips (morsels) instead of the usual sized chocolate chips. Cut down on the amount of chocolate chips the recipe asks for.
  • Use a smaller scoop to make your cookies, which will help with portion control.
  • Replace one cup of white flour with whole wheat flour.
  • Skip the butter when making graham cracker crusts. Just pulse the crackers with about 2 tablespoons of low fat milk and process.

Pureed Bean Brownies
There are many recipes for this, many of them using a box brownie mix such as this recipe. But you can certainly use your favorite recipe and add the pureed beans and cut down on the fat called for in the recipe. Please take note, that although this recipe calls for pureed beans which increase the fiber, the end result is still a treat and therefore should be consumed in moderation. To cut down on portion sizes of brownies, consider making them in mini muffin tins!


  • 1 15 ounce can black beans, rinsed well and drained
  • About 1/3 cup of water to moisten the black beans a bit
  • 1 package of brownie mix

In a food processor or blender, puree the black beans adding water to moisten them if they need it. Beans must be completely smooth but not drippy wet. Add brownie mix to a large bowl and pour in the pureed beans. Mix. Spray muffin tin or use muffin wrappers. You can certainly use a greased 9 x 13 pan as well. Putting them into muffin tins helps with portion control. Bake according to box instructions. If using mini muffin pans, bake at 350 degrees for about 18-20 minutes.

Makes 20 mini muffins.

Approximate Nutrition Facts

Calories: 140

Total Fat: 3.5 g

Sodium: 80 mg

Total Carbs: 26 g

Dietary Fiber: 2 g

Protein: 3 g

Author: Julia E. Salomón, MS, RDN, CD

Don’t let acne get under your skin

Don’t let acne get under your skin

The blackheads and pimples on your chid’s face may seem barely noticeable to you. To the adolescent, they are mountains and craters.

About 90 percent of American teenagers suffer through acne…at the same time that they are dealing with issues of self-esteem, peer acceptance and independence.

Regardless of the severity of the skin disorder, researchers have found that the distress experienced by the adolescent is comparable to that of patients with much more serious problems such as asthma, epilepsy or diabetes.

Acne can and should be treated, particularly if it is causing emotional distress, but the process requires patience and understanding.

Contrary to popular belief, blackheads, pimples and other symptoms of acne are not caused by dirty skin. No food has been shown to contribute to acne. Picking at, squeezing and trying to remove blackheads and pimples is not only futile but will make skin problems more severe.

Acne can appear at any age but is most common among teenagers because of the increased production of sebum related to changing hormone levels during puberty.

Sebum is the oil secreted by the sebaceous glands of the skin. When it collects, along with hair and dead skin cells, to clog the canals of sebaceous glands, the result is a plug that prevents sebum from reaching the surface.

What’s known as a comedo is actually an enlarged and blocked hair follicle that forms a white bump on the skin. This is a whitehead, and it may stay in the skin for a long time.

When a comedo opens up onto the surface of the skin, the sebum that emerges turns black as it is exposed to air. This is a blackhead, and it too may stay in the skin for a long time.

Bacteria that normally live on the skin, Propionibacterium acnes, eventually begin to grow in and around the plugged follicles and lead to an inflammatory reaction. Other lesions that occur include pimples, papules, nodules and cysts. These occur primarily on the face, neck, back, chest and shoulders–areas that are likely to be noticed by others.

Hormonal-related changes in sebaceous glands happen to both sexes during puberty–more frequently to males than females. They can also occur at other times in women, such as before or after menstrual cycles, during pregnancy or when starting or stopping birth control pills. Scientists believe that the tendency to develop acne of varying degrees is in part inherited.

In the early stages, all or most lesions are whiteheads and blackheads. There is very little inflammation, and the problem can usually be treated with an over-the-counter or prescription solution that is applied directly to the lesions or the entire area. Look for product labels that include the words “noncomedogenic” or “for acne-prone skin.”

Available as gels, creams, lotions, soaps or pads, these work to reduce oil production, break down whiteheads and blackheads and reduce the shedding of cells lining the follicles.

It may take eight weeks or longer before these products make any noticeable improvement, and they may cause side effects such as irritation, burning and redness–all of which are likely to go away with continued use. Some trial and error is advised.

Worrying about dirt, many teens tend to wash and scrub the skin too often and too vigorously. Washing twice a day is sufficient; more frequent washing will dry the skin. Strong deodorant soaps and abrasive sponges and cloths can irritate the skin.

When pimples and papules start to appear, inflammation is clearly present. In the later stages, when cysts and nodules start to develop, pitted scarring can occur, and treatment must aim to minimize the damage. A dermatologist’s help is needed.

Tretinoin is a topical medication often prescribed. If it causes irritation, adapalene, tazarotene and azeliac acid are also available. A topical and/or oral antibiotic may also be used to help curb the growth of bacteria.

The most potent oral drug is isotretinoin (Accutane), often recommended for patients with cystic acne and severe scarring. The drug has many adverse side effects and is associated with a high risk of birth defects.

It’s far too easy for the parent to brush off teenage acne as a passing phase. Without treatment, the more severe forms can cause permanent scarring. And youth with even mild cases of acne may be at risk of depression, anxiety and other psychosocial effects.

Affinity Health System offers comprehensive skin health care. Whether you have acne, dandruff or a mole you suspect might be skin cancer, we can help. Our doctors will evaluate your skin and talk to you about your skin health goals, then design an individualized treatment plan that best suits you.

Ministry Health Care offers comprehensive skin health care. Whether you have acne, dandruff or a mole you suspect might be skin cancer, we can help. Our doctors will evaluate your skin and talk to you about your skin health goals, then design an individualized treatment plan that best suits you.

Charlene DeHaven, M.D., FACEP, “Acne,” IS Clinical.
L.K. Dunn, J.L. O’Neill, S.R. Feldman, “Acne in adolescents: quality of life, self-esteem, mood, and psychological disorders,” Dermatology Online Journal, January 15, 2011.
Mayo Clinic Staff, “Acne,” MayoClinic.com, January 20, 2015.
National Library of Medicine, “Acne,” MedlinePlus.
National Institutes of Health, “Questions and answers about acne,” May, 2013.
Andrew Par, “Why does acne still exist?” The Atlantic, June 5, 2013.
Jill Percia, “Adult acne: it’s not a myth,” Women’s Health Magazine, January 19, 2012.
Jaggi Rao, M.D., “Acne vulgaris,” Medscape Reference, updated December 11, 2015.
J.I. Silverberg and N.B. Silverberg, “Epidemiology and extracutaneous comorbidities of severe acne in adolescence: a U.S. population-based study,” The British Journal of Dermatology, 2014;170)5):1136-1142.
Iris Woodard, BSN, ANP, “Adolescent acne: a stepwise approach to management,” Topics in Advanced Nursing eJournal, 2002;2(2).
“Your guide to teen acne: what helps, what hurts,” WebMD Medical Reference, reviewed by Debra Jaliman, M.D., February 18, 2014.



Ulcers, the latest word

Ulcers, the latest word

You may remember your great Uncle Bob drinking buttermilk, taking antacids, denying himself his favorite foods and grumbling under his breath about his ulcers any time he was under stress.

At least in part because of his stomach ulcers, Uncle Bob never had a lot of fun. And if he were alive today, he would be glad to know that the rules for ulcers have changed.

It’s now known that ulcers are not caused by stress or a rich, spicy diet–although stress and spicy foods might make symptoms worse if you already have ulcers. Buttermilk, milk and cream are no longer part of ulcer treatment and may make matters worse.

An ulcer, by definition, is an open sore; pepsin is a digestive enzyme that combines with hydrochloric acid to help break down protein in the stomach. The stomach fluid that results is occasionally acidic enough to break down the protein of the organ itself, creating an ulcer.

You could have an ulcer for some time without knowing it. The major symptom, though, is a gnawing or burning pain in the middle or upper abdomen, usually occurring at night or between meals. You might also experience heartburn, bloating, nausea or vomiting.

The pain comes from the ulcer itself and from the irritation that results when stomach acids come in contact with the ulcerated area. Some patients report that it usually goes away when they eat.

The Sippy diet that became standard ulcer treatment from 1911 well into the 1950s was aimed at reducing or neutralizing stomach acids and protecting the injured lining of the stomach and duodenum from the abrasive action of foods. The milk and buttermilk were designed to neutralize the acid, although it is now known that they actually stimulate acid production.

Since the late 1970s, ulcer patients have had very effective drugs to inhibit acid production–H2 blockers such as Tagamet, Pepcid or Zantac and proton pump inhibitors such as Nexium, Prevacid and Prilosec. But while long-term use of these drugs can keep the pain away, the ulcers and their symptoms usually return when the drugs are stopped.

While stomach acids may create the conditions in which ulcers form, they are not the underlying cause. In the early 1980s, Australian doctors Barry Marshall and Robin Warren discovered that 80 to 90 percent of ulcers are caused by an infection with H. pylori bacteria.

Exactly how these bacteria are transmitted from person to person is not known. But they are widespread; it’s estimated that half of Americans age 60 and over are infected.

Not all persons infected with H. pylori develop ulcers, but nearly all have gastritis at one time or another. They also have an  increased risk of gastric cancer and MALT leukemia as well as peptic ulcers.

Ulcer patients should be tested for H. pylori and treated with antibiotics, if they are infected. Treatment usually involves a combination of antibiotics taken for two weeks or longer plus additional medications to reduce stomach acid.

Medications that protect the lining of the stomach and small intestine include Carafate and Cytotec. An over-the-counter protective agent is bismuth salicylate (found in Pepto-Bismol). Bismuth coats a peptic ulcer, protecting it from stomach acid. It also has antibacterial action against H. pylori but  is usually prescribed along with antibiotics rather than in place of them.

The other major cause of ulcers is use of NSAIDs such as aspirin, ibuprofen and naproxen. These drugs undermine the stomach’s ability to develop its protective lining and protect itself from digestive acids. They also inhibit the clotting action of blood.

If you have an ulcer caused by NSAIDs, treatment requires that you quit taking the drug, or least reduce the dose. If you are taking the drugs for arthritis, talk to your doctor about the benefits and risks. A good alternative is acetaminophen.

To reduce stomach acids, protect the ulcer and help the ulcer heal, your doctor may also prescribe a proton pump inhibitor, H2 blocker or protectant.

If you feel you must take an NSAID, take it with a meal and at the lowest possible dose. Avoid smoking and drinking alcoholic beverages.

There are still many unanswered questions about peptic ulcers. The important thing to know is that they are treatable. Unlike your great Uncle Bob who thought he was destined to battle stress and pain through a lifetime regimen of bland food and buttermilk, you can eliminate that gnawing pain in your belly and go on with your life.

If you think you have an ulcer, talk to your primary care physician. Don’t have a doctor? Find one at Ministry Health Care or Affinity Health System today.

Disclaimer: The information found on Affinity's blog is a general educational aid. Do not rely on this information or treat it as a substitute for personal medical or health care advice, or for diagnosis or treatment. Always consult your physician or other qualified health care provider as soon as possible about any medical or health-related question and do not wait for a response from our experts before such consultation. If you have a medical emergency, seek medical attention immediately.

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