In the US, her home country, Elizabeth Nelson both witnessed and experienced the effect that a ‘non-stop-till-you-drop’ work ethos combined with a sitting culture in unhealthy buildings has on people. That must and can change, she felt. It’s high time for a working environment where people play the key role. She switched from business to research. Now, as project leader of a multidisciplinary Healthy Office Research Team at the University of Twente in the Netherlands, she is currently researching what makes an office healthy and, especially, what the business community itself can do to create a healthy work culture in a healthy environment. She hopes to obtain her PhD later in the year with the results of this study. She has also shared her personal experiences and scientific knowledge in her soon-to-be-published book The Healthy Office Revolution.

Nelson, doctoral candidate in Biomedical Engineering, describes herself as “a generalist who is interested in what people can do for themselves to improve their health”. Health Empowerment and Pro-active Health Care are her passions. Designing working environments in such a way as to promote that can have a tremendously positive effect on people themselves and, in turn, on the organisations they work for. People become more motivated, more creative and are much less likely to burn out. Absence through burn-out and other complaints or staff turnover due to employees not being challenged or not feeling at home, is a major cost factor for businesses. So investing in a pleasant, healthy working environment also makes commercial sense.

Putting scientific knowledge to the test in the workplace

At the request of real estate consultants CBRE, Nelson and a multidisciplinary team from the University of Twente and VU University Amsterdam researched the preconditions for a healthy work culture. CBRE provides integral real estate and housing solutions to strengthen organisations and is interested,  in that capacity, in developments regarding healthy working. Earlier research by the international branch of CBRE revealed an increasing interest in workplace wellbeing. CBRE Netherlands decided to test scientific knowledge on healthy working environments in practice at its own head office in Amsterdam. The study lasted a total of seven months. During the first two months, data were collected in the existing office situation to provide a benchmark. Based on literature searches the researchers subsequently chose the five interventions they expected to have the greatest impact. Three were classified as ‘healthy choices’ relating to diet, exercise and relaxation. The other two related to a ‘healthy environment’ and concerned the introduction of different lighting and plants in the workplace.

drawing of green building towers
The Healthy Spot

The study involved setting up a test zone; the so-called Healthy Spot. A new change was implemented every month. Employee participation in the study was voluntary. The 52 women and 72 men who chose to take part were split into three groups. The first group worked in the Healthy Spot and wore activity trackers which registered various biometric data and activity scores. In addition, game elements in the trackers enabled the users to monitor their progress themselves. The employees were also encouraged and motivated to achieve a number of health targets they set for themselves. The second group also worked in the Healthy Spot but did not wear trackers. The third group worked in the normal office environment and served as a control group. In addition to the data from the trackers, the effects of the changes on the shop floor were also monitored by means of interviews and questionnaires. The results were remarkable. Particularly noteworthy was that following the changes in their workplace employees felt much more energetic (the highest score of 78% due to a healthy diet), happier (78% as a result of plants in the office) and healthier (71% related to exercise).

Performance levels were also measured and compared monthly. Following every change the participants in the Healthy Spot performed better than the control group in the normal office.  The objectively measured performance improvement was highest (45%) as a result of a healthy diet. The interviews revealed the perceived performance improvement in this respect to be 20%.

From coffee to healthy waters and fruit

Most people drink a lot of coffee at the office and consume more sugar-rich snacks than is good for them. Coffee increases the level of the ‘stress hormone’ cortisol in the blood and sugar has an adverse effect on the communication between nerve cells thus also on the ability to process ideas, remember instructions and deal with emotions. Not ideal in an often busy working environment.  That is why, in the Healthy Spot, more healthy snacks, a wider selection of caffeine-free teas, different kinds of fruit, and jugs of water with fruit or herbs were provided every afternoon. Health seminars were also organised and the participants with trackers received personal advice. The healthy snacks proved extremely popular, also with those outside the Healthy Spot, and people started drinking much less coffee. An effect which also continued after the study. Moreover, participants felt that their performance had improved by 20%.

Busy, busy, busy or legitimate relaxation at work

Stress reduces performance levels. Though not yet very common in the Netherlands, more and more companies organise mindfulness training or set up special rooms for yoga, meditation and relaxation, with a view to the proven positive effects this can have on people’s physical fitness and mental resilience. It is at least as important, however, that the general corporate culture pays sufficient consideration to rest and relaxation and facilitates staff support and encouragement.

At CBRE head office two rooms were converted so that they could be used for meditation, yoga, a power nap or a weekly massage. Sound-cancelling headphones were also provided in the often noisy workplaces.  The measures taken were popular. The massages were fully booked, mostly by female employees to start with. The yoga, meditation and power naps proved to depend more on personal preferences and on whether the employee felt that the management would perhaps disapprove. Participants perceived a performance improvement of 16% and said they felt much better. The objectively measured performance improvement was 30%.

Sitting balls, desk bikes and lunchtime walks

It is commonly acknowledged that too much sitting is not good for us. There is a reason for calling sitting ‘the new smoking’. An office is typically a place where people sit a lot and where there are few reasons to move very much at all. That makes it even more difficult to break the habit. Various healthy alternatives for the traditional desk and conference chair were introduced in the Healthy Spot: ranging from sitting balls, balancing boards and standing tables to hometrainers and ‘desk bikes’. Various walks in the vicinity of the office were marked on a map, including the estimated walking time, to encourage people to hold walking meetings more often and to spend their lunch break outdoors. All participants felt these modifications were a good idea and 75% used them for at least part of the day. They felt that their performance had improved by 11%. The objectively measured improvement was 12%. Not all changes were implemented to the same extent. Writing or typing while treadmill walking is not easy, for instance. Using a desk bike during meetings, on the other hand, did work very well. Outside walks were particularly considered a pleasant break-time activity.

Circadian light to match our biorhythm

Light influences our mood, energy level and powers of concentration. Our biological clock is regulated on the basis of light signals from our surroundings. The effects of a disturbed biorhythm can be considerable. We are less alert and our memory and other brain functions are not as good. It can also lead to a chemical imbalance in the brain causing people to sleep poorly or even go for whole periods without sleeping at all. While the lighting in the CBRE office complied with the appropriate standards, the researchers discovered that it was really more suitable for after work or before going to sleep. They introduced biodynamic lighting according a circadian rhythm. This lighting follows the human biorhythm, with warm light in the morning, bright light in the afternoon and dimmed light in the evening, and shades changing from yellow via blue to a paler yellow. Furthermore, the perception of natural light was intensified by directing the light sources at the walls.  The lighting in some rooms was much brighter than it used to be. Staff found it very difficult to get used to the new lighting but eventually noticed the positive effects. The objectively measured performance improved by 12%. After completion of the study it took people a long time to get used to the old situation again and the circadian lighting was one of the things they would like to see return.

A green environment

Much is already known about the health benefits of having plants in the workplace and a nature-inspired working environment. Among other things, plants are known to improve air quality and absorb noise. People also feel better and consequently perform better in a green environment. However, the average office is not exactly a natural environment, so employees are not able to benefit from these proven advantages. The CBRE was no exception and ‘living green’ was limited to a bunch of flowers near the coffee machines which couldn’t even be seen from the workplaces. This study therefore called for some restyling. In the Healthy Spot, plants (both living and artificial) were placed in the pantries and the main office areas, and posters with nature themes were hung on several central walls and in smaller offices. Photo wallpaper with a green print was applied to one large wall. Eventually, plants could be seen from every workplace. Both the objectively measured and the perceived performance improved by 10%. Thanks to these measures, 76% of the participants in the Healthy Spot felt more energetic, 65% felt healthier and as many as 85% felt happier.

How technology supports healthy choices

The activity trackers enable objective measurement of this group’s exercise behaviour, for example. Just as important if not more so, however, was that the participants could use this ‘small data’ to monitor the effects on their behaviour and the targets they had set for themselves. This personalised approach, together with the competitive game element, motivates people even more to achieve their goals and to do ‘better’ than before. Furthermore, and very importantly, users feel they are in control of their own health. This, in turn, makes them feel healthier and happier and improves the chance that they will maintain their healthier habits for longer. Using smart office technology to create a healthy office.

In collaboration with the University of Twente, CBRE has developed a Healthy Office Quick Scan to help companies in practice aiming to implement changes to benefit the health and wellbeing of their employees.

Healthy in the office, healthy outside the office

What struck Nelson most during her study and when people approached her after a presentation somewhere, is that a healthy corporate culture with plenty of healthy choices can also lead to healthier choices outside the office. “People come to tell me how they have changed their lifestyle. They feel happier, partly because they have more control of their own lives. We had good reason to entitle our report ‘The snowball effect of healthy offices’.

As a researcher, I have always wanted to make a difference and for our interventions to have this effect is hugely satisfying. My dream for the future is for everyone to be able to work in a healthy office environment, where people really are pivotal and where people can take matters into their own hands as regards their own health. Organisations and businesses can contribute to that significantly. There is massive social potential. And their financial investments will more than pay themselves back”.