Health, a state of complete physical, mental and social well-being according to the World Health Organization, is a critical issue in the workplace as it is directly related to human capital, the most important and expensive asset of an organization. When it comes to workplace health, there are seven key performance indicators to consider. These include physical fitness, physical comfort, physical nourishment, cognitive well-being, social well-being, emotional well-being, and environmental well-being. Various environmental attributes in these seven KPIs in the workplace affect not only health but also performance and engagement of employees via their physical, mental, and social interactions within the environment. For instance, ergonomics, acoustics, lighting, thermal comfort, and olfactory comfort address the overall physical comfort while biophilic components contribute to employee cognitive functions as well as their capacity to cope with mental stress and fatigue. These seven KPIs of workplace health ultimately contribute to five positive organizational outcomes, including healthy organizational culture, higher productivity, improved individual health and safety, financial savings, and enhanced reputation of the organization. This chapter discusses critical health factors in the workplace and their contributions to the capacity of human capital at the individual as well as organizational levels.
- KPIs of workplace health
- human performance
- physical fatigue
- mental restoration
- organizational health outcomes
1. Global health epidemics
We now often hear that chronic diseases are the great health epidemics of our times. This expresses critical concerns about rapidly growing and spreading chronic diseases across the world. Chronic diseases have been blamed for over 60% of all deaths and are expected to grow to nearly 75% by 2020 . The main driver behind this trend is a shift from physical labor-intensive primary industries to knowledge-intensive industries and a technologically advanced lifestyle, which led to physical inactivity, sedentary lifestyle, and unhealthy dietary behaviors. These factors are the causes of intermediate risks such as overweight and obesity, which explain incidents of the majority of chronic diseases such as heart disease, stroke, and diabetes.
The World Health Organization (WHO) statistics reveals that obesity across the world has nearly tripled since 1975 with 39% of adults being overweight, body mass index (BMI) 25 and over, while nearly 13% obese, BMI 30 and over, worldwide . The urgency of these health issues is even prevalent in the US where nearly 70% of adults are overweight and 35% obese based on the WHO statistics. The criticality of the problems with overweight and obesity lie in their links to many illnesses including asthma, musculoskeletal disorders, cardiovascular disease, stroke, type 2 diabetes, osteoarthritis, and certain cancers . Along with physical health issues, mental health issues have also increased due to financial instability, higher demands at job, work-life imbalance, and social isolation. The WHO speculates that a quarter of the world populations experience some sort of mental health issues in their life time with depression being the fourth leading cause of the disease worldwide .
With globally prevalent health epidemics of chronic illnesses, various disciplines have joined forces to seek and implement interventions beyond the medical and public health realms. In addition, multi-disciplinary approaches are sought as more desirable in tackling such a complex problem in a collective, systematic way, bringing professionals together in environmental design, food science, health science, neuroscience, and policy. A recent action plan from the WHO to increase physical activity clearly exhibits this approach by calling for strategies in four areas: social culture, physical environments, people’s activities, and systems support .
The role of physical environment is gaining more traction than ever before in terms of increasing physical activities, changing behaviors, and controlling environmental toxins and pollutants for occupant’s health. The sustainable building communities in particular are emphasizing occupant health to mitigate negative environmental impacts on human health. More stringent systems for healthy materials have been developed such as Health Product Declaration and Living Building Challenge Red List. Health and well-being building certification systems have emerged such as Facility Innovations toward Wellness Environment Leadership (FITWEL)® and WELL Building Standard™. Various green building rating systems such as LEED™, BREEAM® and Nabers are evolving to include more occupant health-related criteria to respond to these global epidemics.
2. Workplace health
As global concerns on health epidemics of chronic illnesses prevail, workplaces have become the center of attention in two regards: (1) the relationship between employee health and astronomical costs associated with it, and (2) a unique role of workplaces being a main source of health issues as well as a central place to implement health interventions more effectively.
2.1 Workplace health and its costs
Healthy employees are an important issue as an organization not only for higher productivity and economic benefits but also for organizational culture. People are the most important asset, human capital, to any organization. The majority of the costs related to doing business are attributed to people costs including salaries and benefits. Thus, means to support their optimal performance are important to organizations. Health in the workplace has become critical as organizations have learned that health conditions significantly affect the performance of their employees.
Employee health affects an organization in various ways, sometimes as direct costs such as healthcare costs and workers compensation claims but other times as indirect costs such as productivity, absenteeism, presenteeism, and engagement. Healthcare costs have been the most troublesome concern in the US workplaces due to a huge amount of healthcare costs imposed on employers. The concerns with rising healthcare costs in the workplaces are also growing in Europe. And even bigger concerns exist with humongous indirect costs associated with unhealthy workforce: higher absenteeism and presenteeism, decreased productivity, and lower engagement.
In the EU, adult obesity accounts for 6% of direct healthcare costs and 12% of indirect costs . Among these indirect costs are sickness absenteeism, being absent at work due to illness. There have been abundant studies on sickness absence, especially, in the public health realm for the last couple decades due to a clearer and simpler methodological advantage. In a study, sickness absence was speculated to cost UK employers over £600 per employee . In more recent studies, the intangible but more impactful costs associated with presenteeism, being present at work but not productive, has become at the center of attention. A conservative calculation of the cost of presenteeism tells us that presenteeism may be nearly twice as high as absenteeism .
Productivity and engagement are also indirect costs frequently associated with health issues in the workplace. Productivity loss due to mental health issues explains 3–4% of GDP in the EU , and Gallup surveys show a close relationship between unhealthy workforce and low engagement as well as a positive relationship between engagement level and productivity level . While it is important to understand the impact of health in the workplace on absenteeism, presenteeism, productivity, and engagement, we must be cautious in interpreting intangible indirect costs associated with workplace health to actual dollar amounts. This is because of discrepancies observed among the studies as well as credibility of assumptions and reliability of data used for calculations of these impacts in dollar amounts.
2.2 Workplace as a source of health issues and a place to cure them
Workplaces are known as a main source of many health issues in the contemporary society, including sedentary workstyle, work-life imbalance, and increased job demands. People spend a majority of their time at work, allegedly 2/3 of their waking time . Due to the contemporary work settings prevalent in knowledge-intensive industries, sedentary work settings have become the main workplace environment where people tend to have a sedentary posture for a prolonged period. The sedentary work settings have shown an association with overweight and obesity as people who spent longer working hours in the workplace exhibited a higher body mass index . In addition to physical health, the workplace is also a major source of mental health issues. Stress, depression, and anxiety were the number one cause of all absences at work and accounted for nearly half of all reported work-related illnesses . Stress, especially, was the second highest among all reported work-related health issues .
While workplaces are a main source of health issues, workplaces also hold an advantageous situation in tackling people’s health in a large group setting rather than working with individuals. Workplaces have been sought as a practical place to implement health interventions by health professions to change the prevalent health epidemics for the past several decades. This is because the workplace is where people spend a substantial amount of their time, so it naturally becomes a central place to not only easily implement health programs in social settings with necessary social supports but also reach larger groups of people to effectively control and prevent the health epidemics.
Addressing health issues in the workplace has been a long battle in the public health domain over several decades, especially, for chronic disease prevention and health promotion. Leading health organizations, including the WHO, the European Network for Workplace Health Promotion (ENWHP), and the US Centers for Disease Control and Prevention (CDC), have introduced a concept of workplace health promotion or health-promoting workplaces more than a decade ago targeting four areas: physical exercise, healthy diet, mental health, and healthy lifestyle in the workplace. Since then, various workplace health promotion programs have been suggested, implemented, and shown positive outcomes.
3. Environmental health in the workplace
There are currently growing efforts to integrate environmental health issues into the realm of public health as a comprehensive approach to tackle workplace health. Health in the physical environment of workplaces has two approaches to workplace health: environmental design to promote physical movement, healthy diet, mental health, and healthy lifestyle at work; and environmental control and monitoring of harmful toxins, pollutants, and irritants as well as provision of human comfort factors. Health-promoting environmental design focuses on environmental interventions such as spatial layout for physical movement, stair use, fitness spaces, spatial features for conscious eating, or biophilic design that integrates nature into the workspaces. Environmental control and monitoring emphasizes proper levels of indoor air quality, comfort factors in temperature, lighting, and acoustics, as well as managing toxic materials and substances in building components.
This section describes both approaches in seven topics called seven key performance indicators (KPIs) of workplace health (7 KPIs of WH). The indoor environmental features, conditions, and design approaches described in this section are derived from various theories and practices, such as biophilic design, environmental preference theory, evolutionary psychological design, and active design, as well as standards and guidelines in the built environment, such as FITWEL®, WELL™, LEED™, BREEAM® and health-related recommendations from the WHO and other relevant governmental agencies. It focuses on the major KPIs of Workplace Health in a comprehensive manner from a design and planning purpose so, further specific issues and items should be discussed in details with experts in each respective field when applying it in practice.
3.1 Seven key performance indicators of workplace health
Workplace health relevant to the environment can be addressed in seven dimensions within three health domains defined by the WHO: physical, mental, and social domains. Since health is defined as a state of complete physical, mental and social well-being , workplace health can be categorized into seven dimensions of well-being states: physical fitness, physical comfort, physical nourishment, cognitive well-being, social well-being, emotional well-being, and environmental well-being. These are essentially seven key performance indicators (KPIs) of workplace health (7 KPIs of WH) when it comes to the environment. Physical fitness, physical comfort, physical nourishment, and environmental well-being fall under the physical domain; cognitive well-being and emotional well-being under the mental domain; and social well-being under the social domain of health (Figure 1). This model is called PROWELL. The list of 7 KPIs in the PROWELL model delineates a comprehensive approach to workplace health to accomplish the overall health promotion in the workplace as various factors influence one another in the complex layers of workplace health. The 7 KPIs of WH contribute to overall five positive organizational outcomes: healthy organizational culture, higher employee productivity, improved individual health and safety, enhanced company reputation, and financial savings. Health-enhanced workplaces by the 7 KPIs of WH contribute to healthy organizational culture by promoting engagement and morale, increasing retention rates, decreasing turnover rates, and increasing job satisfaction; higher productivity by reducing sickness absenteeism and presenteeism, decreasing overtime hours to cover absent employees, producing more innovative outcomes, enhancing focus and memory retention, and decreasing mental stress as well as physical fatigue; improved health and safety by reducing workers compensation claims, lower visits to an employee assistance program as well as hospital admissions and emergency visits, and better physical fit; enhanced company reputation by improved external image and increased job applications from highly talented candidates; and financial savings from cost of absenteeism and presenteeism, cost to cover absent employees, cost of turnover, healthcare premium, and financial returns from more innovative items produced by healthy employees (Figure 1). This section explains the role of these KPIs and focuses on principles and basis of strategies to achieve each KPI in workplace health.
3.1.1 Physical fitness
The physical fitness (PF) dimension focuses on the workplace environmental features that contribute to promoting and maintaining physical fitness by creating physical movements and providing spaces for physical activities in the workplace. This is parallel to the principles of active design that recognizes the built environment as a critical venue for promoting physical activities through the design and layout of the physical environment . Established to develop built environments to increase physical activities to stop the rising level of obesity in the UK, the major agendas of active design involve active travel (or transport) that promotes the use of public transport; active buildings and interiors that integrate physical activity-promoting designs of buildings and indoor spaces; and active outdoor and public spaces that increase physical activities . As sedentary postures and inactivity are prevalent in contemporary workplaces, various design and spatial resolutions can be integrated to promote physical movement and activity.
Interior stairs use is a well-known method for interior active design. The use of interior stairs can facilitate more frequent physical movement in the workplace via three elements: stair design, visibility, and accessibility. People are more likely to be motivated to use stairs instead of elevators when stairs are designed as a focal point with pleasant design elements; clearly visible from the main entrance and even located before elevators; and easily accessible from the major workspaces and during the regular business hours to all employees. In addition, the use of signage/message board can be an effective means to encourage employees to take stairs instead of elevators by especially posting it next to elevators. A post motivating people to use stairs can significantly increase the use of stairs, four times higher likelihood of using stairs when stairs are visible .
Using interior design elements is a great way to motivate employees to be willing to walk more often to other parts of workspaces by creating a pleasant ambience using visual and auditory elements around stairs: art and installations; natural elements such as green plants, plant wall, water feature, or daylight; and pleasant music or nature sounds. Lastly, providing the onsite fitness space and equipment would be a vital way to encourage people to be engaged in physical exercise and activity in the workplace. Onsite physical exercise activities can be further enhanced if a combination of exercise equipment are available for both cardiorespiratory and muscle-strengthening exercises in the space. The WHO recommends adults between 18 and 64 years old be engaged in a minimum of 150 min of moderate aerobic activity (or a minimum of 75 min of vigorous aerobic activity or a combination of both) and a minimum of two times of muscle-strengthening activities a week . When providing a fitness/exercise space and equipment, it is also necessary to provide shower and locker facilities for people to be able to clean themselves after workouts.
Active workstations such as treadmill desks or portable desk pedals, a combination of a desk and a treadmill or a bike pedal to facilitate physical movement while working, can also be integrated to encourage physical movement. However, it is important to note that this is not a means for fitness exercise or weight control. While those who use active workstations are overall more engaged in physical movement than those who do not use them as they tend to break more often sedentary workstyle habits, the amount of exercise is neither enough to meet the recommendations of the WHO as a fitness activity nor to lose weight as a weight control mechanism .
3.1.2 Physical comfort
The physical comfort dimension addresses comfort issues in major human senses and body systems. This includes comfort issues in four major senses:
Solar glare control strategies have been frequently emphasized in green buildings. Solar glare has become problematic in green buildings as an increased amount of vision glass, glass lower than 7 feet, has been used in office buildings to introduce a higher amount of daylight into the workspaces, coupled with a design intent relevant to the architectural esthetics of glass towers which has driven higher window-to-wall ratios (WWR) in office buildings. Several major strategies to control solar glare include incorporating window shading devices such as interior blinds or curtains, exterior shading systems, variable opacity glazing, interior light shelves, and reflective film of micro-mirrors on windows; meeting WWRs between 30 and 40% ; and limiting the amount of direct sunlight that can potentially cause glare discomfort by calculating/simulating the Annual Sun Exposure (ASE). ASE measures the floor area that receives minimum 1000 lux from the sun for at least 250 occupied hours a year, and the recommended ASE is no more than 10% of the total floor area for visual comfort .
The strategies to achieve the quality of lighting involve providing proper color rendering of light bulbs through color rendering index (CRI) for the realism of colors in objects; light reflecting property of interior finish materials with light reflectance value (LRV); and brightness contrast level between monitors and immediate surroundings including desk surfaces. The European Standard (EN 12464-1) recommends a minimum CRI of 80 for R1-R8 colors for architectural lighting in offices. While only R1-R8 colors are considered for CRI ratings, the importance of considering R9 in selecting architectural lighting has been emphasized as many LED lights in the market have shown poor scores in R9. With the technological advancement in LED lighting, it is advised to consider various color rendering-related factors simultaneously including fidelity, gamut and correlated color temperature of a light source. LRV recommendations for interior finishes in the office environment vary between the standards and guidelines; more narrowly ranged in the recent green building and high-performance building standards and guidelines for the purpose of energy conservation with a range of 80–90% for floors, 50–70% for walls, 50% for cubicle partitions, and 20–25 for floors [28, 29], but more broadly defined as 70–90% for floors, 50–80% for walls, and 20–40% for floors for visual comfort, specifically, in the office environment . However, LRV is not only related to the amount of light available in the space but also visual ergonomics for visually impaired. It has been noted an association between a lack of contrast between interior finish materials and increased visual fatigue as well as loss of concentration . Visual disability codes and guidelines prescribe the contrast ratios of architectural surfaces and details as follows: a LRV difference of 30 points between two contrasting areas in the British Standard: BS 8300:2009 + A1:2010 and a contrast ratio of minimum 70% between the LRV of the lighter area and the LRV of the darker area in the Americans with Disabilities Act (ADA). Lastly, brightness contrast ratio not exceeding 1:3 should be provided between the monitors and desk surfaces and between the immediate surroundings and the background areas in the office environment to prevent visual fatigue and eye strains .
Space planning principles provides a basis of noise control in the workplace and include grouping similar types of spaces; placing buffer spaces to separate noisy spaces; avoiding room shapes causing sound to reflect or focus in specific spots; staggering doorways to avoid a straight path for noise; and placing quiet spaces away from noise sources such as major traffic roads and copy rooms (Figure 3). Various technical measures can be employed for internal noise control via three typical principles of soundproofing: sound absorption, sound blocking, and sound masking. These technical measures include sound absorption coefficient, noise criteria (NC), reverberation time (RT), sound transmission class (STC), and sound masking systems in open-plan offices. Sound absorption coefficient is a measure that is based on the sound absorption of materials and can assess sound absorption of either individual materials: noise reduction coefficient (NRC) or rooms: design coefficient (DC). As a rule of thumb, a NRC of 0.7–0.8 in ceilings and walls/partitions is considered as a good solution for private offices and meeting/conference rooms, and a NRC of 0.9 or higher for spaces requiring a higher level of speech privacy and open-plan offices [28, 37]. However, the total coverage of the materials applied in an area would determine the overall performance of sound absorption in the space. In addition, the NRC of ceiling materials will be more important than the NRC of wall materials in open-plan offices. It should be noted that NRC is to be replaced by a similar rating system called sound absorption average (SAA). DC is also related to sound absorption of materials but rather assesses the overall sound absorption of a room by considering both the area and NRC ratings of materials in the area.
NC is a sound pressure-based measure and typically used to measure the background noise such as the heating, ventilating and air conditioning (HVAC) systems as this type of noise can be annoying and disruptive in the workplace. A NC of 45-40 is considered appropriate for open-plan offices, multi-occupant spaces and common spaces; a NC of 35-30 for conference and meeting rooms with normal speech privacy, a NC of 25 for conference and meeting rooms with high speech privacy, and a NC of 20-25 for teleconference rooms [37, 38]. According to Noise Rating (NR), a NC equivalent in Europe, NR 35 is recommended for open-plan offices and 30 for general offices. RT in a room is measured by the amount of time it takes for sound to decay by 60 decibels (T60). A RT of 0.5–0.6 is considered for private offices, meeting/conference rooms, and teleconference rooms, and a RT of 0.8 for open-plan offices [37, 39]. The overall performance of RT in a room will be determined by sound absorption of materials and the volume of the space as it gets longer with less sound absorption and a larger volume.
STC, as a laboratory test - based rating for sound blocking and isolation, measures the degree of sound attenuation of a wall partition in adjoining areas, commonly ranging between 30 and 75 . STC 40 is considered a threshold for a sense of privacy and higher numbers are required to provide speech privacy and noise isolation. A minimum of STC of 45 is required between standard offices to block loud speech and 50 between meeting rooms, conference rooms, and hallway to isolate louder sounds [28, 39]. Sound Reduction Index (Rw), instead of STC, is used in Europe to measure sound insulation levels by calculating the reduction in the intensity of sound through a partition. Rw 45dB means when loud speech is audible but unintelligible through a wall and, RW 50dB and over when loud speech is difficult to be audible. A field test version of Rw, Sound Level Difference (Dw) with NR together is often used to determine Acoustic Privacy in Europe. A privacy rating of 75 is considered as a good acoustic privacy level and, 85 a high level of acoustic privacy where loud speech is barely audible and intelligible. Sound masking is a vital acoustic system for sound privacy in open-plan offices by adding background noise. An electronic sound masking system typically used in open-plan offices generates ambient background noise that matches the frequency of human speech. This makes conversations in open environments unintelligible to nearby coworkers, providing sound privacy. Various masking sounds such as white noise and pink noise have been explored to reduce the intelligibility level of speech from adjacent co-workers in open-plan offices. While high acoustic variation such as music can affect emotion positively, it tends to distract people’s concentration and disrupt with short-term working memories and cognitively demanding functions. Among nature soundscapes, water sounds with limited acoustic variation have shown more effectiveness than high acoustic variation such as bird songs. Sound mitigating construction methods help decrease sound travel and increase sound isolation via the details during the construction, including constructing interior walls/partitions with staggering gypsum board seams; completely sealing interior walls at the top and bottom; using a door with a non-hollow core, gaskets all around door perimeters, and door sweeps for meeting rooms, conference rooms, and private offices; using sound isolation hardware, such as resilient channel clips or floor isolation hardware.
The fundamental ergonomics for workplace furniture include providing individual workstations with ergonomic sizes and clearances; ergonomic conditions of individual workstations in open-plan offices; and ergonomic chairs for individual workstations. Ergonomic sizes and clearances of individual workstations include: a minimum desk surface of 20 inches (50 cm) between a seated person and a monitor and a minimum of 30 inches (76 cm) to place both a keyboard and a monitor; height-adjustable desk between 20 inches (50 cm) and 28 inches (72 cm) for seated tasks; height-adjustable desk to accommodate standing tasks; sufficient under-desk clearance, minimum width of 20 inches (50 cm) and a minimum depth of 15 inches (38 cm) for knees and 24 inches (60 cm) for feet. Ergonomic conditions of individual workstations should address: perpendicular placement of desks to window panes to reduce glare and brightness contrast issues; matt finish on desk surfaces to reduce glare; 24–27 inches wide desk surface edge to accommodate armrests of chairs; and round front edge of desk to avoid contact stress of wrists. Ergonomic chairs for individual workstations should have such attributes as height- and depth-adjustable seat; seat with a minimum width of 18 inches (45 cm) and the length between 15 inches (38 cm) to 17 inches (43 cm); rounded, waterfall edged front of the seat; height-adjustable armrests; armrests with tilting capability (inward and outward from the user); backrest with reclining capability, a minimum of 15 degrees; backrest with a minimum height of 15 inches (38 cm) and a minimum width of 12 inches (30 cm) with a lumbar support; and chairs in different sizes/fit available for people with a particularly small height (5′2″ and lower) or tall height (6′3″ and above).
3.1.3 Physical nourishment
The science clearly tells us how physical activity and diet issues go hand-in-hand together in human health. According to the WHO, poor diet, especially, consuming a significant amount of foods and beverages high in calories but low in nutrients, is the main culprit of overweight and obesity along with physical inactivity . A medical condition called metabolic syndrome or insulin resistance syndrome, a combination of metabolic disorders showing the symptoms of obesity, high blood pressure, and diabetes is a particular concern of public health related to chronic diseases. Dietary factors significantly contribute to both the development and control of metabolic syndrome. Metabolic syndrome as well as cardiovascular disease (CVD) and certain cancers can be improved and prevented by certain dietary factors, including consuming healthy fats, consuming fruits and vegetables, eating whole grains, and limiting sugar intake and overall excessive calories . In addition to dietary factors, professionals in the workplace design, planning, and management have also started developing strategies through environmental attributes, choice architecture, and workplace policy to support healthier diet and behaviors in the workplace. In this capacity, the built environment professionals are expanding their traditional roles to facilitate and orchestrate the overall workplace health, working with other professionals in nutrition, diet, genetics and neuroscience, as well as human resources to tackle such a complex problem through multi-disciplinary interventions. This section focuses on providing
The strategies to support healthy eating via
The main strategies to encourage
3.1.4 Cognitive well-being
The cognitive well-being dimension emphasizes environmental supports to enhance cognitive mental processes of attention, memory, problem-solving, reasoning, and thinking for occupational functions. Cognitive domain mainly focuses on the mental capacity related to thinking process, acquiring knowledge and associated behaviors, while emotional domain focuses on the feelings that affect moods, attitudes, and consequently behaviors. However, human mental domain is a complex territory that is intertwined and influential among the components within themselves. It is often seen that a positive emotional mood is associated with enhanced cognitive performance. Thus, cognitive well-being in this section mainly concerns on how to enhance mental capacity related to job functions through the environment, and the emotional well-being section, on workplace environmental attributes to create positive moods and attitudes in its own dimension.
A cognitive performance-conducive environment in the workplace is an age-old discussion since job performance in the contemporary knowledge workplace is mainly related to employees’ cognitive functions. Many studies in organizational behavior and management have explored how to create work environments conducive to employees’ creative and innovative ideas and problem-solving under the innovation economy. As entrepreneurship, technological interventions, and innovations have become important for economic growth under new financial challenges and downturns, specific workplace strategies have been sought to enhance employees’ cognitive performance in the knowledge workplace. Cognitive performance and well-being has also been discussed in cognitive and organizational ergonomics. As a study of human-system interactions at work, when applied to the environment, cognitive ergonomics focuses on environmental supports for mental process of information and memory, while organizational ergonomics, on organizational structures and policies . Cognitive well-being strategies comprise three major themes to reduce cognitive overload and increase support systems: providing appropriate
According to the literature in organizational management, choices and autonomy in the workplace contribute to organizational creativity and innovation by building trust, transparency, and even engagement. Allowing employees to be able to find appropriate
Respite or recharge spaces are a fourth type of spaces necessary for employees to mentally cope with stress, work demand, and physical fatigue. Contemporary workers are frequently cognitively overloaded, receiving more information every second than their conscious brain can digest. This causes a constant mental fatigue and blocks that adversely affect their performance. There are multiple studies that highlight the benefits and the power of breaks and respite on physical and mental restoration. When taking micro-breaks, especially, engaging in relaxation and socialization activities throughout a day, employees tend to be less stressed by work demands and better recover from negative affect from work-related stress . They also tend to have a higher level of focus, a greater creative thinking capability, and a substantially increased sense of health and well-being . Respite or recharge spaces, intending to provide a short mental break and cognitive restoration, consist of play spaces, solitude spaces, social spaces, and designated outdoor respite spaces (Figure 4). Play spaces are provided for physical activities and games with supportive equipment. Solitude spaces are for personal lounging, reflection, contemplation, meditation, or religious practice. Social spaces are for social interactions and gatherings. Designated outdoor respite spaces include outdoor lounge areas, outdoor garden, balconies, or rooftop hangout places. If there are not designated outdoor respite spaces associated with the workplace, having access to public respite spaces is another great way to offer employees outdoor respite spaces.
3.1.5 Social well-being
The social well-being dimension focuses on enhancing
3.1.6 Emotional well-being
The emotional well-being dimension mainly concerns workplace environmental features providing individual emotional state of happiness and satisfaction. Emotional well-being is a dimension above the first two basic human needs: biological and physiological need and safety need in Maslow’s hierarchy of needs that explains behavioral motivation . Emotional well-being is a critical dimension to the overall quality of life, and can be addressed via three major topics related to environmental features in the workplace:
Sensory stimulation by nature and integrating natural elements are related to visual, auditory, and olfactory sensory experiences with natural elements as well as their components expressed in design elements. There is a plethora of studies that provide evidence of multiple benefits from the power of seeing or contacting with nature on human mental capability coping with physical healing, stress and fatigue reduction, and faster cognitive restoration. In addition, using vegetation or plants in interior spaces can be an effective strategy to reduce noise, provide privacy, and decrease negative feelings of crowding, which also contribute to health and well-being in the workplace. Recently, organizations have started paying attention to the positive relationship between natural elements and employee’s enhanced cognitive function and performance, and, thus, potential organizational benefits from increased productivity as well as engagement. Providing sensory stimulation by nature and integrating natural elements can be achieved by presence of green vegetation; water elements; 2D or 3D artwork depicting natural elements or scenes; sounds of nature; smells of nature; shapes and forms of nature in workspaces or materials; patterns of nature applied to the spatial design; materials of nature; colors of nature.
Circadian lighting is a recent focus among lighting professionals to provide human-centric lighting by supporting human innate body clocks, circadian rhythms, that synchronize human physiological functions with the approximate 24-h day-night solar cycle. As a type of neuron in the retina of eyes, the intrinsically photosensitive retinal ganglion cells (ipRGCs), sends information on the time of day to an area in the brain called the suprachiasmatic nucleus which synchronize clocks in peripheral tissues and organs in human body, the role of light has become more than providing visual functions. Circadian lighting is known to regulate various hormones such as growth hormone, melatonin, and cortisol that affect sleep, mood, stress, and eating and diet habits. Imbalance in circadian rhythms can cause adverse health consequences such as sleep disorder, obesity, diabetes, cardio-metabolic diseases, and even memory and productivity [68, 69, 70].
Views to outdoors and circadian lighting support can be incorporated through non-obstructive views and no tints on the windows; minimum two lines of sights to vision glass in the primary workspaces; views of natural elements outside the windows such as plants, skies, etc.; non-obstructive views within the distance; locating at least half of the primary workspace (or regularly occupied spaces) within 40 feet (12 m) of windows or atriums. Furthermore, using a technical metric, either circadian stimulus (CS) or melanopic lux (ML), to assess the amount of circadian light can assist the enhancement of circadian impactful lighting (Figure 5). However, when it comes to design solutions for circadian lighting, a cautious approach is necessary. While there is a sufficient amount of research indicating the impact of light on our body clock, it is still too early to be conclusive on what solutions are truly desirable and effective. In addition, daylight is a complex issue as it can create other undesirable problems: glare, overheat, and higher cooling loads. It is worth noting an approach suggested by the US General Services and Administration (GSA) called daylight ecosystems that require a comprehensive approach to daylight solutions by integrating daylight design for daylight penetration strategies, interior design for choices of finish materials and desk orientations, and human factors to support user behaviors .
Evolutionary psychology is an approach to the study of human behaviors that explains how the brain works and behaviors form based on biological reasons. Prospect-refuge theory, similar to mystery theory discussed in the active design section, explains many aspects of human visual and environmental preferences in nature and their psychological comfort, security, and safety related to these preferences. According to the theory, people feel secure, safe, and comfortable in a space with an open view: prospect for easy surveillance to detect hazards, and a space protected from behind and above: refuge to safeguard themselves from unexpected hazards. Prospect-refuge theory has many implications especially in open-plan offices. These implications include visual access to activity hubs or similar central spaces from individual workspaces with lower partitions and transparent materials; dropped ceiling and/or elevated floors in areas with high ceilings; quiet spaces covered by three sides such as reading nooks, booths, or alcoves; operable or adjustable translucent screens or semi-opaque partitions; clusters of workstations; freestanding planters or vegetated partitions in circulation paths between clusters of workstations; and retreat spaces looking out to outside views.
Art is known to have not only emotional impact but also cognitive and psychological stimulation. In addition, the literature suggests its healing power shown through positive physiological improvements related healthy symptoms . Art and design elements deal with conventional artwork and installation as well as unconventional design components in the workplace. According to the organizational management literature, ease and laughter in the organizational culture in the workplace is one of the critical elements contributing to less stress, cognitive release, and social cohesion. These concepts can be expressed by fun, whimsical, unconventional design features that we have witnessed in successful tech companies and creative industries as part of their effort to create an ambience of ease . Art and design elements for pleasure include artwork, designwork or installation in major common spaces and regularly occupied spaces; interior components with unconventional functions and shapes; unconventional use of finish or furnishing materials; and fun and unique decor such as whimsical signage, ornaments, or similar items.
The sensory engagement in common or open spaces involves three common sensory systems: visual, auditory, and olfactory as well as another sensory system that is typically expressed in interior design elements: tactile. Sensory engagement comprises visual elements utilizing colors and patterns; auditory elements, music or sounds of nature; olfactory elements, smell or scent such as smell of coffee or herbs; and tactile elements, various levels of soft and hard textiles and textures. These sensory stimulations tend to influence emotional states and also raise mental awareness and cognitive engagement. There are, in general, more design strategies to create visual stimuli utilizing colors and patterns than other types of sensory stimuli. This is due to the human neurophysiological condition that 30–40% of human cerebral cortex is allotted to vision, making vision the most dominant sense in the human body, while the cerebral cortex for auditory sense is only 3%.
Relaxing settings create an ambience of positive state of mind and ease. Relaxing settings are related to expanded experiences in the workplace that are associated with the first place (home) and the third place (café) beyond the second place (workplace). The attributes of the first place bring psychological comfort to the workplace, and the attributes of the third place, a sense of community and social activities as an anchor in the community. Home-like settings, especially, enhance such organizational cultures as freedom and autonomy which contribute to flattened hierarchy and nonconformity that are critical to employees’ mental well-being. In addition, certain successful start-up companies have seen a significant role of such a home-like environment as a work environment in increased creative and innovative outcomes. This is because such an environment enhances organizational cultures vital to business success such as less hierarchical structure, more social connections between colleagues, and shared visions and goals. Sensory engagement in common and open spaces can be enhanced by providing furniture/furnishing types associated with the first place or the third place; and spaces emulating residential setting or the third place.
3.1.7 Environmental well-being
The environmental well-being dimension concerns providing non-toxic and clean environment for employee health. There has been a plethora of research conducted in this topic, and many technical standards and guidelines have been established to protect human health in the built environment. While an extensive list can be sought to battle the problems related to toxins, chemicals, and cleanliness in work environments, this section discusses four main sources that are typically found in the workplace:
Volatile organic compounds (VOCs), organic chemicals that easily evaporate at room temperature due to a high vapor pressure, cause irritations in eye, nose and throat, headaches, nausea, and damage to human organs and central nervous system. VOCs must be controlled and limited in various building, interior, and cleaning products. There are various standards and guidelines in relation to VOCs in the built environment that can be complied with when seeking to purchase particular items in the workplace. These include but not limited to the following: Green Seal Standard GS-36 Paints & Coatings, GS-11 Paints, and GC-03 Anti-Corrosive Paints, ASTM D 2369-10 Standard Test Method for Volatile Content of Coatings, ISO 11890 Paints and varnishes—Determination of VOC content, CRI Green Label Plus Program & Green Label Program for carpet, cushions and adhesives, FloorScore for surface flooring materials, adhesives, and underlayments, and ANSI/BIFMA e3-2011 Sustainability Standard Method for furniture.
Air filtration systems are a good means to enhancing
The workplace can further explore other strategies to enhance
Promoting workplace health is a complex challenge that requires multi-layers of approaches from various disciplinary solutions in a collaborative manner to increase physical exercise, healthy diet, mental health, and healthy lifestyle all together to change the current health epidemics. These approaches include not only technical measures but also spatial planning, design strategies, and workplace policies (Figure 6). The PROWELL model and its 7 KPIs of WH suggest a comprehensive approach to workplace health to address this. While 7 KPIs of WH address comprehensive topics, WH is not limited to only the strategies and specific measures discussed in this chapter. Other strategies, thus, can be further implemented to increase mental health and social well-being through various assistance programs and workplace policies to provide a balanced health in all three domains of health. Individual workplaces can also seek specific KPIs and strategies to promote a particular target domain or organizational outcomes more desirable to a workplace under specific pursuits and circumstances.
It is worth noting that while many health interventions at work have focused on health impacts at the individual level, companies are more interested in understanding the impacts of workplace health at the organizational level by exploring organizational outcome measures such as the sickness absenteeism, accident rates, work-related injuries, presenteeism, job performance, employee engagement, and retention rates . Through decades-long research in public health, we have learned certain organizational outcome measures are more meaningful to the organization level decisions. For instance, sickness absence analysis tends to be less meaningful as a health measure to organizational decision-making in establishing better health promotion strategies, or motivating employees to engage in healthier behaviors, compared to other types of measures .
When looking for workplace health outcomes at the organizational level, it is important to note many discrepancies shown in various studies. These discrepancies are likely due to validity and reliability issues in research designs. The poorer the research methodological quality is, the higher the effects are [80, 81]. Thus, we need to be aware of possibilities of either under- or over-valuation of certain health interventions in research reports instead of trusting the impacts interpreted as exact numbers and dollar amounts. What is important is that there is a consistent discovery of the benefits of workplace health in both employee health and organizational outcomes. At the same time, it is important to develop further proper research methods and designs to yield more accurate results to narrow the discrepancies.
I would like to express my gratitude to many colleagues and experts who supported me with the development of PROWELL and writing of this book chapter. I send special thanks to Barbara Marini, James Rice, Janice Barnes, Joseph Connell, Susan Chung, and Bryan Steverson. And a heartfelt thank you goes to Matthew Schottenfeld, Assistant Director in Business of Innovative Workplace Institute, for his long time support for my work and reviewing this book chapter.