Stair climbing interventions at work; more than 700,000 reasons for caution

Abstract

Background: Stair climbing is a vigorous lifestyle activity with a range of health benefits. Increased stair climbing at work is currently promoted to improve population health by CDC and NICE. Nonetheless, consistent effects of point-of-choice stair climbing interventions in public access settings have not been replicated at work. Pedestrian movement within buildings has major effects on stair use, independent of any intervention. This paper used pooled data from workplace studies in the UK and Spain to test the effects of stair climbing interventions when pedestrian movement was measured, and controlled for, throughout. Methods: Automated counters measured stair and lift usage throughout the working day. Point-of-choice interventions employed previously successful campaigns, further refined in focus groups. In the UK, minute-by-minute measures of choice estimated effects of momentary traffic at the choice-point (n=426,605). In Spain, measures of traffic every 30 minutes estimated effects for ‘busyness’ of the building (n=293,300). Analyses employed hierarchical regression with bootstrapping, in which effects of pedestrian movement were added to effects of intervention alone. Findings: Significant intervention effects on stair descent (3 of 4 analyses) were more frequent than effects on stair climbing (1 of 4 analyses). Where effects occurred, they were at least an order of magnitude smaller that the effects of pedestrian movement. Momentary traffic at the choice-point reduced stair climbing whereas ‘busyness’ of the building generally increased it. Discussion: These pooled data provide no encouragement for recommendations from CDC and NICE that stair climbing interventions at work will enhance health at a population level.