. 2021 Dec 13;18:159. doi: 10.1186/s12966-021-01191-y

Table 2.

Characteristics of the observational occupational cohort studies

Study ID + Country	Study population + Duration + Sample size + Average age/ BMI + %Female + Study name	Nature of occupation	Sedentary behaviour (SB) domain + measures	Musculoskeletal pain (MSP) conditions + % Prevalence + Measures	Statistical analysis + Adjusted covariates	Conclusions on associations of SB with MSP conditions + Effect Size/p-value	Quality score
Study design – cross-sectional
*Occupational Sedentary Behaviour*
Ayanniyi et al. 2010 [80] Nigeria	All adults Sample size = Computer users = 236; Non-computer users = 236; Total = 472 Average: age – Computer users = 29(4.87), Non-computer users = 31(6.23); BMI = NR %Female: Computer users = 42.4%; Non-computer users = 42.4%	Office workers	Occupational – Computer time Self-reported	Musculoskeletal symptoms (Neck/shoulder pain, UBP, elbows, wrists/hands, LBP, hips/thighs, knees, and ankles/feet pain) – 7- and 12-month prevalence %Prevalence: 7 days point prevalence – Computer users = 55.9%, Non-computer users = 27.5%; 12-months prevalence – Computer users = 93.2%, Non-computer users = 33.9% Self-reported	Regression analysis Adjusted for age, sex, marital status	Positive association of computer time with musculoskeletal symptoms 7-day prevalence: 2–4 h – OR = 1.36(95%CI = 0.92 – 1.68, p < 0.05); > 4 h – OR = 4.12(95%CI = 3.21 – 5.16, p < 0.05); 12-Month prevalence: 2–4 h – OR = 3.25(95%CI = 1.84 – 4.73, p < 0.05); > 4 h – OR = 5.04(95%CI = 3.66 – 6.33, p < 0.05)	0.73
Benyamina et al. 2018 [81] Canada	All adults Sample size = 2208 Average: age = 35.8(8.1), BMI = NR %Female: 31.1%	Professionals – Car-patrol police officers	Occupational –vehicle time (time spent sitting in a vehicle) Self-reported	LBP – 12-month prevalence %Prevalence: Chronic LBP = 28.1%, acute/subacute LBP = 40.7% Self-reported – NMQ	Multinomial regression Adjusted age, sex, country of birth, income, the region of residency, depressed mood, and anxiety	No association of vehicle time with LBP Acute/subacute LBP vs No-LBP: OR(95%CI) = 1.005 (0.998 – 1.012), p = 0.169; Chronic LBP vs No-LBP: OR(95%CI) = 1.002 (0.993 – 1.010), p = 0.702	0.77
Cagnie et al. 2007 [82] Belgium	All adults Sample size = 512 Average: age = NR, BMI = 24.0(3.4) %Female: 41.7%	Office workers	Occupational – prolonged workplace sitting and computer time (> 4 h/day) Self-reported	Neck pain – 12-month prevalence %Prevalence: 45.5% Self-reported – NMQ	Logistic regression Adjusted for age, gender, mental tiredness, and sport	Positive associations of prolonged workplace sitting and computer time with neck pain Workplace sitting: OR(95% CI) = 2.06(1.17 – 3.62); Computer time: OR(95% CI) = 1.57(1.10 – 2.22)	0.73
Celik et al. 2018 [83] Turkey	All adults Sample size = 528 Average: age = 38.55(9.79), BMI = 25.44(3.85) %Female: 51.14%	Office workers	Occupational – Total workplace sitting [mean = 4.64(2.21) Self-reported	LBP, UBP, Shoulder pain, Neck pain, Leg pain, Arm pain, Foot pain, Wrist pain %Prevalence: LBP – Female = 60.4%, Male = 49.6%; UBP – Female = 62.6%, Male = 43.0%; Shoulder pain – Female = 50.0%, Male = 31.0%; Neck pain – Female = 61.9%, Male = 42.6%; Leg pain – Female = 39.6%, Male = 26.7%, Arm pain – Female = 33.0%, Male = 20.5%; Foot pain – Female = 45.6, Male = 37.2%; Wrist pain – Female = 33.7%, Male = 19.0% Self-reported	Multiple-linear regression Adjusted for age, BMI, marital status, exercise in daily life, working experience	No significant association of workplace sitting with LBP, UBP, shoulder and wrist pain. Negative association of workplace sitting with neck and extremities pain (arm, leg, and foot) in females LBP: Female B = –0.07, SE = 0.04, 95%CI = –0.16–0.00, p = 0.080; Male B = –0.03, SE = 0.04, 95%CI = –0.13–0.05, p = 0.458; UBP: Female B = –0.00, SE = 0.04, 95%CI = –0.09–0.07, p = 0.825; Male B = 0.06, SE = 0.04, 95%CI = –0.03–0.15, p = 0.195; Neck pain: Female B = –0.110, SE = 0.04, 95%CI = –0.20–(–0.02), p = 0.009; Male B = 0.04, SE = 0.04, 95%CI = –0.04–0.13, p = 0.352. Shoulder pain: Female B = –0.02, SE = 0.04, 95%CI = –0.10–0.06, p = 0.648; Male B = 0.01, SE = 0.04, 95%CI = –0.06–0.10, p = 0.711; Leg pain: Female B = –0.08, SE = 0.04, 95%CI = –0.170–0.000, p = 0.043; Male B = –0.01, SE = 0.04, 95%CI = –0.11–0.07, p = 0.687; Foot pain: Female B = –0.09, SE = 0.040, 95%CI = –0.18–(–0.01), p = 0.027; Male B = 0.00, SE = 0.04, 95%CI = –0.07–0.08, p = 0.891; Arm pain: Female B = –0.10, SE = 0.04, 95%CI = –0.18–(–0.02), P = 0.010; Male B = 0.00, SE = 0.04, 95%CI = –0.07–0.08, p = 0.919; Wrist pain: Female B = –0.04, SE = 0.04, 95%CI = –0.12–0.04, p = 0.343; Male B = 0.03, SE = 0.03, 95%CI = –0.03–0.11, P = 0.292	0.73
Chee & Rampal 2004 [84] Malaysia	All adults Sample size = 906 Average: age = NR, BMI = NR %Female: 100%	Tradespeople – Semiconductor factory workers	Occupational – Workplace sitting (≥ 4 h/day) Self-reported	Neck/shoulder pain, and lower limbs – 12-month prevalence %Prevalence: 80.5% Self-reported – NMQ	Multivariate binary logistic regression Adjusted for age, work task, work schedule, overtime work, whether work environment was too cold, and stress	Positive association of workplace sitting with neck/shoulder pain [OR(95% CI) = 1.6(1.2 – 2.1)]; a negative association with Lower limbs OR(95% CI) = 0.5(0.4 – 0.8)	0.91
Chrasakaran et al. 2003 [85] Malaysia	All adults Sample size = 529 Average: age = 31.2(7.4), BMI = NR %Female: 100%	Tradespeople –Semiconductor factory workers	Occupational – Workplace sitting (≥ 4 h/day) Self-reported	Neck, shoulder, arm (elbow and forearm), wrist and fingers, upper leg (hips/thighs/knees), lower leg (ankles/feet) – 12-month prevalence %Prevalence: lower leg (48.4%), shoulder (44.8%), upper leg (38.8%) and neck (29.7%) Self-reported – NMQ	Logistic regression Adjusted for age, number years of work, the stress of work, cold working temperature	Positive association of workplace sitting with NSP, but no association with extremities pain Neck: [OR(95% CI) = 2.1(1.3 – 3.2); Shoulder: [OR(95% CI) = 1.7(1.2 – 2.5); Upper leg: [OR(95% CI) = 0.6(0.3 – 1.0); Lower leg: [OR(95% CI) = 0.6(0.4 – 1.0)	0.73
Constantino et al. 2019 [86] Brazil	All adults Sample size = 530 Average: age = NR, BMI = NR %Female: 95.4%	Professionals – Teachers	Occupational – workplace sitting (≥ 2 h/day), computer time(≥ 2 h/day); and Non-occupational – TV time(≥ 2 h/day) Self-reported	Clinically diagnosed MSP disease; musculoskeletal symptoms (back/neck); and MSP-related disability – 12-month prevalence %Prevalence: > 30% Self-reported – NMQ	Poisson regression Adjusted for age, gender, length of employment, high stress, common mental disorder, physical activity	Negative association of workplace sitting with lower limbs disability [Adjusted PR(95%CI) = 0.64(0.43–0.94)]; No association of TV time with back & neck pain [Adjusted PR(95%CI) = 1.03(0.88–1.21)]; Positive association of TV time with clinically diagnosed MSP disease [Adjusted PR(95%CI) = 1.37(1.02–1.85)]; No association of computer time with clinically diagnosed MSP disease [Adjusted PR(95%CI) = 0.78(0.60–1.02)]	0.77
Dianat & Karimi, 2016 [87] Iran	All adults Sample size = 632 Average: age = 34.5(11.5), BMI = 24.9(4.1) %Female: 58.9%	Tradespeople – Handicraft workers	Occupational – Workplace sitting (> 2 h/day) Self-reported	Neck, shoulders, LBP –1-month prevalence %Prevalence: 76.2% Self-reported – NMQ	Logistic regression Adjusted for age, gender, BMI, marital status, education level, smoking, physical activity, years working	Positive association of workplace sitting > 2 h with neck pain in multivariate analysis [OR(95% CI) = 2.85(1.79 – 4.53), p < 0.001] Univariate analysis showed a positive association of workplace sitting with shoulder pain [OR(95% CI) = 1.54(1.02 – 2.31)];and no association with LBP [OR(95% CI) = 0.99(0.66 – 1.47)]	0.86
Dianat et al. 2015 [88] Iran	All adults Sample size = 251 Average: age = 33.2(9.9), BMI: 24.1(4.1) %Female: 39.8%	Tradespeople – Sewing machine operators	Occupational – workplace sitting (> 2 h/day) Self-reported	Neck, shoulders, UBP, LBP, elbows, wrists/hands, hips/thighs/buttocks, knees, and ankles/feet – 12-month prevalence %Prevalence: 9.6% Self-reported – NMQ	Logistic regression Adjusted for demographic (age, gender, BMI, educational level, marital status, smoking, physical activities, and job characteristics, and RULA scores	Positive association of workplace sitting > 2 h with neck pain [OR(95% CI) = 3.34(1.40 – 7.95), p = 0.006]; and shoulder pain [OR(95% CI) = 3.12(1.19 – 8.18), p = 0.020] in multivariate analysis However, univariate analysis showed no association of workplace sitting with LBP [OR(95% CI) = 1.12(0.41 – 2.99), p = 0.821], and UBP [OR(95% CI) = 1.04(0.93 – 1.16), p = 0.102]; but positive association with Hand/wrist [OR(95% CI) = 2.49(1.08 – 5.72), p = 0.031]	0.86
Ilic et al. 2021 [89] Serbia	Young to middle-aged Sample size = 499 Average: age = 22.0(2.2) %Female: 67.7%	Professionals – Students	Occupational – Workplace sitting (prolonged sitting) Self-reported	LBP – Point prevalence %Prevalence: 20.8% Self-reported	Logistic regression Adjusted for smoking, BMI, Incorrect body posture, stress, incorrect sitting position, family history of LBP	Multivariate analysis: No association of prolonged sitting with LBP [OR (95%CI) = 1.5(0.5 – 4.2), p = 0.424 Univariate analysis – prolonged sitting associated with LBP (p = 0.018)	0.82
Hakim et al. 2017 [90] Egypt	All adults Sample size = 180 Average: age = NR, BMI = NR %Female: 0%	Bus divers	Occupational – vehicle time (> 8 h/day) Self-reported	LBP – 12-month prevalence %Prevalence: 73.9% Self-reported – NMQ	Binary logistics regression Adjusted for age, BMI, marital status, education, smoking, work duration	Positive association of vehicle time (> 8 h) with LBP OR(95%CI) = 2.93(1.45 – 5.93)	0.68
Larsen et al. 2018 [91] Sweden	All adults Sample size = 4114 Average: age = NR, BMI = NR %Female: 25.8%	Professionals – Duty police officer	Occupational – Vehicle time (% shift time sitting: 25 – 50%, 50 – 75%, > 75%) Self-reported	Multisite MSP (pain in two or more body regions) – 3-month prevalence %Prevalence: 41.3% Self-reported – 5-point scale	Binominal logistic regression.; adjusted for age, sex, physical exercise, physical workload factors, and psychosocial factors	Vehicle time vehicles were not significantly associated with multi-site MSP among police Shift time sitting: 25 – 50% OR(95%CI) = 0.97(0.74 – 1.28); 50 – 75% OR(95%CI) = 1.11(0.84 – 1.47); > 75% OR(95%CI) = 1.10(0.77 – 1.57)	0.86
Lourenço et al. 2015 [92] Portugal	21-year cohorts Sample size = 1733 (Non-workers = 1083; Workers = 650) Average BMI = NR %Female: Non-workers = 51.8%; Workers = 51.2% Epidemiological Health Investigation of Teenagers in Porto (EPI-Teen)	Professionals – Student	Occupational – Workplace sitting (> 4.2 h/week); computer time (> 5.0 h/week) Self-reported	Neck, shoulders, elbows, wrists/hands, upper back, lower back, hips/thighs/buttocks, knees, and ankles/feet – 12-month prevalence Self-reported	Logistic regression Adjusted for sex, BMI, physical activity, smoking, education, and job strain (Karasek’s Job Strain Model)	A positive association of workplace sitting with LBP [OR(95%CI) = 1.70(1.20 – 2.42)]; no association with neck pain [OR(95%CI) = 1.23(0.89 – 1.71)] and extremities pain [OR(95%CI) = 0.83(0.60 – 1.16)]	0.91
Mehrdad et al. 2012 [93] Iran	All adults Sample size = 405 Average: age = 44.6 (7.9), BMI: 23.7(2) %Female: 47%	Professionals – physicians	Occupational – Prolonged workplace sitting (> 20 min) Self-reported	Neck pain^a – 12-month prevalence %Prevalence: 41.7% Self-reported – NMQ	Logistic regression Adjusted for both individual and work-related factors such as age, gender, BMI, shift work, type of employment, and secondary job	A positive association of prolonged workplace sitting with neck pain Coefficient(B) = 0.204, OR(95%CI) = 1.227(1.032 – 1.458), p = 0.020	0.86
Omokhodion et al. 2003 [94] Nigeria	All adults Sample size = 840 Average: age = NR, BMI = NR %Female: 43%	Office workers	Occupational – Workplace sitting (> 3 h) Self-reported	LBP – 12-month prevalence %Prevalence: 37.5%; Self-reported	Not reported	Workplace sitting for > 3 h associated with increased severity of LBP	0.36
Pradeepkumar et al. 2020 [95] India	24 – 55 years Sample size = 301 Average: age = 39(7.3), BMI = NR %Female: NR	Bus drivers	Occupational – Vehicle time (Prolonged sitting) Self-reported	MSP conditions – 7-day and 12-month prevalence %Prevalence: 55.8%; Self-reported – NMQ	Chi-square test	Prolonged sitting in a vehicle is positively associated with the risk of MSP conditions χ2 = 5.833, p < 0.05	0.55
Ratzon et al. 2000 [96] Israel	All adults Sample size = 60 Average: age = 46.0 (8.66), BMI – Sitting position = 25.14(2.18), Alternating position = 25.31(2.44) %Female: 0%	Professionals – Dentist	Occupational – Workplace sitting (≥ 80% of work time) Self-reported	General MSP, LBP – 7-days and 12-month prevalence %Prevalence; Low back pain = 55% Self-reported – NMQ	Pearson and Spearman correlations	Sitting position at work positively and significantly correlated with LBP Correlation coefficient – MSP = − 0.16; LBP: r = 0.41, p < 0.01	0.45
Şimşek et al. 2017 [97] Turkey	All adults Sample size = 1682 Average: age = 37.9(7.46), BMI: NR %Female: 60%	Professionals – Healthcare workers	Occupational – Workplace sitting (> 4 h), computer time (> 4 h) Self-reported	LBP – 7-days, 12-month, and lifetime prevalence %Prevalence: Lifetime prevalence 53%, 12-month prevalence 39% and 7-days prevalence 29.5% Self-reported – NMQ (10-cm-long Visual Analogue Scale (VAS))	Binary logistic regression Adjusted for sex, BMI, marital status, smoking habit, physical exercise, job satisfaction, workplace stress	Positive associations of workplace sitting and computer time > 4 h with LBP Workplace sitting time: OR(95%CI) = 4.7(1.25 – 17.64), p = 0.021; Computer time: OROR(95%CI) = 0.0(0.00 – 0.04), p = 0.0001	0.86
Spyropoulos et al. 2007 [98] Greece	All adults Sample size = 648 Average: age = 44.5, BMI = NR %Female: 75.8%	Office workers	Occupational – Workplace sitting (≥ 6 h) Self-reported	LBP – Lifetime prevalence %Prevalence: Lifetime 61.6% Self-reported – Visual Analogue Scale (VAS) and physical examination by a physiotherapist	Multiple logistic regression Adjusted for age gender, BMI, psychosocial factors	Positive association of workplace sitting time > 6 h with lifetime LBP OR(95z5CI) = 1.588(1.064 – 2.368)	0.82
Szeto & Lam, 2007 [99] Hong Kong	All adults Sample size = 481 Average: age = NR, BMI – Male = 25.24(3.42); Female = 23.60(2.74) %Female: 16%	Bus drivers	Occupational – Vehicle time (prolonged sitting) Self-reported	LBP^a – 12-month prevalence %Prevalence: 92.7% Self-reported – NMQ	Logistic regression Adjusted for age, gender, company	Positive association of prolonged vehicle time with LBP OR(95% CI) = 3.71(2.40 – 5.74)	0.77
Temesgen et al. 2019 [100] Ethiopia	All adults Sample size = 754 Average: age = 42(9.73), BMI = NR %Female: 57.8%	Professionals – Teachers	Occupational – Workplace sitting (prolonged sitting > 4 h/day) Self-reported	Neck/shoulder pain – 12-month prevalence %Prevalence: 57.3% Self-reported – NMQ	Logistics regression Adjusted for age, marital status, salary, smoking, alcohol, physical exercise, diabetes, hypertension, respiratory diseases	Positive association of prolonged workplace sitting > 4 h with neck/shoulder pain OR(95%CI) = 1.50(1.02 – 2.23)	0.95
Tsigonia et al. 2009 [101] Greece	All adults Sample size = 102 Average: age = 38.42(10.74), BMI = 23.09(2.86) %Female: 93%	Tradespeople – Cosmetologists	Occupational – Workplace sitting (High exposure to prolonged sitting – often or always) Self-reported	Neck, shoulder, hand/wrist, low back, knee; 12-month prevalence; %Prevalence: Neck = 58%; shoulder = 35%; hand/wrist = 53%; low back = 53%; knee = 28%; Self-reported– NMQ	Logistics regression; adjusted for age and sex	Positive association of high exposure to prolonged workplace sitting with hand/wrist complaints, OR(95%CI) = 55.7(18.75- 354.93) Univariate analysis indicates workplace sitting is significantly related to the occurrence of LBP, neck/shoulder pain, hand and knee pain (both acute and chronic complaints)	0.73
van Vuuren et al. 2005 [102] South Africa	All adults Sample size = 366 Average: age = 31.76(7.80), BMI = NR %Female: NR	Tradespeople – Steel plant workers	Occupational – Workplace sitting (sitting position half the time or more) Self-reported	LBP, LBP disability – Point, 1-month, 12-month, and lifetime prevalence %Prevalence: Point 35.8%, 1-month 41.3%, 12-month 55.7%, and lifetime 63.9%; LBP disability – ≥ 30% Self-reported – Functional Rating Index (FRI)	Multivariate logistic regression Adjusted for all risk factors including work organization, trunk posture, handling activities, body position, and environmental demands	Positive association of workplace sitting with LBP, but no significant association with LBP disability LBP: [OR(95%CI) = 2.33(1.01 – 5.37)]; LBP disability: [OR(95%CI) 1.89(0.75 – 4.78)]	0.77
Yue et al. 2012 [103] China	All adults Sample size = 893 Average: age = 32.21(10.6), BMI = 39(2.79) %Female: 67%	Professionals – Teachers	Occupational – Workplace sitting (≥ 4 h/day); Computer time (≥ 4 h/day) Self-reported	LBP, neck/shoulder pain – 12-month prevalence %Prevalence: LBP = 45.6%, NSP = 48.7% Self-reported – NMQ	Binary logistic regression Adjusted for age, gender, BMI, education, smoking, exercise, years of work, duration of work	Positive association of prolonged workplace sitting (≥ 4 h) with neck/shoulder pain [OR(95%CI) = 1.76(1.23 – 2.52)] and LBP[OR(95%CI) = 1.42 (1.01 – 2.02)] No significant association of computer time (≥ 4 h) with neck/shoulder pain [OR(95%CI) = 1.02 (0.63 – 1.65)] and LBP [OR(95%CI) = 0.71 (0.44 – 1.14)]	0.86
*Non-occupational Sedentary Behaviour*
Ben-Ami et al. 2018 [104] Israel	All adults Sample size = 1026 Average: age = 27.2(6.4), BMI = NR %Female: 57.7%	Professionals – Students	Non-occupational – Leisure-time SB (at least half an hour a day) Self-reported	LBP – 6-month prevalence %Prevalence: 38.6% Self-reported	Multinominal logistic regression Adjusted for sociodemographic, lifestyle, and personal vulnerability	No significant association of total SB with LBP (backache) AOR(95%CI) = 0.96(0.78 – 1.18)	0.86
Hildebrandt et al. 2000 [56] Netherlands	All adults Sample size = 2030 Average: age = 33.7(9.6), BMI: NR %Female: 51%	Tradespeople – Industry (shipyard, metal, transport) and services (cleaners, childcare); Professionals – Healthcare(nurses); and Office workers	Non-occupational – Leisure-time SB Self-reported	LBP, neck/shoulder pain, and lower extremity pain – 12-prevalence %Prevalence: LBP = 60%, NSP = 44%, and lower extremity pain = 31% Self-reported	Logistic regression Adjusted for age, gender, education, and type of workload	Leisure-time SB is positively associated with LBP [OR(95%CI) = 1.46(1.18 – 1.29)]; and no associated with neck/shoulder pain [OR(95%CI) = 1.02(0.82 – 1.27)], and lower extremities pain [OR(95%CI) = 1.07(0.85 – 1.36)]	0.73
Ibeachu et al. 2019 [105] UK	18 – 39 years Sample size = 314 Average: age = 22.0(5.2), BMI = 24.3(4.1) %Female: 43.9%	Professionals – Student	Non-occupational – Total SB (mean 5.6(2.6)hrs/day) Self-reported – IPAQ	Knee pain – 12-month prevalence %Prevalence: 31.8% Self-reported – Knee Pain Screening Tool (KNEST)	Logistic regression Adjusted for age, gender, BMI, mental distress	Total SB has a borderline non-significant association with knee pain (p = 0.069) Quadratic term: OR(95%CI) = 1.02(1.00 – 1.05) Linear term: OR(95%CI) = 1.04 (0.93 – 1.16)	0.82
Rodríguez-Nogueira et al. 2021 [106] Spain	All adults Sample size = 472 Average: age – Male = 48.1(10.9); Female = 45.3(11.2) %Female: 60%	Professionals – University staff	Non-occupational – Daily sitting time (Mean daily sitting time (hrs): Male = 7(2.5); Female = 6.9(2.3)) Self-reported	General MSP – 12-month prevalence Self-reported – NMQ	Logistic regression Adjusted for age, sex, anxiety, physical activity, self-perceived stress	No significant association of daily sitting with general MSP OR(95%CI) = 0.934(0.86 – 1.01), p = 0.09	0.86
Sklempe et al. 2019 [107] Croatia	Young adults Sample size = 517 Average: age – 20(2), BMI = 22.3(4.3) %Female: 63.8%	Professionals – Student	Non-occupational – Total SB (mean 5(3.5)hrs/day) Self-reported – IPAQ	Musculoskeletal symptoms (neck, shoulder, upper back, and lower back) – 12-month prevalence %Prevalence: 81% Self-reported – NMQ	Point-biserial correlation coefficient	No significant association between the time spent sitting and MSP score	0.73
Tavares et al. 2019 [108] Brazil	Young to middle-aged adults Sample size = 629 Average: age – median(IQR) = LBP = 22.5(21.0 – 24.0); no LBP = 23.0(21.0 – 25.0); Average BMI = NR %Female: 72.8%	Professionals – Student	Non-occupational – Total SB Self-reported	LBP – Lifetime prevalence; %Prevalence: 81.7%; Self-reported	Chi-squared test	No association of total SB with LBP	0.59
*Occupational and Non-occupational Sedentary Behaviour*
Gupta et al. 2015 [109] Denmark	All adults Sample size = 201 Average: age = 44.7(9.7), BMI = 26.4 (5.0) %Female: 41.8	Tradespeople – Construction workers, cleaners, garbage collectors, manufacturing workers, assembly workers, mobile plant operators, and workers in the health service sector	Occupational – Total workplace sitting (low: ≤ 2.0 h, moderate: 2.1 – 3.7 h, high: > 3.7 h); and non-occupational – Total full day sitting (low: ≤ 6.4 h, moderate: 6.5 – 8.3 h and high: > 8.3 h); Total leisure-time sitting (Low: < 4.4 h, moderate: 4.0 – 5.4 h, high: > 5.4 h Device-measured – ActiGraph	LBP intensity – 1-month prevalence Low intensity: ≤ 5 pain score; high intensity: > 5 pain score Self-reported – NMQ	Binary logistic regression Adjusted for age, gender, BMI, and smoking, job seniority, influence at work, and occupational lifting/carrying time at work	Positive associations of the total full day sitting time and leisure-time with LBP intensity, and marginally significant association of total workplace sitting with LBP intensity Total full day sitting: OR = 1.43(1.15 – 1.77), p = 0.01; Workplace sitting: OR = 1.34(0.99 – 1.82), p = 0.06; Leisure sitting: OR = 1.45(1.10 – 1.91), p = 0.01. High total full day sitting: OR = 3.31(1.18 – 9.28), p = 0.03; High Workplace sitting: OR = 3.26(0.89 – 11.98), p = 0.08; High Leisure sitting: OR = 5.31(1.57 – 17.90), p = 0.01	0.95
Hallman et al. 2015 [110] Denmark	All adults Sample size = 202 Average: age = NR, BMI = NR %Female: 41.8% Danish PHysical ACTivity cohort with Objective measurements (DPHACTO)	Tradespeople – Construction workers, cleaners, garbage collectors, manufacturing workers, assembly workers, mobile plant operators, and workers in the health service sector	Occupational – Mean total workplace sitting = 3.0(1.4); and Non-occupational – mean total full day sitting = 7.3 (2.1), mean total leisure-time sitting = 4.8(1.7) Device-measured – ActiGraph	Neck/shoulder pain-intensity – 1-month prevalence %Prevalence: 75.2% Self-reported – NMQ (numeric rating scale (NRS))	Logistic regression Adjusting for age and gender, individual factors (i.e., BMI and smoking), work-related factors (i.e., seniority, influence at work, and lifting/carrying)	Positive associations of the total full day sitting and workplace sitting with neck/shoulder pain intensity. Low total workplace sitting is associated with reduced neck/shoulder pain intensity in men. No association of leisure-time sitting with neck/shoulder pain intensity Total full day Sitting: High sitting (Overall) OR(95%CI) = 2.97(1.25 – 7.03), p = 0.01; (Male) OR(95%CI) = 6.44(1.76 – 23.56), p = 0.005; (Female) OR(95%CI) = 1.19(0.31 – 4.51), p = 0.44. Workplace sitting: High sitting (Overall) OR(95%CI) = 0.92(0.41 – 2.06), p = 0.83; (Male) OR(95%CI) = 0.94(0.31 – 2.85), p = 0.92; (Female) OR(95%CI) = 1.17(0.32 – 4.33), p = 0.82; Low sitting (Overall) OR(95%CI) = 0.54(0.23 – 1.25), p = 0.15; (Male) OR(95%CI) = 0.26(0.07 – 0.96), p = 0.04; (Female) OR(95%CI) = 1.01(0.28 – 3.59), p = 0.99. Leisure-time: High sitting (Overall) OR(95%CI) = 1.60(0.68 – 3.74) p = 0.28; (Male) OR(95%CI) = 2.76(0.83 – 9.18), p = 0.097; (Female) OR(95%CI) = 1.02(0.28 – 3.74), p = 0.97	0.91
Hallman et al. 2016 [111] Denmark	All adults Sample size = 659 Average: age = 45.0(9.9), BMI = 27.5(4.9) %Female: 44.9% DPHACTO	Tradespeople – Cleaning, manufacturing, transport	Occupational –workplace sitting pattern and absolute sitting time (brief: < 5 min, moderate: > 5 – 20 min, prolonged: > 20 min) and Non-occupational –leisure-time sitting pattern and absolute sitting time (brief: < 5 min, moderate: > 5 – 20 min, prolonged: > 20 min) Device-measured – ActiGraph	Neck/shoulder pain-intensity – 3-month prevalence %Prevalence: 74% Self-reported – NMQ [numeric rating scale (NRS)]	Binary logistic regression Adjusted for age, gender, smoking, BMI, job seniority, lifting/carrying time at work, physical activity at work, and leisure, sitting with arms above 90°	Negative association of short workplace sitting bout with neck/shoulder pain intensity and positive association with moderated workplace sitting bout with neck/shoulder pain intensity. No association of prolonged Workplace sitting bout nor leisure-time sitting bouts with neck/shoulder pain intensity Workplace sitting bout: Brief Coefficient (B) = -0.38, OR(95%) = 0.60(0.40 – 0.91), p = 0.04; Moderate B = 0.28, OR(95%CI) = 1.23(0.93 – 1.63), p = 0.02; Prolonged B = − 0.08, OR(95%CI) = 0.84(0.69 – 1.02), p = 0.33. Leisure sitting bout: Brief B = 0.23, OR(95%CI) = 1.25(0.71 – 2.21), p = 0.44; Moderate B = 0.27, OR(95%CI) = 0.76(0.52 – 1.10), p = 0.15; Prolonged B = 0.11, OR(95%CI) = 0.90(0.71 – 1.14), p = 0.37	0.91
Study design – prospective
*Occupational Sedentary Behaviour*
Hallman et al. 2016 [112] Denmark	All adults Duration: 12-months Sample size = 625 Average: age = 44.8(9.8), BMI = 27.5(4.9) %Female: 45% DPHACTO	Tradespeople – Cleaning, manufacturing, transport	Occupational – Total workplace sitting [2.4(1.7)hrs] Device-measured – ActiGraph	Neck/shoulder pain-intensity – 1-month prevalence (measured over 12 months) %Prevalence/incidence: 70%; mean pain score 3.1(2.7) Self-reported – Numerical rating scale (NRS)	Linear mixed models Adjusted for age, gender, and BMI; occupational sector, lifting/carrying time at work, physical activity at and leisure, working with the dominant arm elevated > 60°	Negative association of increased workplace sitting with neck/shoulder pain-intensity (i.e., reduced neck/shoulder pain-intensity) after 12-month follow-up in the Tradespeople Coefficient, B = 0.012, SE = 0.055, 95%CI = 0.000 – 0.025, p = 0.006	0.91
Korshøj et al. 2018 [39] Denmark	All adults Duration: 12-months Sample size = 665 Average: age = 45.0(10.0), BMI = 27.4(4.9) %Female: 44.2% DPHACTO	Tradespeople – Cleaning, manufacturing, transport	Occupational – Total workplace sitting, sitting bout Device-measured – ActiGraph	LBP-intensity – 3- and 12-month prevalence Mean pain score 3.1(2.7) Self-reported – Numerical rating scale (NRS), which ranges from 0 (‘no pain’) to10 (‘worst pain imaginable’)	Linear mixed models Adjusted for herniated disc, occupational lifting and carrying, LBP the last 3 months from baseline, sitting time during leisure time	Negative association of both total workplace sitting and temporal patterns of sitting (sitting bout) with LBP intensity across 12-month Total workplace sitting: Coefficient(B) = -0.050, SE = 0.007, p < 0.001, 95%CI = -0.065 – -0.040; Brief (bouts ≤ 5 min): B = -0.118, SE = 0.017, p < 0.001, 95%CI = -0.152 – -0.084; Moderate (bouts of > 5 − 20 min): B = -0.117, SE = 0.017, p < 0.001, 95%CI = -0.151 – -0.084; Prolonged (bouts of > 20 min): B = -0.123, SE = 0.018, p < 0.001, 95%CI = -0.158 – -0.088	0.95
Yip, 2004 [113] Hong Kong	All adults Duration: 12 months Sample size = 144 Average0: age = 31.1, BMI = NR %Female: 85.5%	Professionals – Nurses	Occupational – Workplace sitting (≥ 2 h) Self-reported	LBP – 12-month incidence %Prevalence: 56% Self-reported	Chi-square test	No association of prolonged workplace sitting ≥ 2 h/day with the prevalence of LBP, p = 0.47	0.59
*Non-occupational Sedentary Behaviour*
Santos et al. 2020 [114] Brazil	All adults Duration: 24-months Sample size = 978 at baseline Average: age – median age(IQR) Baseline = 42(34 – 49), Follow-up = 44(36 – 51); BM – median BMI(IQR) Baseline = 25.2(22.8 – 28.2), Follow-up = 25.6(23.2 – 28.6) %Female: 66.6% baseline Pro-Mestre study	Professionals – Teachers	Non-occupational – TV time Self-reported	Chronic MSP – 6-month prevalence % Prevalence – baseline = 32.3%; follow-up = 24.7% Self-reported	Generalized estimating equation (GEE) regression Adjusted for age, sex, BMI, and depression	Positive association of change in TV time (30 min/day) with chronic MSP, OR(95%CI) = 1.051(1.001 – 1.102)	0.95
Jun et al. 2020 [115] Australia, South Korea	All adults Duration: 12-month Sample size = 214 (Australia – Brisbane = 156; South Korea – Daegu = 58) Average: age = 37.3(9.9), BMI = 24.0(4.2) %Female: 55.1%	Office workers – University faculty members, research centre, management service, industrial institution	Non-occupational – Total SB [total hours sitting in weekdays = 51.9(11.8)] Self-reported – IPAQ	Neck pain – monthly prevalence for the 12-month %prevalence/incidence: 18.2% self-reported	Survival analysis Adjusted for age, gender, and BMI	Positive association of increased total SB during weekdays with increased risk of neck pain Adjusted HR(95%CI) = 1.04(1.03 – 1.06), p < 0.001	0.82
*Occupational and Non-occupational Sedentary Behaviour*
Lunde et al. 2017 [57] Norway	All adults Duration: 6-month Sample size = 124 Average: age – Construction = 39.9(13.6), Health = 44.5(9.6); BMI – Construction = 25.7(3.3), Health = 25.1(3.8) %Female – Construction = 1.6%, Health = 77.8%	Tradespeople – Construction; Professionals – Healthcare workers	Occupational – Total workplace sitting (Construction = 156.8(114.2) Health = 171.6(93.8); and Non-occupational – Leisure-time sitting (Construction = 282.0(78.4); Health = 274.0(94.3)) Device-measured – ActiGraph	LBP-intensity; 1-month prevalence %Prevalence: Health – Baseline = 59%; 6-month = 55%; Construction – Baseline = 52%; 6-month = 49%; mean pain score Baseline – Construction = 0.5(0.5); Health = 0.6(0.5); 6-months – Construction = 0.7(0.9); Health = 1.0(1.0) Self-reported	Linear mixed models Adjusted for age, gender, smoking, body mass index, heavy lifting, forward bending at work, social climate, decision control, fair leadership, empowering leadership, sitting (minutes) during leisure time	Total full day Sitting: Association of the total full day sitting with LBP-intensity in both healthcare and construction workers at baseline and 6-months Healthcare: Baseline – B(95%CI) = -0.16(-0.40 – 0.08), p = 0.183; 6-month – B(95%CI) = -0.17(-0.40 – 0.07), p = 0.168 Construction: Baseline B(95%CI) = -0.07(-0.31– 0.18), p = 0.596; 6-months – B(95%CI) = -0.08(-0.31– 0.17), p = 0.541 Workplace Sitting Healthcare workers – a negative association of workplace sitting with LBP intensity at baseline and 6-months’ follow-up Baseline: B(95%CI) = B(95%CI) = -0.31(-0.63 – 0.01), p = 0.058; 6-Month: B(95%CI) = -0.34(-0.66 – -0.02), p = 0.040 Construction workers – no associations of workplace sitting with LBP intensity Baseline: B(95%CI) = -0.00001(-0.35 – 0.35), p = 1.00; 6-Month: B(95%CI) = -0.003(-0.36 – 0.35), p = 0.986	0.95

Study ID + Country

Study population + Duration + Sample size + Average age/ BMI + %Female + Study name

Nature of occupation

Sedentary behaviour (SB) domain + measures

Musculoskeletal pain (MSP) conditions + % Prevalence + Measures

Statistical analysis + Adjusted covariates

Conclusions on associations of SB with MSP conditions + Effect Size/p-value

Quality score

Study design – cross-sectional

Occupational Sedentary Behaviour

Ayanniyi et al. 2010 [80]

Nigeria

All adults

Sample size = Computer users = 236; Non-computer users = 236; Total = 472

Average: age – Computer users = 29(4.87), Non-computer users = 31(6.23); BMI = NR

%Female: Computer users = 42.4%; Non-computer users = 42.4%

Office workers

Occupational – Computer time

Self-reported

Musculoskeletal symptoms (Neck/shoulder pain, UBP, elbows, wrists/hands, LBP, hips/thighs, knees, and ankles/feet pain) – 7- and 12-month prevalence

%Prevalence: 7 days point prevalence – Computer users = 55.9%, Non-computer users = 27.5%; 12-months prevalence – Computer users = 93.2%, Non-computer users = 33.9%

Self-reported

Regression analysis

Adjusted for age, sex, marital status

Positive association of computer time with musculoskeletal symptoms

7-day prevalence: 2–4 h – OR = 1.36(95%CI = 0.92 – 1.68, p < 0.05); > 4 h – OR = 4.12(95%CI = 3.21 – 5.16, p < 0.05); 12-Month prevalence: 2–4 h – OR = 3.25(95%CI = 1.84 – 4.73, p < 0.05); > 4 h – OR = 5.04(95%CI = 3.66 – 6.33, p < 0.05)

0.73

Benyamina et al. 2018 [81]

Canada

All adults

Sample size = 2208

Average: age = 35.8(8.1), BMI = NR

%Female: 31.1%

Professionals – Car-patrol police officers

Occupational –vehicle time (time spent sitting in a vehicle)

Self-reported

LBP – 12-month prevalence

%Prevalence: Chronic LBP = 28.1%, acute/subacute LBP = 40.7%

Self-reported – NMQ

Multinomial regression

Adjusted age, sex, country of birth, income, the region of residency, depressed mood, and anxiety

No association of vehicle time with LBP

Acute/subacute LBP vs No-LBP: OR(95%CI) = 1.005 (0.998 – 1.012), p = 0.169; Chronic LBP vs No-LBP: OR(95%CI) = 1.002 (0.993 – 1.010), p = 0.702

0.77

Cagnie et al. 2007 [82]

Belgium

All adults

Sample size = 512

Average: age = NR, BMI = 24.0(3.4)

%Female: 41.7%

Office workers

Occupational – prolonged workplace sitting and computer time (> 4 h/day)

Self-reported

Neck pain – 12-month prevalence

%Prevalence: 45.5%

Self-reported – NMQ

Logistic regression

Adjusted for age, gender, mental tiredness, and sport

Positive associations of prolonged workplace sitting and computer time with neck pain

Workplace sitting: OR(95% CI) = 2.06(1.17 – 3.62); Computer time: OR(95% CI) = 1.57(1.10 – 2.22)

0.73

Celik et al. 2018 [83]

Turkey

All adults

Sample size = 528

Average: age = 38.55(9.79), BMI = 25.44(3.85)

%Female: 51.14%

Office workers

Occupational – Total workplace sitting [mean = 4.64(2.21)

Self-reported

LBP, UBP, Shoulder pain, Neck pain, Leg pain, Arm pain, Foot pain, Wrist pain

%Prevalence: LBP – Female = 60.4%, Male = 49.6%; UBP – Female = 62.6%, Male = 43.0%; Shoulder pain – Female = 50.0%, Male = 31.0%; Neck pain – Female = 61.9%, Male = 42.6%; Leg pain – Female = 39.6%, Male = 26.7%, Arm pain – Female = 33.0%, Male = 20.5%; Foot pain – Female = 45.6, Male = 37.2%; Wrist pain – Female = 33.7%, Male = 19.0%

Self-reported

Multiple-linear regression

Adjusted for age, BMI, marital status, exercise in daily life, working experience

No significant association of workplace sitting with LBP, UBP, shoulder and wrist pain. Negative association of workplace sitting with neck and extremities pain (arm, leg, and foot) in females

LBP: Female B = –0.07, SE = 0.04, 95%CI = –0.16–0.00, p = 0.080; Male B = –0.03, SE = 0.04, 95%CI = –0.13–0.05, p = 0.458; UBP: Female B = –0.00, SE = 0.04, 95%CI = –0.09–0.07, p = 0.825; Male B = 0.06, SE = 0.04, 95%CI = –0.03–0.15, p = 0.195; Neck pain: Female B = –0.110, SE = 0.04, 95%CI = –0.20–(–0.02), p = 0.009; Male B = 0.04, SE = 0.04, 95%CI = –0.04–0.13, p = 0.352. Shoulder pain: Female B = –0.02, SE = 0.04, 95%CI = –0.10–0.06, p = 0.648; Male B = 0.01, SE = 0.04, 95%CI = –0.06–0.10, p = 0.711; Leg pain: Female B = –0.08, SE = 0.04, 95%CI = –0.170–0.000, p = 0.043; Male B = –0.01, SE = 0.04, 95%CI = –0.11–0.07, p = 0.687; Foot pain: Female B = –0.09, SE = 0.040, 95%CI = –0.18–(–0.01), p = 0.027; Male B = 0.00, SE = 0.04, 95%CI = –0.07–0.08, p = 0.891; Arm pain: Female B = –0.10, SE = 0.04, 95%CI = –0.18–(–0.02), P = 0.010; Male B = 0.00, SE = 0.04, 95%CI = –0.07–0.08, p = 0.919; Wrist pain: Female B = –0.04, SE = 0.04, 95%CI = –0.12–0.04, p = 0.343; Male B = 0.03, SE = 0.03, 95%CI = –0.03–0.11, P = 0.292

0.73

Chee & Rampal 2004 [84]

Malaysia

All adults

Sample size = 906

Average: age = NR, BMI = NR

%Female: 100%

Tradespeople – Semiconductor factory workers

Occupational – Workplace sitting (≥ 4 h/day)

Self-reported

Neck/shoulder pain, and lower limbs – 12-month prevalence

%Prevalence: 80.5%

Self-reported – NMQ

Multivariate binary logistic regression

Adjusted for age, work task, work schedule, overtime work, whether work environment was too cold, and stress

Positive association of workplace sitting with neck/shoulder pain [OR(95% CI) = 1.6(1.2 – 2.1)]; a negative association with Lower limbs OR(95% CI) = 0.5(0.4 – 0.8)

0.91

Chrasakaran et al. 2003 [85]

Malaysia

All adults

Sample size = 529

Average: age = 31.2(7.4), BMI = NR

%Female: 100%

Tradespeople –Semiconductor factory workers

Occupational – Workplace sitting (≥ 4 h/day)

Self-reported

Neck, shoulder, arm (elbow and forearm), wrist and fingers, upper leg (hips/thighs/knees), lower leg (ankles/feet) – 12-month prevalence

%Prevalence: lower leg (48.4%), shoulder (44.8%), upper leg (38.8%) and neck (29.7%)

Self-reported – NMQ

Logistic regression

Adjusted for age, number years of work, the stress of work, cold working temperature

Positive association of workplace sitting with NSP, but no association with extremities pain

Neck: [OR(95% CI) = 2.1(1.3 – 3.2); Shoulder: [OR(95% CI) = 1.7(1.2 – 2.5); Upper leg: [OR(95% CI) = 0.6(0.3 – 1.0); Lower leg: [OR(95% CI) = 0.6(0.4 – 1.0)

0.73

Constantino et al. 2019 [86]

Brazil

All adults

Sample size = 530

Average: age = NR, BMI = NR

%Female: 95.4%

Professionals – Teachers

Occupational – workplace sitting (≥ 2 h/day), computer time(≥ 2 h/day); and

Non-occupational – TV time(≥ 2 h/day)

Self-reported

Clinically diagnosed MSP disease; musculoskeletal symptoms (back/neck); and MSP-related disability – 12-month prevalence

%Prevalence: > 30%

Self-reported – NMQ

Poisson regression

Adjusted for age, gender, length of employment, high stress, common mental disorder, physical activity

Negative association of workplace sitting with lower limbs disability [Adjusted PR(95%CI) = 0.64(0.43–0.94)]; No association of TV time with back & neck pain [Adjusted PR(95%CI) = 1.03(0.88–1.21)]; Positive association of TV time with clinically diagnosed MSP disease [Adjusted PR(95%CI) = 1.37(1.02–1.85)]; No association of computer time with clinically diagnosed MSP disease [Adjusted PR(95%CI) = 0.78(0.60–1.02)]

0.77

Dianat & Karimi, 2016 [87]

Iran

All adults

Sample size = 632

Average: age = 34.5(11.5), BMI = 24.9(4.1)

%Female: 58.9%

Tradespeople – Handicraft workers

Occupational – Workplace sitting (> 2 h/day)

Self-reported

Neck, shoulders, LBP –1-month prevalence

%Prevalence: 76.2%

Self-reported – NMQ

Logistic regression

Adjusted for age, gender, BMI, marital status, education level, smoking, physical activity, years working

Positive association of workplace sitting > 2 h with neck pain in multivariate analysis [OR(95% CI) = 2.85(1.79 – 4.53), p < 0.001]

Univariate analysis showed a positive association of workplace sitting with shoulder pain [OR(95% CI) = 1.54(1.02 – 2.31)];and no association with LBP [OR(95% CI) = 0.99(0.66 – 1.47)]

0.86

Dianat et al. 2015 [88]

Iran

All adults

Sample size = 251

Average: age = 33.2(9.9), BMI: 24.1(4.1)

%Female: 39.8%

Tradespeople – Sewing machine operators

Occupational – workplace sitting (> 2 h/day)

Self-reported

Neck, shoulders, UBP, LBP, elbows, wrists/hands, hips/thighs/buttocks, knees, and ankles/feet – 12-month prevalence

%Prevalence: 9.6%

Self-reported – NMQ

Logistic regression

Adjusted for demographic (age, gender, BMI, educational level, marital status, smoking, physical activities, and job characteristics, and RULA scores

Positive association of workplace sitting > 2 h with neck pain [OR(95% CI) = 3.34(1.40 – 7.95), p = 0.006]; and shoulder pain [OR(95% CI) = 3.12(1.19 – 8.18), p = 0.020] in multivariate analysis

However, univariate analysis showed no association of workplace sitting with LBP [OR(95% CI) = 1.12(0.41 – 2.99), p = 0.821], and UBP [OR(95% CI) = 1.04(0.93 – 1.16), p = 0.102]; but positive association with Hand/wrist [OR(95% CI) = 2.49(1.08 – 5.72), p = 0.031]

0.86

Ilic et al. 2021 [89]

Serbia

Young to middle-aged

Sample size = 499

Average: age = 22.0(2.2)

%Female: 67.7%

Professionals – Students

Occupational – Workplace sitting (prolonged sitting)

Self-reported

LBP – Point prevalence

%Prevalence: 20.8%

Self-reported

Logistic regression

Adjusted for smoking, BMI, Incorrect body posture, stress, incorrect sitting position, family history of LBP

Multivariate analysis:

No association of prolonged sitting with LBP

[OR (95%CI) = 1.5(0.5 – 4.2), p = 0.424

Univariate analysis – prolonged sitting associated with LBP (p = 0.018)

0.82

Hakim et al. 2017 [90]

Egypt

All adults

Sample size = 180

Average: age = NR, BMI = NR

%Female: 0%

Bus divers

Occupational – vehicle time (> 8 h/day)

Self-reported

LBP – 12-month prevalence

%Prevalence: 73.9%

Self-reported – NMQ

Binary logistics regression

Adjusted for age, BMI, marital status, education, smoking, work duration

Positive association of vehicle time (> 8 h) with LBP

OR(95%CI) = 2.93(1.45 – 5.93)

0.68

Larsen et al. 2018 [91]

Sweden

All adults

Sample size = 4114

Average: age = NR, BMI = NR

%Female: 25.8%

Professionals – Duty police officer

Occupational – Vehicle time (% shift time sitting: 25 – 50%, 50 – 75%, > 75%)

Self-reported

Multisite MSP (pain in two or more body regions) – 3-month prevalence

%Prevalence: 41.3%

Self-reported – 5-point scale

Binominal logistic regression.; adjusted for age, sex, physical exercise, physical workload factors, and psychosocial factors

Vehicle time vehicles were not significantly associated with multi-site MSP among police

Shift time sitting: 25 – 50% OR(95%CI) = 0.97(0.74 – 1.28); 50 – 75% OR(95%CI) = 1.11(0.84 – 1.47); > 75% OR(95%CI) = 1.10(0.77 – 1.57)

0.86

Lourenço et al. 2015 [92]

Portugal

21-year cohorts

Sample size = 1733 (Non-workers = 1083; Workers = 650)

Average BMI = NR

%Female: Non-workers = 51.8%; Workers = 51.2%

Epidemiological Health Investigation of Teenagers in Porto (EPI-Teen)

Professionals – Student

Occupational – Workplace sitting (> 4.2 h/week); computer time (> 5.0 h/week)

Self-reported

Neck, shoulders, elbows, wrists/hands, upper back, lower back, hips/thighs/buttocks, knees, and ankles/feet – 12-month prevalence

Self-reported

Logistic regression

Adjusted for sex, BMI, physical activity, smoking, education, and job strain (Karasek’s Job Strain Model)

A positive association of workplace sitting with LBP [OR(95%CI) = 1.70(1.20 – 2.42)]; no association with neck pain [OR(95%CI) = 1.23(0.89 – 1.71)] and extremities pain [OR(95%CI) = 0.83(0.60 – 1.16)]

0.91

Mehrdad et al. 2012 [93]

Iran

All adults

Sample size = 405

Average: age = 44.6 (7.9), BMI: 23.7(2)

%Female: 47%

Professionals – physicians

Occupational – Prolonged workplace sitting (> 20 min)

Self-reported

Neck pain^a – 12-month prevalence

%Prevalence: 41.7%

Self-reported – NMQ

Logistic regression

Adjusted for both individual and work-related factors such as age, gender, BMI, shift work, type of employment, and secondary job

A positive association of prolonged workplace sitting with neck pain

Coefficient(B) = 0.204, OR(95%CI) = 1.227(1.032 – 1.458), p = 0.020

0.86

Omokhodion et al. 2003 [94]

Nigeria

All adults

Sample size = 840

Average: age = NR, BMI = NR

%Female: 43%

Office workers

Occupational – Workplace sitting (> 3 h)

Self-reported

LBP – 12-month prevalence

%Prevalence: 37.5%; Self-reported

Not reported

Workplace sitting for > 3 h associated with increased severity of LBP

0.36

Pradeepkumar et al. 2020 [95]

India

24 – 55 years

Sample size = 301

Average: age = 39(7.3), BMI = NR

%Female: NR

Bus drivers

Occupational – Vehicle time (Prolonged sitting)

Self-reported

MSP conditions – 7-day and 12-month prevalence

%Prevalence: 55.8%; Self-reported – NMQ

Chi-square test

Prolonged sitting in a vehicle is positively associated with the risk of MSP conditions

χ2 = 5.833, p < 0.05

0.55

Ratzon et al. 2000 [96]

Israel

All adults

Sample size = 60

Average: age = 46.0 (8.66), BMI – Sitting position = 25.14(2.18), Alternating position = 25.31(2.44)

%Female: 0%

Professionals – Dentist

Occupational – Workplace sitting (≥ 80% of work time)

Self-reported

General MSP, LBP – 7-days and 12-month prevalence

%Prevalence; Low back pain = 55%

Self-reported – NMQ

Pearson and Spearman correlations

Sitting position at work positively and significantly correlated with LBP

Correlation coefficient – MSP = − 0.16; LBP: r = 0.41, p < 0.01

0.45

Şimşek et al. 2017 [97]

Turkey

All adults

Sample size = 1682

Average: age = 37.9(7.46), BMI: NR

%Female: 60%

Professionals – Healthcare workers

Occupational – Workplace sitting (> 4 h), computer time (> 4 h)

Self-reported

LBP – 7-days, 12-month, and lifetime prevalence

%Prevalence: Lifetime prevalence 53%, 12-month prevalence 39% and 7-days prevalence 29.5%

Self-reported – NMQ (10-cm-long Visual Analogue Scale (VAS))

Binary logistic regression

Adjusted for sex, BMI, marital status, smoking habit, physical exercise, job satisfaction, workplace stress

Positive associations of workplace sitting and computer time > 4 h with LBP

Workplace sitting time: OR(95%CI) = 4.7(1.25 – 17.64), p = 0.021; Computer time: OROR(95%CI) = 0.0(0.00 – 0.04), p = 0.0001

0.86

Spyropoulos et al. 2007 [98]

Greece

All adults

Sample size = 648

Average: age = 44.5, BMI = NR

%Female: 75.8%

Office workers

Occupational – Workplace sitting (≥ 6 h)

Self-reported

LBP – Lifetime prevalence

%Prevalence: Lifetime 61.6%

Self-reported – Visual Analogue Scale (VAS) and physical examination by a physiotherapist

Multiple logistic regression

Adjusted for age gender, BMI, psychosocial factors

Positive association of workplace sitting time > 6 h with lifetime LBP

OR(95z5CI) = 1.588(1.064 – 2.368)

0.82

Szeto & Lam, 2007 [99]

Hong Kong

All adults

Sample size = 481

Average: age = NR, BMI – Male = 25.24(3.42); Female = 23.60(2.74)

%Female: 16%

Bus drivers

Occupational – Vehicle time (prolonged sitting)

Self-reported

LBP^a – 12-month prevalence

%Prevalence: 92.7%

Self-reported – NMQ

Logistic regression

Adjusted for age, gender, company

Positive association of prolonged vehicle time with LBP

OR(95% CI) = 3.71(2.40 – 5.74)

0.77

Temesgen et al. 2019 [100]

Ethiopia

All adults

Sample size = 754

Average: age = 42(9.73), BMI = NR

%Female: 57.8%

Professionals – Teachers

Occupational – Workplace sitting (prolonged sitting > 4 h/day)

Self-reported

Neck/shoulder pain – 12-month prevalence

%Prevalence: 57.3%

Self-reported – NMQ

Logistics regression

Adjusted for age, marital status, salary, smoking, alcohol, physical exercise, diabetes, hypertension, respiratory diseases

Positive association of prolonged workplace sitting > 4 h with neck/shoulder pain

OR(95%CI) = 1.50(1.02 – 2.23)

0.95

Tsigonia et al. 2009 [101]

Greece

All adults

Sample size = 102

Average: age = 38.42(10.74), BMI = 23.09(2.86)

%Female: 93%

Tradespeople – Cosmetologists

Occupational – Workplace sitting (High exposure to prolonged sitting – often or always)

Self-reported

Neck, shoulder, hand/wrist, low back, knee; 12-month prevalence; %Prevalence: Neck = 58%; shoulder = 35%; hand/wrist = 53%; low back = 53%; knee = 28%; Self-reported– NMQ

Logistics regression; adjusted for age and sex

Positive association of high exposure to prolonged workplace sitting with hand/wrist complaints,

OR(95%CI) = 55.7(18.75- 354.93)

Univariate analysis indicates workplace sitting is significantly related to the occurrence of LBP, neck/shoulder pain, hand and knee pain (both acute and chronic complaints)

0.73

van Vuuren et al. 2005 [102]

South Africa

All adults

Sample size = 366

Average: age = 31.76(7.80), BMI = NR

%Female: NR

Tradespeople – Steel plant workers

Occupational – Workplace sitting (sitting position half the time or more)

Self-reported

LBP, LBP disability – Point, 1-month, 12-month, and lifetime prevalence

%Prevalence: Point 35.8%, 1-month 41.3%, 12-month 55.7%, and lifetime 63.9%; LBP disability – ≥ 30%

Self-reported – Functional Rating Index (FRI)

Multivariate logistic regression

Adjusted for all risk factors including work organization, trunk posture, handling activities, body position, and environmental demands

Positive association of workplace sitting with LBP, but no significant association with LBP disability

LBP: [OR(95%CI) = 2.33(1.01 – 5.37)]; LBP disability: [OR(95%CI) 1.89(0.75 – 4.78)]

0.77

Yue et al. 2012 [103]

China

All adults

Sample size = 893

Average: age = 32.21(10.6), BMI = 39(2.79)

%Female: 67%

Professionals – Teachers

Occupational – Workplace sitting (≥ 4 h/day); Computer time (≥ 4 h/day)

Self-reported

LBP, neck/shoulder pain – 12-month prevalence

%Prevalence: LBP = 45.6%, NSP = 48.7%

Self-reported – NMQ

Binary logistic regression

Adjusted for age, gender, BMI, education, smoking, exercise, years of work, duration of work

Positive association of prolonged workplace sitting (≥ 4 h) with neck/shoulder pain [OR(95%CI) = 1.76(1.23 – 2.52)] and LBP[OR(95%CI) = 1.42 (1.01 – 2.02)]

No significant association of computer time (≥ 4 h) with neck/shoulder pain [OR(95%CI) = 1.02 (0.63 – 1.65)] and LBP [OR(95%CI) = 0.71 (0.44 – 1.14)]

0.86

Non-occupational Sedentary Behaviour

Ben-Ami et al. 2018 [104]

Israel

All adults

Sample size = 1026

Average: age = 27.2(6.4), BMI = NR

%Female: 57.7%

Professionals – Students

Non-occupational – Leisure-time SB (at least half an hour a day)

Self-reported

LBP – 6-month prevalence

%Prevalence: 38.6%

Self-reported

Multinominal logistic regression

Adjusted for sociodemographic, lifestyle, and personal vulnerability

No significant association of total SB with LBP (backache)

AOR(95%CI) = 0.96(0.78 – 1.18)

0.86

Hildebrandt et al. 2000 [56]

Netherlands

All adults

Sample size = 2030

Average: age = 33.7(9.6), BMI: NR

%Female: 51%

Tradespeople – Industry (shipyard, metal, transport) and services (cleaners, childcare);

Professionals – Healthcare(nurses); and

Office workers

Non-occupational – Leisure-time SB

Self-reported

LBP, neck/shoulder pain, and lower extremity pain – 12-prevalence

%Prevalence: LBP = 60%, NSP = 44%, and lower extremity pain = 31%

Self-reported

Logistic regression

Adjusted for age, gender, education, and type of workload

Leisure-time SB is positively associated with LBP [OR(95%CI) = 1.46(1.18 – 1.29)]; and no associated with neck/shoulder pain [OR(95%CI) = 1.02(0.82 – 1.27)], and lower extremities pain [OR(95%CI) = 1.07(0.85 – 1.36)]

0.73

Ibeachu et al. 2019 [105]

18 – 39 years

Sample size = 314

Average: age = 22.0(5.2), BMI = 24.3(4.1)

%Female: 43.9%

Professionals – Student

Non-occupational – Total SB (mean 5.6(2.6)hrs/day)

Self-reported – IPAQ

Knee pain – 12-month prevalence

%Prevalence: 31.8%

Self-reported – Knee Pain Screening Tool (KNEST)

Logistic regression

Adjusted for age, gender, BMI, mental distress

Total SB has a borderline non-significant association with knee pain (p = 0.069)

Quadratic term: OR(95%CI) = 1.02(1.00 – 1.05)

Linear term: OR(95%CI) = 1.04 (0.93 – 1.16)

0.82

Rodríguez-Nogueira et al. 2021 [106]

Spain

All adults

Sample size = 472

Average: age – Male = 48.1(10.9); Female = 45.3(11.2)

%Female: 60%

Professionals – University staff

Non-occupational – Daily sitting time (Mean daily sitting time (hrs): Male = 7(2.5); Female = 6.9(2.3))

Self-reported

General MSP – 12-month prevalence

Self-reported – NMQ

Logistic regression

Adjusted for age, sex, anxiety, physical activity, self-perceived stress

No significant association of daily sitting with general MSP

OR(95%CI) = 0.934(0.86 – 1.01), p = 0.09

0.86

Sklempe et al. 2019 [107]

Croatia

Young adults

Sample size = 517

Average: age – 20(2), BMI = 22.3(4.3)

%Female: 63.8%

Professionals – Student

Non-occupational – Total SB (mean 5(3.5)hrs/day)

Self-reported – IPAQ

Musculoskeletal symptoms (neck, shoulder, upper back, and lower back) – 12-month prevalence

%Prevalence: 81%

Self-reported – NMQ

Point-biserial correlation coefficient

No significant association between the time spent sitting and MSP score

0.73

Tavares et al. 2019 [108]

Brazil

Young to middle-aged adults

Sample size = 629

Average: age – median(IQR) = LBP = 22.5(21.0 – 24.0); no LBP = 23.0(21.0 – 25.0); Average BMI = NR

%Female: 72.8%

Professionals – Student

Non-occupational – Total SB

Self-reported

LBP – Lifetime prevalence; %Prevalence: 81.7%; Self-reported

Chi-squared test

No association of total SB with LBP

0.59

Occupational and Non-occupational Sedentary Behaviour

Gupta et al. 2015 [109]

Denmark

All adults

Sample size = 201

Average: age = 44.7(9.7), BMI = 26.4 (5.0)

%Female: 41.8

Tradespeople – Construction workers, cleaners, garbage collectors, manufacturing workers, assembly workers, mobile plant operators, and workers in the health service sector

Occupational – Total workplace sitting (low: ≤ 2.0 h, moderate: 2.1 – 3.7 h, high: > 3.7 h); and non-occupational – Total full day sitting (low: ≤ 6.4 h, moderate: 6.5 – 8.3 h and high: > 8.3 h); Total leisure-time sitting (Low: < 4.4 h, moderate: 4.0 – 5.4 h, high: > 5.4 h

Device-measured – ActiGraph

LBP intensity – 1-month prevalence

Low intensity: ≤ 5 pain score; high intensity: > 5 pain score

Self-reported – NMQ

Binary logistic regression

Adjusted for age, gender, BMI, and smoking, job seniority, influence at work, and occupational lifting/carrying time at work

Positive associations of the total full day sitting time and leisure-time with LBP intensity, and marginally significant association of total workplace sitting with LBP intensity

Total full day sitting: OR = 1.43(1.15 – 1.77), p = 0.01; Workplace sitting: OR = 1.34(0.99 – 1.82), p = 0.06; Leisure sitting: OR = 1.45(1.10 – 1.91), p = 0.01. High total full day sitting: OR = 3.31(1.18 – 9.28), p = 0.03; High Workplace sitting: OR = 3.26(0.89 – 11.98), p = 0.08; High Leisure sitting: OR = 5.31(1.57 – 17.90), p = 0.01

0.95

Hallman et al. 2015 [110]

Denmark

All adults

Sample size = 202

Average: age = NR, BMI = NR

%Female: 41.8%

Danish PHysical ACTivity cohort with Objective measurements (DPHACTO)

Tradespeople – Construction workers, cleaners, garbage collectors, manufacturing workers, assembly workers, mobile plant operators, and workers in the health service sector

Occupational – Mean total workplace sitting = 3.0(1.4); and

Non-occupational – mean total full day sitting = 7.3 (2.1), mean total leisure-time sitting = 4.8(1.7)

Device-measured – ActiGraph

Neck/shoulder pain-intensity – 1-month prevalence

%Prevalence: 75.2%

Self-reported – NMQ (numeric rating scale (NRS))

Logistic regression

Adjusting for age and gender, individual factors (i.e., BMI and smoking), work-related factors (i.e., seniority, influence at work, and lifting/carrying)

Positive associations of the total full day sitting and workplace sitting with neck/shoulder pain intensity. Low total workplace sitting is associated with reduced neck/shoulder pain intensity in men. No association of leisure-time sitting with neck/shoulder pain intensity

Total full day Sitting: High sitting (Overall) OR(95%CI) = 2.97(1.25 – 7.03), p = 0.01; (Male) OR(95%CI) = 6.44(1.76 – 23.56), p = 0.005; (Female) OR(95%CI) = 1.19(0.31 – 4.51), p = 0.44. Workplace sitting: High sitting (Overall) OR(95%CI) = 0.92(0.41 – 2.06), p = 0.83; (Male) OR(95%CI) = 0.94(0.31 – 2.85), p = 0.92; (Female) OR(95%CI) = 1.17(0.32 – 4.33), p = 0.82; Low sitting (Overall) OR(95%CI) = 0.54(0.23 – 1.25), p = 0.15; (Male) OR(95%CI) = 0.26(0.07 – 0.96), p = 0.04; (Female) OR(95%CI) = 1.01(0.28 – 3.59), p = 0.99. Leisure-time: High sitting (Overall) OR(95%CI) = 1.60(0.68 – 3.74) p = 0.28; (Male) OR(95%CI) = 2.76(0.83 – 9.18), p = 0.097; (Female) OR(95%CI) = 1.02(0.28 – 3.74), p = 0.97

0.91

Hallman et al. 2016 [111]

Denmark

All adults

Sample size = 659

Average: age = 45.0(9.9), BMI = 27.5(4.9)

%Female: 44.9%

DPHACTO

Tradespeople – Cleaning, manufacturing, transport

Occupational –workplace sitting pattern and absolute sitting time (brief: < 5 min, moderate: > 5 – 20 min, prolonged: > 20 min) and

Non-occupational –leisure-time sitting pattern and absolute sitting time (brief: < 5 min, moderate: > 5 – 20 min, prolonged: > 20 min)

Device-measured – ActiGraph

Neck/shoulder pain-intensity – 3-month prevalence

%Prevalence: 74%

Self-reported – NMQ [numeric rating scale (NRS)]

Binary logistic regression

Adjusted for age, gender, smoking, BMI, job seniority, lifting/carrying time at work, physical activity at work, and leisure, sitting with arms above 90°

Negative association of short workplace sitting bout with neck/shoulder pain intensity and positive association with moderated workplace sitting bout with neck/shoulder pain intensity. No association of prolonged Workplace sitting bout nor leisure-time sitting bouts with neck/shoulder pain intensity

Workplace sitting bout: Brief Coefficient (B) = -0.38, OR(95%) = 0.60(0.40 – 0.91), p = 0.04; Moderate B = 0.28, OR(95%CI) = 1.23(0.93 – 1.63), p = 0.02; Prolonged B = − 0.08, OR(95%CI) = 0.84(0.69 – 1.02), p = 0.33. Leisure sitting bout: Brief B = 0.23, OR(95%CI) = 1.25(0.71 – 2.21), p = 0.44; Moderate B = 0.27, OR(95%CI) = 0.76(0.52 – 1.10), p = 0.15; Prolonged B = 0.11, OR(95%CI) = 0.90(0.71 – 1.14), p = 0.37

0.91

Study design – prospective

Occupational Sedentary Behaviour

Hallman et al. 2016 [112]

Denmark

All adults

Duration: 12-months

Sample size = 625

Average: age = 44.8(9.8), BMI = 27.5(4.9)

%Female: 45%

DPHACTO

Tradespeople – Cleaning, manufacturing, transport

Occupational – Total workplace sitting [2.4(1.7)hrs]

Device-measured – ActiGraph

Neck/shoulder pain-intensity – 1-month prevalence (measured over 12 months)

%Prevalence/incidence: 70%; mean pain score 3.1(2.7)

Self-reported – Numerical rating scale (NRS)

Linear mixed models

Adjusted for age, gender, and BMI; occupational sector, lifting/carrying time at work, physical activity at and leisure, working with the dominant arm elevated > 60°

Negative association of increased workplace sitting with neck/shoulder pain-intensity (i.e., reduced neck/shoulder pain-intensity) after 12-month follow-up in the Tradespeople

Coefficient, B = 0.012, SE = 0.055, 95%CI = 0.000 – 0.025, p = 0.006

0.91

Korshøj et al. 2018 [39]

Denmark

All adults

Duration: 12-months

Sample size = 665

Average: age = 45.0(10.0), BMI = 27.4(4.9)

%Female: 44.2%

DPHACTO

Tradespeople – Cleaning, manufacturing, transport

Occupational – Total workplace sitting, sitting bout

Device-measured – ActiGraph

LBP-intensity – 3- and 12-month prevalence

Mean pain score 3.1(2.7)

Self-reported – Numerical rating scale (NRS), which ranges from 0 (‘no pain’) to10 (‘worst pain imaginable’)

Linear mixed models

Adjusted for herniated disc, occupational lifting and carrying, LBP the last 3 months from baseline, sitting time during leisure time

Negative association of both total workplace sitting and temporal patterns of sitting (sitting bout) with LBP intensity across 12-month

Total workplace sitting: Coefficient(B) = -0.050, SE = 0.007, p < 0.001, 95%CI = -0.065 – -0.040; Brief (bouts ≤ 5 min): B = -0.118, SE = 0.017, p < 0.001, 95%CI = -0.152 – -0.084; Moderate (bouts of > 5 − 20 min): B = -0.117, SE = 0.017, p < 0.001, 95%CI = -0.151 – -0.084; Prolonged (bouts of > 20 min): B = -0.123, SE = 0.018, p < 0.001, 95%CI = -0.158 – -0.088

0.95

Yip, 2004 [113]

Hong Kong

All adults

Duration: 12 months

Sample size = 144

Average0: age = 31.1, BMI = NR

%Female: 85.5%

Professionals – Nurses

Occupational – Workplace sitting (≥ 2 h)

Self-reported

LBP – 12-month incidence

%Prevalence: 56%

Self-reported

Chi-square test

No association of prolonged workplace sitting ≥ 2 h/day with the prevalence of LBP, p = 0.47

0.59

Non-occupational Sedentary Behaviour

Santos et al. 2020 [114]

Brazil

All adults

Duration: 24-months

Sample size = 978 at baseline

Average: age – median age(IQR) Baseline = 42(34 – 49), Follow-up = 44(36 – 51); BM – median BMI(IQR) Baseline = 25.2(22.8 – 28.2), Follow-up = 25.6(23.2 – 28.6)

%Female: 66.6% baseline

Pro-Mestre study

Professionals – Teachers

Non-occupational – TV time

Self-reported

Chronic MSP – 6-month prevalence

% Prevalence – baseline = 32.3%; follow-up = 24.7%

Self-reported

Generalized estimating equation (GEE) regression

Adjusted for age, sex, BMI, and depression

Positive association of change in TV time (30 min/day) with chronic MSP,

OR(95%CI) = 1.051(1.001 – 1.102)

0.95

Jun et al. 2020 [115]

Australia, South Korea

All adults

Duration: 12-month

Sample size = 214 (Australia – Brisbane = 156; South Korea – Daegu = 58)

Average: age = 37.3(9.9), BMI = 24.0(4.2)

%Female: 55.1%

Office workers – University faculty members, research centre, management service, industrial institution

Non-occupational – Total SB [total hours sitting in weekdays = 51.9(11.8)]

Self-reported – IPAQ

Neck pain – monthly prevalence for the 12-month

%prevalence/incidence: 18.2%

self-reported

Survival analysis

Adjusted for age, gender, and BMI

Positive association of increased total SB during weekdays with increased risk of neck pain

Adjusted HR(95%CI) = 1.04(1.03 – 1.06), p < 0.001

0.82

Occupational and Non-occupational Sedentary Behaviour

Lunde et al. 2017 [57]

Norway

All adults

Duration: 6-month

Sample size = 124

Average: age – Construction = 39.9(13.6), Health = 44.5(9.6); BMI – Construction = 25.7(3.3), Health = 25.1(3.8)

%Female – Construction = 1.6%, Health = 77.8%

Tradespeople – Construction;

Professionals – Healthcare workers

Occupational – Total workplace sitting (Construction = 156.8(114.2) Health = 171.6(93.8); and

Non-occupational – Leisure-time sitting (Construction = 282.0(78.4); Health = 274.0(94.3))

Device-measured – ActiGraph

LBP-intensity; 1-month prevalence

%Prevalence: Health – Baseline = 59%; 6-month = 55%; Construction – Baseline = 52%; 6-month = 49%; mean pain score Baseline – Construction = 0.5(0.5); Health = 0.6(0.5); 6-months – Construction = 0.7(0.9); Health = 1.0(1.0)

Self-reported

Linear mixed models

Adjusted for age, gender, smoking, body mass index, heavy lifting, forward bending at work, social climate, decision control, fair leadership, empowering leadership, sitting (minutes) during leisure time

Total full day Sitting: Association of the total full day sitting with LBP-intensity in both healthcare and construction workers at baseline and 6-months

Healthcare: Baseline – B(95%CI) = -0.16(-0.40 – 0.08), p = 0.183; 6-month – B(95%CI) = -0.17(-0.40 – 0.07), p = 0.168 Construction: Baseline B(95%CI) = -0.07(-0.31– 0.18), p = 0.596; 6-months – B(95%CI) = -0.08(-0.31– 0.17), p = 0.541

Workplace Sitting

Healthcare workers – a negative association of workplace sitting with LBP intensity at baseline and 6-months’ follow-up

Baseline: B(95%CI) = B(95%CI) = -0.31(-0.63 – 0.01), p = 0.058; 6-Month: B(95%CI) = -0.34(-0.66 – -0.02), p = 0.040

Construction workers – no associations of workplace sitting with LBP intensity

Baseline: B(95%CI) = -0.00001(-0.35 – 0.35), p = 1.00; 6-Month: B(95%CI) = -0.003(-0.36 – 0.35), p = 0.986

0.95

^aMeasured multiple MSP conditions but presented only the MSP condition that was reported in the study result NR: Not reported, NMQ: Nordic musculoskeletal questionnaire, TV: Television-viewing,