If you tend to do a lot of standing at work, you may want to be sitting down to read this.

A study published in the American Journal of Epidemiology found that workers who primarily stand on the job are twice as likely to have heart disease than workers who mainly sit.

That puts them more at risk of getting heart disease than smokers, said Peter Smith, a scientist from the Institute for Work and Health (IWH) and lead author of the study.

The study, by researchers at the Institute for Clinical Evaluative Sciences and the IWH, followed 7,300 heart disease-free Ontario workers for 12 years, from 2003 to 2015, to compare their standing/sitting work habits with whether they developed heart disease.

The workers were respondents to the 2003 Canadian Community Health Survey, which collected a range of information on them from their work conditions and job title to their health and health behaviour.

In total, 3.4 per cent of workers developed heart disease. Of that, 6.6 per cent of workers who mainly stood — in jobs that ranged from cashiers to chefs and from nurses to bank tellers — and 2.8 per cent of those who mostly sat at work developed heart disease.

The risk of heart disease remained the same even after adjusting for factors like age, education, health conditions and ethnicity.

“There are a couple of different mechanisms by which prolonged standing can increase your risk of heart disease,” Smith said.

“One of them is by blood pooling in your legs and the other is by increased venous pressure in your body by trying to pump that blood back up to your heart and that increases oxidative stress.”

The results may come as a surprise to many after earlier studies found prolonged sitting can raise the risk of dying.

Smith acknowledged being sedentary is bad for health, but said not enough attention has been given to too much standing.

Hilary Poirier, a customer service agent at WestJet in Halifax, spends most of the workday on her feet.

“We don’t really sit down very frequently at all because we’re always out on the floor,” she said. Though she said she has “the best job ever,” all the standing puts a toll on her body: feet, back, hips, legs, everything.

The results came as a surprise to her.

“For something like heart issues I wasn’t imagining that because usually you’re on your feet you’re being healthy,” she said.

Karen Messing, an ergonomics expert and professor emeritus at the Université du Québec à Montréal, called the study “an important contribution.”

The volume of participants is both one of its strengths and its weaknesses though, she said that because of the size, it’s hard to know exactly what people’s working posture is.

“Control over your working posture is a really important variable that is really hard to study, so there’s a lot of complexity in the area of working postures and health,” she said.

“For example, when you talk about standing, would you say a hockey player stands at work? And what’s the difference between a hockey player standing at work and a supermarket cashier standing at work?” she asked.

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The solution to all that standing is relatively simple: sit more.

“If you think about all the work we do across Canada to prevent people being exposed to smoke at work, I think one of the things we need to ask ourselves is how much are we doing to prevent people being exposed to prolonged standing,” Smith said.

That means increasing the perception that standing for long periods of time is actually a health hazard and giving people opportunities to sit at work, by providing chairs or stools they can use if they get tired.