Use of Wearables in the Office

British Council for Offices April 2021

USE OF WEARABLES IN THE OFFICE

A review and examples in practice

ABOUT THE AUTHORS

The BCO is the UK’s leading forum for the discussion and debate of issues affecting the office sector. Established in 1990, its membership base comprises organisations involved in creating, acquiring or occupying office space, including architects, lawyers, surveyors, financial institutions and public agencies.

PLP Labs is the research and innovation arm of PLP Architecture, an industry-leading collective of architects, designers and researchers who value the transformative role of ideas and the capacity for architecture to inspire. The practice is known for its innovative designs and ability to get projects built, and has conceived and delivered projects on six continents from its base in London. It has produced some of the world’s greenest, most intelligent and ground‑breaking designs through a profound commitment to social, economic and environmental values. The project team was led by PLP Architecture Partners Ron Bakker, Midori Ainoura and Bernard Storch, with PLP Labs team lead Alex Davidson.

Other members of the PLP team participated in the pilot study.

The BCO recognises that offices don’t just house companies, they hold people and so what goes on inside them is paramount to workplace wellbeing.

ACKNOWLEDGEMENTS The report authors and the BCO would like to thank the following for their key contributors to this project:

Derek Clements-Croome works as Emeritus Professor in architectural engineering research at the School of the Built Environment at the University of Reading. His projects focus on the impact of wearables on office workers, health and mental wellbeing in the workplace, and intelligent buildings.

Derek has co-authored numerous reports and guidance, including with the BCO. His recent book Designing Buildings for People discusses some of the aspects that are researched in this project.

• Prisca Winata, whose master’s degree thesis (UCL, London) on the use of wearables in improving spinal posture is included as Appendix 2 to this report • Dr Daniel Fujiwara of Simetrica-Jacobs, for his wellbeing valuation cost-and-benefits model and advice from an economist’s perspective • Airthings, whose helpful technical and customer service teams were critical to the planning and setting up of the indoor environmental quality (IEQ) sensors for the study

Joyce Chan-Schoof is an architect and a PhD researcher at the Design School of Loughborough University. Her research explores the wellbeing value in architecture, and her projects focus on bringing academic research into practical implementation. She is currently the Sustainability Lead of the UK Parliament; her team is responsible for the holistic sustainable development and ongoing operation of the Westminster Estate.

• the PLP Architecture employees who agreed to be participants in the study.

CITATION Derek Clements-Croome, Joyce Chan-Schoof, PLP Architecture and Prisca Winata (2021). Use of Wearables in the Office – A Review and Examples in Practice http://www.bco.org.uk/Research/Publications/Use_of_Wearables_in_the_Office_A_Review_and_Examples_in_Practice.aspx British Council for Offices (2021). Use of Wearables in the Office – A Review and Examples in Practice http://www.bco.org.uk/Research/Publications/Use_of_Wearables_in_the_Office_A_Review_and_Examples_in_Practice.aspx

COPYRIGHT © BRITISH COUNCIL FOR OFFICES, 2021 All rights reserved by British Council for Offices. No part of this publication may be reproduced, stored or transmitted in any form or by any means without prior written permission from the British Council for Offices. The BCO warrants that reasonable skill and care has been used in preparing this report. Notwithstanding this warranty the BCO shall not be under liability for any loss of profit, business, revenues or any special indirect or consequential damage of any nature whatsoever or loss of anticipated saving or for any increased costs sustained by the client or his or her servants or agents arising in any way whether directly or indirectly as a result of reliance on this publication or of any error or defect in this publication. The BCO makes no warranty, either express or implied, as to the accuracy of any data used by the BCO in preparing this report nor as to any projections contained in this report which are necessarily of any subjective nature and subject to uncertainty and which constitute only the BCO’s opinion as to likely future trends or events based on information known to the BCO at the date of this publication. The BCO shall not in any circumstances be under any liability whatsoever to any other person for any loss or damage arising in any way as a result of reliance on this publication.

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COVER IMAGE Courtesy of Jeremy Felson

ABOUT THE BCO

CONTENTS

USE OF WEARABLES IN THE OFFICE A Review and Examples in Practice

EXECUTIVE SUMMARY

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REVIEW OF WEARABLES

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PILOT STUDY

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FUTURE HORIZONS

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APPENDIX 1 – ERICSSON CONSUMERLAB STUDY: KEY FINDINGS ABOUT WEARABLES

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APPENDIX 2 – STUDY BY PRISCA WINATA, UCL: WEARABLES IN IMPROVING SPINAL POSTURE

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REFERENCES

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EXECUTIVE SUMMARY This report updates our knowledge about wearable technologies, and describes pilot experiments demonstrating their use in offices and, due to COVID-19, homeworking situations. Wearables play an important role in the health and wellbeing agenda, which has become even more important in these pandemic times as offices need to be designed and managed for low infection risk in addition to all the other environmental attributes described in the 2019 BCO Guide to Specification.1 Whether we are discussing climate change, virus risk or health and wellbeing in general, human behaviour features along with design and management measures. Wearables help to guide us to preferred behaviour options, whether this applies to sitting, standing and moving around, or to making us aware of the health of our bodies. There is a continuous link between bodies and minds; they affect each other.

Cundall Office, London

The wearables market is expanding rapidly, as is the range of health conditions they can inform us about. Heartbeat patterns, sleep quality, stress via skin conductance and brain waves are all measurable, so practical data about diabetes, for example, can be captured. In the future we will be able to do much more, and this will eventually mean virus health checks too.

Courtesy of Cundall

circumstances. The social dynamics within offices cannot be underestimated, but this needs to be offset against the need for contemplation spaces too, whether at home or in the office.

After a review of the wearables that are currently available and how developments in these and others might progress in the future, an account is given of the pilot study, which shows how the use of wearables can give a much deeper and more enriched approach to post-occupancy evaluation (POE) in the future.

• Wearables can detect problems. For example, a lack of ergonomic design of furniture can lead to musculoskeletal problems, which are the cause of a lot of medical absenteeism in the UK.

The main conclusions of this pilot work suggest the following.

• The Flourish framework (as described in the 2019 BCO Guide to Specification) can be used to obtain an individual’s health and wellbeing profile using data obtained from wearables and questionnaires.

• A new approach to POE has been established.

• Space settings are important in terms of open or closed places; environmental features such as green landscaping can bring enormous benefits.

This project was hampered by restrictions due to COVID-19.

However, even in the short time period available, we were able to conclude that a methodology using a multi-sensory approach to design and management is preferable. This is because it informs us, as we perceive the interconnected world around us, about the strong and weak impacts the environment can have on health and wellbeing. From this, we can make economic evaluations. Individuals, companies and the nation profit from having a healthy population.

• Homeworking and office-based working can offer similar wellbeing and social value benefits. However, each has its upsides and downsides, so a hybrid solution is likely, as conditions vary so much between people’s locations and

We believe the work done in this project can be refined by carrying out case studies over a whole year, so that all the seasons are taken into account when making assessments using the methodology proposed here. ■

• Design should include design for social value,2, 3 which enables the economic outcome to be assessed. Health and wellbeing is an investment, not merely a cost.

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REVIEW OF WEARABLES Sensors and Internet of Things (IoT) devices are providing data on environmental conditions and anonymised people locations in real time.

This data gives us unprecedented insights into our behaviour within a workplace, for example how often people leave their desks for a break, where they bump into each other and start a conversation, and how long a ‘one-hour meeting’ actually is. Deep analytics then help us build a complete picture of how effective a workplace is in terms of its space utilisation, environmental and energy efficiency, and, most importantly, connectivity, productivity and wellbeing of its people.

Shrikant Sharma, Buro Happold, April 2020

INTRODUCTION

9 Charlotte Street, Manchester

There have been rapid developments in wearables since the review carried out by the BCO in 2016, as both companies and private individuals are investing heavily in them. In addition, there is an acute awareness of health and wellbeing, which will have been magnified further by the COVID-19 pandemic. In particular, the medical profession is actively promoting work in this field because the raising of people’s awareness of their health, both physical and mental, through the use of visually displayed measurements, deepens their knowledge about themselves. There are economic benefits for both commercial companies and the NHS. Insurers are studying ways of encouraging people to self-monitor in order to nudge them into healthy habits and lifestyles.4

Courtesy of Hilson Moran

CONNECTED HEALTH Jungmann et al.5 describe how wearables and sensors are being used in medicine for remote monitoring, gathering behavioural, physiological health and environmental (e.g. air pollution) data. They comment that data storage and the interpretation of data are issues that need attention, in addition to the trust in the safety and privacy regarding the data that is necessary between the stakeholders.

In the Victoria and Albert Museum in London there is a ring made by an unknown maker in AD 300–400. So, wearables have been around for a long time. Then, rings were signs of allegiance and power, as recognised by Wagner in his opera cycle The Ring. Today, wearables are part of an interconnected world, and rings and other adornments have extended their power into the internet world. Sensors are worn not only as attachments, but can be embedded in jewellery, clothing and the human body itself.

In an earlier paper, Iqbal et al.6 gave an overview of 13 body sensors available at that time, which were fitted to various parts of the body, such as the wrist, ankle, finger, thumb, chest, abdomen, shoulder and head, and even included sensors embedded in shoes and walking sticks. Most of the sensors had limited performance, but since the time of that study wearables and sensors have become much more reliable, and associated data analytic tools have advanced the practical use of the data.

Most of the companies that produced these sensors were based in the USA, with others in Northern Ireland, the EU and Japan.

Sensors can also be embedded in objects such as furniture, or even the structures around us. These sensors can interact with wearables too, like the intelligent sit–stand desk, for example.

The wearable detects, say, back strain while sitting, and signals the desk to rise and nudges the person to stand. Other sensors may just monitor environmental conditions in structures.

These open a gateway to riches of data that can enable us to track the performance of buildings and help the occupant in terms of health and wellbeing in various settings.

The Institute and Faculty of Actuaries (IFoA)7 has published a list of examples of wrist-worn wearables, as well as medical devices for particular illnesses and the elderly and infirm.

Paolo Bonato8 at the Harvard Medical School concluded: Wearable technology allows clinicians to gather data where it matters the most in the home and community settings. Direct observations concerning the impact of clinical interventions on mobility, level of independence, and quality of life can be performed by means of wearable systems.

Robots, at human or even nano scale, are governed by arrays of sensors. Robots can search hidden or inaccessible places, for example. This can aid maintenance of air or water systems in building services.

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Loncar-Turukalo et al.9 concluded that researchers have focused on three main areas of work to develop tools of clinical interest: • the design and implementation of sensors that are minimally obtrusive and reliably record movement or physiological signals • the development of systems that unobtrusively gather data from multiple wearable sensors and deliver this information to clinicians in the way that is most appropriate for each application • the design and implementation of algorithms to extract clinically relevant information from data recorded using wearable technology.

They further concluded that:

Copyright Andrey_Popov | Shutterstock

Wearable medical solutions, integrated into the wider concept of IoT, provide for pervasive data acquisition from a body and beyond, and rely on powerful data analytics, smart networking, and machine-to-machine communications to facilitate patient-centric, personalized, and holistic care.

The widespread adoption of wearables is still hindered by numerous concerns related to reliability, security, and cost-effectiveness.

This study confirms that applications of the wearable technology in the connected health domain are becoming mature and established as a scientific domain. However, further research and development are required to improve their reliability, comfortability, and dependability levels.

The research focus shifts from sensors and data analytics toward the sustainable delivery of valuable recommendations, reliable, energy‑efficient, and low-latency communications and computation offloading. Sensor data integration goes beyond body-level integration to include context sensing, location and environment metrics, medical history, pattern of activities, and user preferences.

The main findings from a survey of 2406 articles written between 2010 and 2019 described the key drivers in the field, some research gaps and relevant topics that would benefit from more systematic qualitative knowledge synthesis: • User concerns were the least addressed topic, whereas the enabling technology research was the main focus in the literature;

There is a further need to explore and provide the literature evidence supporting the positive experiences, improved patient outcomes, and cost-effectiveness of connected health solutions.

Practical adoption in the field still demands design and validation of new care pathways, optimization of interventional strategies, and a sound business model.

• Major breakthroughs were made in sensor technology, data analytics, communications, and computing architectures (edge and cloud); • Research on battery technology and efficient solutions for energy harvesting has lagged, implying energy efficiency as one of the major constraints in designing wearable solutions for pervasive monitoring;

Data from internet-of-things (IoT) wearable devices can help to identify optimal physical environment conditions (temperature, lighting, indoor air and many of the factors in WELL v2) which affect users’ concentration and performance.

Which combination of temperature and lighting leads to high concentration levels? This is the kind of question Nappi and De Campos10 believe could be answered by adopting wearables.

• Research on communication technologies focuses on 5G featuring low-latency, massive connectivity, and high capacity to mitigate the current challenges with respect to real-time feedback, energy, and computing constraints; • The research related to the user-associated information delivery was mainly focused on monitoring and measurement information and much less on the provision of feedback recommendation and prescriptive insight; and

Wearables can monitor office workers’ stressresponse (increase in the heart rate, quickening of breathing, tightening of muscles, changes in skin conductance and rises in blood pressure) and measured signals can alert occupants to take a small break, or start another task or move around. But it is essential to have analytical platforms to interpret the immense quantity of data that can be collected.

• The most addressed concerns from the user perspective were technology acceptance and issues related to safety and security, implying privacy and reliability as the most central topics.

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EXAMPLES OF CURRENT DEVELOPMENTS

Here is one example of how a physiological measure like heart rate variability can be used as a biomarker for thermal comfort.

Nkurikiyeyezu et al.11, 12 believe that:

Wireless patch for monitoring baby’s heartbeat during labour

It could be possible to design computerized systems that regulate thermal comfort based on the physiological sensation of office occupants.

Previous studies have indicated that most people complain about being too hot or too cold; thermal neutrality in buildings does not necessarily reflect thermal comfort — most people prefer non-neutral conditions [references are given], so the authors believe that it could be possible to allow indoor office temperatures to drift away from the neutral thermal conditions and readjust the indoor temperature only when the office occupants are feeling either too cool or too warm.

This approach could reduce energy consumed for thermal comfort provision, and could be achieved without significantly sacrificing people’s thermal comfort. Moreover, due to the availability of unobtrusive ECG sensors and a proliferation of inexpensive wearable devices with built-in HRV monitoring capability (e.g. smart watches and fitness trackers), this ambition could be achieved in a non-invasive manner and at low cost.

One of many examples of wearables being used in telemedicine is a wireless patch system for women in labour, which continuously monitors the baby’s heartbeat.14 The patch, which is simply attached to the woman’s abdomen by an adhesive, has electrode areas that pick up electrocardiogram (ECG) and electromyogram (EMG) signals from the skin. These signals pass to a pod, which analyses the signals to give useful information about the wellbeing of the mother and baby.

Sprayable user interfaces The Computer Science and Artificial Intelligence Laboratory (CSAIL) at MIT in the USA and the University of Bristol and the University of Bath in the UK have developed ‘sprayable user interfaces’.15 The technology combines a top design layer and an underlying conductive copper ink layer that is able to recognise touch, along with a microcontroller that connects to the ink and responds to it. The interfaces work on rough surfaces and curved surfaces, and even in wet outdoor settings.

The copper ink systems can respond to a sliding finger or hand (e.g. to adjust the brightness of a light) or even to proximity (e.g. waving a hand in front of a door to open it). An output in the form of an electroluminescent display can be added too.

Spraying can create output that covers entire walls or even building façades. It could one day be used as part of smart buildings or smart architecture – stencilled, airbrushed designs that are able to respond to your touch.

Adapted from Nkurikiyeyezu et al.11, 12

Nkurikiyeyezu et al. are developing computerised systems to achieve this at their laboratory in Japan.

Wearables do not just measure physical effects. Body and mind are interconnected, so affective states expressed (e.g. happiness or anger) affect heart rate and skin conductivity. Picard and Healey13 at the MIT Media Laboratory describe how wearables can be used to indicate affective states such as mood and other mental states. Picard and her team at MIT subsequently developed the currently available Empatica wristband.

Electronic skin Workers at Tokyo University are developing an electronic skin, which they define as: A flexible, lightweight, stretchable sensor array that can essentially computerize a surface, including that of robots and human beings … it will be sensitive to heat and pressure and also be so light that a user or wearer is unaware of its presence. It will stretch and conform to a variety of surfaces, including over large areas. Such a bionic skin applied directly to the human body could be used to monitor medical conditions or to provide more sensitive and life-like prosthetics with sensing ‘skins’.

Nappi and De Campos10 undertook a literature review and identified aspects that must be considered by companies desiring to deploy IoT technology in office settings: employees’ attitudes toward IoT technology, employees’ awareness of the benefits and the risks associated with the use of this technology in office settings, and employees’ control of the data they generate.

Finally, employees’ privacy concerns, data ownership and risks associated with IoT devices in the workplace environment must be considered by companies, as it is essential that trust is established between the company and its employees.

USE OF WEARABLES IN THE OFFICE A Review and Examples in Practice

Sekitani et al.16

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THE FUTURE You can now shop using a wrist band that lets you match your food choices to your DNA profile. Eventually, we can expect wearable sensor patches that display your immunological health and detect viral and bacterial infections.

Here are some of the current developments in wearables: • Galaxy Watch Active2 (Samsung, September 2019) – accelerometer, gyro, barometer, heart rate and ambient light; a falls sensor and ECG to be added during 2020 • Verily Study Watch (Verily, USA) – ECG, heart rate, electrodermal activity, inertial movements • HeartGuide (Omron, Japan) – blood pressure

Neo Building Manchester Courtesy of Bruntwood

• K’Watch Glucose (PK Vitality, France) – glucose level • HRM1 (Xonix, China) – ECG and body mass • Gen 5 (Fossil, USA) – ECG

Wearable scent technology

• KardiaMobile (AliveCor, USA) – ECG

Jenny Tillotson at the University of Cambridge is developing the concept of eScent,17 which she describes as an emotionally responsive wearable technology that picks up on your emotions and vital signs and sends a personalised ‘scent bubble’ to your nose. It combines sensing and dispensing of aromatics for immersive experiences and multiple health benefits. It presents an empowering, sensory intervention and resilience builder that emits mood-enhancing aromas in a controllable way, depending on biofeedback. The use of essential oils together with biometric sensors and intelligent tracking devices (e.g. a smart watch) could lead to a new palette of scents that are bio-synchronised to an individual’s emotional, mental and/or physical state, and in a real-time manner alleviate high levels of stress, thus preventing the risk of a serious mental ill-health relapse.

• Moodbeam (Moodbeam, UK) – mood tracking • BioBeats (BioBeats Group, UK) – wellbeing • Versa (Fitbit) – menstrual cycles • Ionic (Fitbit) – blood oxygen levels • fēnix 5 (Garmin) – oximeter.

The IFoA7 lists other wrist-worn wearables: • HELO (HELO) • UP3 (Jawbone) • Ray (Misfit) • Moov Now (Moov)

Headsets for monitoring brain rhythms

• Sence (Planexta)

There is an increasing number of research studies using headsets to monitor brain rhythms. One example is the work being done at Southampton University using electroencephalography (EEG), which detects electrical activity in the brain, to measure the effects of CO2 on drowsiness.18

• Touch (TomTom) • Steel HR (Withings) • Mi Band Pulse (Xiaomi).

At the Wearable Technology Show in London in March 2020 the following wearables relevant to the human reaction to the built environment were shown:

Sweat sensors An emerging technology is sensors that detect compounds in sweat, which can give indications about health, such as blood glucose and alcohol levels. Likewise, tears contain such compounds.

• body media SenseWear systems by APC Cardiovascular • mobile human monitoring by Eqivital • Keri smart fitness tracker by August International

Virus sensors

• smart meditation ring by Dhyana

At present, wearable sensors cannot detect the presence of a virus like COVID-19 but, as discussed later, there is research which suggests this will soon be possible.19 Other research is being undertaken to see if sudden changes in data patterns may indicate emerging poor health that might be due to a virus.

This could then be used as an alert system to signal that further steps need then to be taken to check for any impending medical condition.20, 21

• posture wear by Posture360

USE OF WEARABLES IN THE OFFICE A Review and Examples in Practice

• flash glucose monitoring by Abbott and the FreeStyle Libre Academy • smart rings.

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Papagiannidis and Marikyan22 believe there is a need to focus on the role of technology in managing the effects of the workplace, as well as the effects of the work itself, on people’s physiology and psychology. How can technology be effective for remote working? How do organisations need to change? What are the benefits of personalisation brought about by wearables?

A team of researchers in Switzerland, led by Jing Wang,19 has been researching sensors that can detect bacteria and viruses in the air for several years, and has succeeded in developing a new optical biosensor for detecting the new coronavirus. The sensor combines thermal and optical data to detect the SARS-CoV-2 virus safely and reliably. In the future, this sensor could be used to measure the concentration of the virus in the environment (e.g. in places where there are many people or in ventilation systems).

Multi-function e-glasses are being developed by a team led

by Associate Professor Suk-Won Hwang23 at the KU-KIST Graduate School of Converging Science and Technology at Korea University. The e-glasses have sensors that measure electrical signals from the brain (electroencephalogram; EEG) or eyes (electrooculogram; EOG), so registering brain activity and eye movements; an accelerometer to sense body posture and gait; and a UV sensor for colour tuning according to the sun’s intensity. In laboratory tests, the EEG was successfully used to record volunteers’ alpha rhythms, which could in turn be used to monitor their health. The EOG data, on the other hand, allowed participants to play a brick-stacking video game simply by moving their eyes. Such a feature might conceivably find use in hands-free control of computers, or in assistive technologies designed for the physically challenged.

The coronavirus is an RNA virus, i.e. its genome does not consist of a DNA double strand, as in other organisms, but of a single RNA strand. The sensor has tiny gold structures, called nano-islands, on a glass substrate, and artificially produced DNA receptors that match specific RNA sequences of SARS‑CoV-2 are grafted onto the nano-islands. An optical sensor located on the back of the sensor is used to determine whether the sample contains the RNA strands in question.

Tests have shown that the sensor can clearly distinguish between the very similar RNA sequences of the SARS-CoV (2003) and SARS-CoV-2 (2019) viruses, and the results are ready in a matter of minutes. There is still development work to be done, but once the sensor is ready the principle could be applied to other viruses and help to detect and stop epidemics at an early stage.*

The Belgian company Rombit has developed the Romware Covid Radius,24 a digital bracelet that ensures social distancing is maintained at or beyond 1.5 m (the required distance varies between 1 and 2 m in different countries) by emitting a vibration when the wearer comes too close to another person.

It also permits contact tracing. If someone happens to be infected, a health advisor or trusted confidant can check which work colleagues the person has come in contact with, in order to prevent further infection. Privacy is guaranteed because the wearer’s location or other sensitive information is never passed to the employer. The bracelet was being trialled at the Port of Antwerp in 2020.

COVID-19 has shown us how fragile human biology is. We need to be aware of how our behaviour affects our health, as well as our use of resources such as energy and water. Measuring and monitoring is of paramount importance, so we need to have the data to deepen our understanding. This knowledge can lead us to ‘prevention better than cure’ solutions, which also have economic benefits for companies and the NHS. Wearables are a vital part of helping us to fulfil these needs. ■

* Material provided by Swiss Federal Laboratories for Materials Science and Technology (Empa). Original written by Karin Weinmann, but edited here.

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PILOT STUDY INTRODUCTION As wearable technologies become more widely commercially available and more scientifically rigorous, new doors open for their use in day-to-day life. To support the investigations into the potential future uses of wearables in the workplace, the authors conducted a pilot study to establish a methodology for undertaking an occupant health and wellbeing assessment in a real-world scenario.

The pilot study is meant as a first exploration into how these technologies, and other supporting data-gathering methods, can be used in the office. The pilot study aimed to establish: • What types and combinations of equipment would be most effective and practical for a real-world occupant health and wellbeing assessment?

Fitbit Inspire 2 Source: https://www.fitbit.com/global/uk/products/trackers/inspire2

• What supplementary data-gathering methods would be required to collect data that the wearables are not able to, such as subjective experiences?

• What types of data would need to be collected, and what would be the best way to collect these specific metrics?

• How should the data collected be analysed to draw out meaningful results on the health and wellbeing of occupants in a specific office, and how could these results be fitted into existing frameworks on health and wellbeing?

A full in-depth study would be necessary to fully investigate these aspects of an occupant health and wellbeing assessment.

However, working around constraints made necessary by the global coronavirus health crisis, the research team was only able to conduct a condensed pilot study.

METHODOLOGY The pilot study involved six participants, volunteers from PLP Architecture’s staff, conducting their usual day-to-day computer-based work in one of four specially designed environmental scenarios. Regular recordings were made of participants’ vital signs, the environmental quality and participants’ subjective feelings.

UPRIGHT GO 2 Source: https://www.uprightpose.com/en-gb

The test subjects were each equipped with a Fitbit Inspire 2 fitness wristband and an UPRIGHT GO 2 posture tracker.

Participants’ environments were continuously monitored using an Airthings Wave Plus indoor environmental quality (IEQ) sensor.

For four days in the week (Monday to Thursday) participants were required to work in a single designated workplace environment (called a ‘scenario’ in this study). Each scenario was different, with certain environmental variables removed or added to elicit different changes in the test subjects that could be measured by the wearable devices. The scenarios aimed to mimic real-world workplace environments: a cubicle-like environment, a standard open-plan office space, a biophilic workspace and a working-from-home scenario.

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Airthings Wave Plus Courtesy of Airthings

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The three core scenarios, which had easily comparable variables, were situated in PLP Architecture’s offices. The working-from-home scenario was added as a result of the drastic changes required in working conditions after the start of the project as a result of the COVID-19 pandemic. Although, traditionally, a study like this would have focused only on the different types of environment in the office, moving forward we will see far more of the workforce spending at least part of their working week at home. In this scenario it is difficult to control the worker’s environment, as everyone’s home is different. With this in mind, the daily questionnaire included an extra survey for those working from home, so participants in this scenario could log information about their environment and thus allow differences to be taken into account during the analysis.

The Flourish framework The Flourish framework reflects, to some extent, Maslow’s hierarchy of human needs.27 It comprises a combination of three layers: • comfort, as a background • personal control • transient experiences, which form a sparkle layer.

This multi-sensory approach has been used in the 2019 BCO Guide to Specification1 and the 2018 BCO report Wellness Matters.28 It has also been referred to in reports by the World Green Building Council,29 the UK Green Building Council,30 and CIBSE.31 ■

Throughout the day, the Fitbit Inspire 2 and UPRIGHT GO 2 monitored the participants’ vital signs, and the data was collected online through the corresponding app or an online dashboard. The majority of the data collected was accessed by researchers through the online Fitbit dashboard. However, for data from the UPRIGHT GO 2, data from the Fitbit that was not available on the dashboard, or data that was easier to capture through the UPRIGHT GO 2 app, participants were required to log the data or take screenshots of the app screens at certain times each day, and save them in a designated location on a shared drive. Participants were also required to fill in a daily diary, which included a questionnaire that captured qualitative aspects of their experience.

scenarios each week to enable the research team to compare data across different types of environment. Unfortunately, national lockdowns implemented due to the pandemic meant that this part of the study could not be done.

After the study, the research team analysed the data and attributed different aspects to the Flourish framework (Figure 1),25, 26 with the aim of establishing the individual’s overall health and wellbeing profile while working in the environment scenarios.

The study ran for only one week. Had it been possible to continue the study for longer, participants would have changed

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I M PA C T Figure 1 The Flourish model:26 concept stage Courtesy of Derek Clements-Croome; illustrated by Marylis Ramos and used by Joyce Chan with PLP Architecture

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USE OF THE MIXED METHOD FLOURISH FRAMEWORK study we explored how the parameters can be applied in a POE process. Table 1 details the ‘why’ and the ‘how’ of the Flourish framework as applied to both the workplace and the home‑working scenarios.

We employed a multi-sensory approach and further developed the Flourish parameters. Buildings are all unique and respond to specific constraints and opportunities, and therefore any POE framework needs to be adaptable. In this pilot

Table 1 How the quadrants in the Flourish model were adapted for the pilot study at PLP Architecture What is the purpose?

How to measure?

Design – subjective parameters Design and aesthetics Layout and functionality Indoor green Views out

Spatial strategies, such as open plan and active furnishings, can influence personal control, physical inactivity and sedentary behaviour (WELL standard).

Description

Access to nature and views out help to relieve stress and encourage overall mental wellbeing (WELL – Mind).

Line of sight (photograph)

Design – objective parameters Indoor environmental quality (IEQ) Temperature Humidity Air quality

IEQ sensors These parameters ensure that the IEQ is maintained within an acceptable level – comfort as a background.26 IEQ can affect mood, performance and productivity. Some people are more affected by glare and disorderly visual of space, while others experience distraction in a noisy, buzzy environment.32

°C Relative humidity (%) CO2 (ppm)

Light level

lux

Sound

dB

Impact – perceptual and psychological Self-report Mood and alertness

Questionnaire These attributes evaluate the emotional states of individuals using valence (moods and emotions) and arousal (alertness and boredom) as the indicators.

They refer to James Russell’s two-dimensional affective model;33 it can be applied in EEG wearable studies.46

Positive = 5, Negative = 1

These four attributes evaluate the perceived quality of a workspace. They are known to have an impact on productivity in various degrees.25, 35, 36

Good = 3, Adequate = 2, Poor = 1

Perceived activeness and posture

Workspace design influences how active a person behaves physically (WELL – Movement).

Active = 5, Non-active = 0

Perceived sleep score

Experience during the day may impact on sleep quality (WELL – Sleep support).

Positive = 5, Negative = 0

Aesthetics and biophilia Access to light

(Recorded in morning and afternoon

(Recorded daily)

Perceived air and thermal quality Social setting

Objective measurements Upright vs slouch Sleep score Resting heart rate (range 60–100 bpm)

Wearable These objective attributes measure the physiological changes throughout the testing period, providing continuous and unobtrusive data to understand how the participants feel and behave – during and outside working hours.

Breathing rate (12–20 breaths/minute)

% of upright Bad = 0, Good = 10 Beats per minute (bpm) Breaths per minute

Impact – economic Design value

This quadrant requires data from the human resources department on absenteeism for medical reasons, staff turnover and other factors, such as organisation culture and management.

This pilot study focuses on the social capital element – value generation – rather than merely economic gain, and applies the wellbeing and wearable outcomes to a design value.37 Improving the IEQ of workspace can generate value to the organisation, such as decreasing medical absenteeism and presenteeism whilst increasing staff retention rates, besides other health and insurance benefits

Questionnaire and IEQ sensors

Wellbeing value

Wellbeing valuation quantifies the wellbeing outcomes experienced by individuals.38, 39

The Warwick–Edinburgh Mental Well-being Scale41 and wearable

Social value

Social value of the built environment captures wider aspects of social public good in design.40

Questionnaire and organisation/ procurement record

Economic value

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Good = 3, Adequate = 2, Poor = 1

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Conceptual diagrams showing how the Flourish model can be applied in practice are shown in Figure 2.

Concept Concept

Concept

DESIGN

The framework looks at how design (the top two quadrants of the wheel) may impact people (the bottom two quadrants of the wheel) in terms of feelings and economic values. It is a simple but powerful tool for designers to capture the outcomes of workplace design holistically.

IMPACT

Measurement The design can be evaluated both objectively and subjectively.

Data is collected using a combination of methods, such as questionnaires, interviews, sketches and wearable sensors, to access physiological and psychological factors. The data covers a variety of biomarkers, such as heartbeat patterns, activity levels, sleep scores and posture. Moods and emotions can be measured by means of brain waves or facial expressions, but in this pilot study we used a wellbeing questionnaire. A consistent and robust economic model based on a wellbeing evaluation developed by the HACT38, 41 was applied to capture the true value of good workplace design.

Measurement Measurement Photos Drawings Observation

IEQ or BMS sensor

SUBJECTIVE

OBJECTIVE

MIXED

MIXED

Questionnaire Interview

Scales

KPIs Cost–benefit analysis

Wearable

This pilot study explored how we can provide a consistent way to present the data captured by the various instruments and self-reported diaries. A three-point scale (good, adequate, poor) is used for the design elements, whereas a five-point scale (strongly agree, agree, neutral, disagree, strongly disagree) is used to capture feelings and opinions. A traffic light system is applied to indicate positive (green) and negative (red) outcomes.

Scale Scale 3 2 1

1 2 3 4 5

Figure 2 Conceptual diagrams showing how the Flourish model can be applied in practice

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PROVING THE DESIGN VALUE The economic quadrant requires data to be obtained from the human resources department, but it is sometimes not possible to obtain information on factors such as medical absence, presenteeism and staff retention rates. This pilot study proposes the introduction of a social value methodology that is specifically designed to evaluate wellbeing38, 42 using the Warwick–Edinburgh Mental Well-being Scale (WEMWBS).43 It provides a cost–benefit analysis for wellbeing, and is referred to in the UK Government’s Green Book44 and RIBA’s Social Value Toolkit for Architecture.40 For example, introducing a green space near a residential area often generates wellbeing and social value by creating healthier and happier communities. It may also cascade to wider economic benefits, such as reducing NHS costs and increasing house value (Figure 3).

=

Wellbeing/ social value

×

Number of people

Value associated with improvement

Figure 3 The monetisation of social value

An example of the social value bank methodology for evaluating wellbeing

Social value is a way of describing the benefits arising out of sustainable design and development. The BCO has reported on the topic around the procurement and planning processes,2, 3 and the latest BCO briefing notes highlight that social value can support ‘building a better, fairer, and greener’ post-COVID future.3 Social value also has the potential to emphasise the positive value of good workplace design on wellbeing. This value can be recognised by investors and workplace portfolio managers in the commercial evaluation stage. In this pilot study, predefined factors were assigned to questionnaire findings in order to generate a monetised measure of social value.

None of the time

Rarely

Some of the time

Often

All of the time

I’ve been feeling optimistic

1

2

3

4

5

I’ve been feeling useful

1

2

3

4

5

I’ve been feeling relaxed

1

2

3

4

5

I’ve been dealing with problems well

1

2

3

4

5

I’ve been thinking clearly

1

2

3

4

5

I’ve been feeling close to other people

1

2

3

4

5

I’ve been able to make up my own mind about things

1

2

3

4

5

Statement

The social value calculation It is recommended by the HACT that organisations delivering community-based programmes conduct a proper evaluation, with a control group, to calculate the causal impact of the programme using the short form of the Warwick–Edinburgh Mental Well-being Scale (SWEMWBS).42 If this is not possible, the second-best approach is to ask project participants to respond to the SWEMWBS statements before and after an intervention, and record the total score (range 7–35) for each person at both points.

Category

Overall SWEMWBS score

Full model value

1

7–14

£0

2

15–16

£9,639

3

17–18

£12,255

4

19–20

£17,561

5

21–22

£21,049

6

23–24

£22,944

7

25–26

£24,225

3. Subtract the total costs to deliver the intervention from the total social impact to reveal the net social impact.

8

27–28

£24,877

9

29–30

£25,480

An example of the calculation method is given in the box opposite.

10

31–32

£25,856

11

33–34

£26,175

12

35

£26,793

1. Subtract the before value from the after value, and subtract 27% as deadweight. (Deadweight is a measure of the proportion of the outcome that would have happened even if the activity had not taken place. It is calculated as a percentage.)

2. Sum the resulting values for all the participants to calculate the total social impact.

Methodology and methods

Source: Fujiwara et al. (2017)38

• Wearables allow designers to apply an outcome-driven approach to human-centric workplace design.

• Subjective opinion can be verified by objective data from wearables to enable meaningful evaluation of ‘before’ and ‘after’ values.

• Wearables can provide empirical evidence to prove the value of good design. Social, economic and environmental value can be used for reporting and benchmarking. ■

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PEOPLE AND PLACE

MEASURING TOOLS After investigating the new wearables and environmental sensors available on the market, the research team settled on using a fitness band, a posture sensor and IEQ sensors in order to collect the required range of data. These tools were supplemented by a questionnaire to record the qualitative aspects of the participants’ experiences, light and sound meter apps, and a sketching exercise.

PEOPLE The participants of the pilot study were all members of PLP Architecture’s staff, and all volunteered to take part in the study. It was important that there was some level of diversity among the participants in terms of gender and age, in order to reflect the demographics of today’s offices. The male/female ratio on the study participants was 50:50, and their ages ranged from 26 to 50 years.

FITNESS BANDS

It was also important, for the accurate recording and comparison of data sets, that the participants all undertook a similar type of work. All of the study participants spent the majority of their working day at a computer, rather than attending meetings or engaging in manual work.

• The everyday nature of fitness bands allows for the easy collection of a wide range of data.

• They are easy to use and unobtrusive to wear. Wearing them is not an alien concept, as many people have them already.

• They make it easy to collect a wide range of data for a relatively cheap price.

PLACE

• Many have readily available dashboards with easy to read metrics and user interfaces.

The locations for the pilot study were PLP Architecture’s offices in central London and the homes of some participants.

PLP Architecture’s offices have a range of spaces, making this location suitable for conducting studies in a variety of environments. The inclusion of home-working locations of participants added another dimension to the investigation, which explores the use of wearable technologies in a world where, due to the coronavirus pandemic, people are working from home more often.

• They enable the measurement of the following, which were important in this study: – heart rate – breathing rate – sleep quality – activity.

PLP Architecture’s offices are set in an historic building that has been refurbished to a high standard into a modern open‑plan workspace. The offices are located on the sixth floor, and have far-reaching views across London, including to key landmarks such as the Tower of London, Tower Bridge, the City of London cluster and more. The workspace comprises one main open‑plan area, with a perpendicular wing on each side containing ancillary working space and meeting rooms. The offices are mechanically ventilated and artificially lit. However, all the external walls have approximately 40% glazing and, when the weather permits, the office receives plenty of natural light.

POSTURE MONITORS • Musculoskeletal issues account for a large proportion of workplace absenteeism and long-term injury. Many offices often do not employ adequate ergonomic design to mitigate the risks of sitting at a desk all day.

• While posture monitors do not usually come in a form that can be worn in a familiar way, they are largely unobtrusive and comfortable to wear.

All the study participants lived in London. This includes both those who were required to travel into work, as well as those who were in the working-from-home scenario.

USE OF WEARABLES IN THE OFFICE A Review and Examples in Practice

• While posture monitors are a relatively new technology, they are fairly low cost and easy to operate when considering the potential returns in both value and health.

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IEQ SENSORS • When monitoring the impact of a person’s environment on their health and wellbeing, it is absolutely critical to understand the state of that environment. Comprehensive IEQ sensors are available for monitoring a wide variety of variables in one, easy to use package.

• With the rise in public awareness of the impact of our environment on our health, more IEQ sensor packages have become commercially available, with easy to use interfaces.

• IEQ sensors are able to record the following, which were important to this study: – humidity (%) – CO2 (ppm) – temperature (°C).

Copyright Girts Ragelis | Shutterstock

LIGHT AND SOUND METER APPS • Part of understanding the environment that the participant is in requires the measurement of light and sound levels. Both these variables can impact physical and mental health in the workplace. Too much noise can impact concentration levels, increase anxiety or even damage a person’s ear drum. Too little light can cause eye strain and lead to long-term damage.

QUANTITATIVE DATA COLLECTION METHODS • Despite the large number of data points that wearables can collect, there will always be more subjective elements of the perception of spaces and mood that will remain quantitative.

• Questionnaires or diary entries, completed by participants each day or at several points throughout the day, can capture how participants are feeling.

• Affordable hand-held light meters and sound meters are available on the market. However, this study looked at the viability of using smartphone apps instead – something which is (often) free and uses equipment that nowadays every participant will have.

• Questionnaires and diary entries can capture information such as: – mood

• The apps proved to be accurate and consistent enough to be used in this study, although they were not as precise as stand-alone light and sound meters. The advanced light sensors and microphones in today’s smartphones are capable of collecting accurate data.

– activity – posture – caffeine and water intake – other stressors throughout the day (e.g. commute, meetings).

• Other methods for capturing the subjective elements of a study can include participants sketching the spaces they are in or asking them to write about their experience.

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THE TOOLS USED IN THE STUDY

saturation (SpO2) and skin temperature). However, Fitbit’s smart watches are more focused on aesthetics and on other uses, such as GPS tracking, music players and smart assistants (Alexa). These added features and the increased focus on aesthetics put the smart watches in a significantly higher price range and, while they may be more suitable for avid athletes, they offered no significant benefit over the fitness trackers for the purpose of this study.

Fitbit Inspire 2 The Fitbit Inspire 2 (see page 10) is, at time of writing, the latest health and fitness tracker by the world-leading wearables brand. Fitbit’s wrist-worn products fall into two distinct categories: health and fitness trackers, and smart watches.

The first of these focus primarily on collecting health metrics, whether in a range of sports environments or just in day-to-day activity. These products are cheaper than their smart watch counterparts but offer a more limited range of features. The smart watches offered by Fitbit do also collect the wearer’s health metrics, in some cases collecting a wider range of features than the health and fitness trackers (e.g. blood oxygen

Key metric

Description

Therefore, this study used the Fitbit Inspire 2, a relatively affordable wrist-worn band with a small interactive screen. The product comes with access to the Fitbit app, and extra features are available through Fitbit Premium. For the purpose of the study, each Fitbit was set up with a Premium account to allow for access to a greater range of data points (Table 2).

Relevance to the study

Measurement regime

Daily metrics Resting heart rate

The number of times your heart beats per minute when you are resting (i.e. not undertaking activity). Measured in beats per minute (bpm).

While resting heart rate is an indicator of general fitness and overall cardiovascular health, it is particularly useful in this study as an indicator of stress.

Measured throughout the day and night.

Monitored through the Fitbit dashboard.

Heart rate (continuous)

Measurement of heart rate throughout the day.

A high heart rate, relative to the resting heart rate, can be an indicator of stress or activity.

When mapped on a graph, heart rate can be an indicator of periods of stress or relaxation during the day, which in turn can be mapped to key events or other metrics in the study.

Measured throughout the day and night.

Monitored through the Fitbit dashboard.

Heart rate variability (HRV)

The variation in the time between each heartbeat. Measured in milliseconds (ms).

A higher HRV can be a sign of better health, whereas a significant drop in HRV may indicate that the body is experiencing stress, strain or potential illness.

HRV is calculated using heart rate data from a period of sleep longer than 3 hours. HRV was analysed using a screenshot of the Fitbit app taken by the participants.

Breathing rate

The number of breaths taken in a minute. It fluctuates in response to the body’s need for more, or less, oxygen. Measured in breaths per minute (breaths/minute).

Breathing rate during sleep is a good indicator of overall wellbeing. Of particular relevance in this study, it can be a marker of anxiety.

The Fitbit monitors the wearer’s breathing rate from the latest period of sleep longer than 3 hours. In the study, breathing rate was analysed using a screenshot of the Fitbit app taken by the participants.

The sleep score is broken down into ‘time asleep’, ‘deep and REM’ and ‘restoration’.

Each of these can be used to determine how restful and restorative the sleep was. This can impact overall health, in particular energy levels, memory and attention span.

All scores can be seen through the app as a score out of 25 (‘deep and REM’, and ‘restoration’) or 50 (‘time asleep’). More in‑depth metrics and graphs are available in the Fitbit app.

Sleep metrics Sleep score

A metric given by Fitbit that is scored out of 100 to establish the wearer’s sleep quality.

Physical activity Steps

The number of steps taken throughout the day.

An indicator of the quantity of physical activity.

Analysed through the online dashboard, but can be seen through the device and app.

Calories burned

The number of calories burned throughout the day, taking into account activity and user input data on height and weight.

An indicator of the quantity and intensity of physical activity.

Analysed through the online dashboard, but can be seen through the device and app.

Distance travelled (km)

The distance that the wearer travelled throughout the day.

An indicator of the quantity of physical activity.

Analysed through the online dashboard but can be seen through the device and app.

Active minutes

How much high-paced activity the wearer did during the day.

An indicator of the quantity and intensity of physical activity.

Analysed through the online dashboard.

Active hours

The number of hours in the day in which the wearer took more than 250 steps.

An indicator of the quantity and frequency of physical activity.

Analysed through the online dashboard, but can be seen through the device and app.

Table 2 Fitbit Inspire 2: metrics

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UPRIGHT GO 2 The UPRIGHT GO 2 (see page 10) is a posture trainer that notifies the wearer when their posture is bad by vibrating gently. The device attaches to the base of the wearer’s neck with an adhesive strip and measures posture through an inbuilt accelerometer. The device comes with an easy to use and clear app that allows the user to calibrate the device, monitor their current posture and also to see their past data (Table 3).

Airthings Wave Plus Airthings offers a range of IEQ solutions for homes and businesses. The company has comprehensive packages, along with an easy to use interactive dashboard and personalised customer support, which allow for easy and accurate readings of IEQ. The Airthings team worked with the study’s research team to develop a comprehensive system of sensors and hubs that would be most appropriate for the scenarios in PLP Architecture’s offices and participants’ homes.

Airthings produces a range of different sensors, the most appropriate for this research project being the Wave Plus.

The Wave Plus collects data on radon, volatile organic compounds (VOCs), CO2 levels, humidity, temperature, light and air pressure. All the sensors are packaged into a small and unobtrusive package, no larger than an average smoke detector, which can be easily placed on any appropriate wall using an adhesive strip. Each Wave Plus has a relatively large range, and only one was needed for each of the study scenarios. The Wave Plus (see page 10) runs on its own 4G network, connected by a central hub at each location, which is also provided by Airthings as part of the package (Figure 4 and Table 4).

Key metric

Description

Figure 4 Airthings Wave Plus for Business network Courtesy of Airthings

Relevance to the study

Measurement regime

Posture Upright vs slouch

The percentage of the day for which the wearer was sitting/standing with a postural position deemed acceptable or ‘upright’ by the GO 2 app.

Good posture is directly related to musculoskeletal issues, which can greatly affect workplace performance, comfort and long-term health.

Scores were calculated in the GO 2 app.

Participants read the data from the app and wrote it in their daily questionnaire.

Table 3 UPRIGHT GO 2: metrics

Key metric

Description

Relevance to the study

Measurement regime

Indoor environmental quality Carbon dioxide (CO2) (ppm)

The prevalence of CO2 in the air measured in parts per million (ppm).

Increased levels of CO2 in the air can lead to drowsiness, and in the long term can be harmful to health.

Levels were recorded and displayed 24/7 through the Airthings dashboard. Historical data was accessible at the end of the study.

Humidity (%)

The level of humidity in the air.

Low humidity can sometimes cause skin or eye problems, and can dry the respiratory system, making coughs and colds more likely. High humidity can be uncomfortable, and may threaten health through increased surface condensation and mould growth.

Levels were recorded and displayed 24/7 through the Airthings dashboard. Historical data was accessible at the end of the study.

Temperature (°C)

The ambient temperature.

Both low and high room temperatures can cause discomfort for occupants.

Levels were recorded and displayed 24/7 through the Airthings dashboard. Historical data was accessible at the end of the study.

Table 4 Airthings Wave Plus: metrics

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Light and sound meters Participants were required to log the sound and light levels of their locations throughout the day (at 10 a.m., 2 p.m. and 4 p.m.) on apps on their smartphones (Table 5). By opting for an app, rather than a stand-alone light or sound meter, the research team was able to test the applicability of more accessible forms of data recording, which everyone has in their pocket.

Questionnaire/diary entries To record qualitative aspects of the study, each participant was given a questionnaire to fill in on each day of the study. The questionnaire included questions about their mood, hourly activity and posture, caffeine and water consumption, and their commute. Participants were required to fill in the questionnaire each day at 4 p.m., with the exception of questions about mood, which they were required to answer in the morning as well.

The questionnaire was designed to have as little impact on the participants’ work day as possible, taking a maximum of 10 minutes to complete.

Questions from the questionnaire were based on previous projects (see Appendix 2) and other well-established wellbeing scale models: • the Warwick–Edinburgh Mental Well-being Scale (WEMWBS)43 • the valence-arousal model33 • the self-assessment manikin (SAM).45

Sketches On the final day in their respective scenarios, participants were asked to make a sketch of their environment (Figure 5). This task was aimed at giving participants the opportunity to convey their feelings about the space in a way that they might not be able to through words or the other methods provided in the study. Although each sketch would be radically different, they go some way to capture the participants’ subjective feelings about the spaces they inhabited for the week.

Key metric

Figure 5 Sketches made by participants of their environment

Description

Relevance to the study

Measurement regime

Light level (lux)

The level of light in the space occupied by the participant.

Poor levels of lighting can lead to eye strain, headaches, low mood, poor concentration and absenteeism.

Participants took readings at certain intervals throughout the day using the app on their smartphone. They recorded the readings in their daily questionnaire.

Sound level (dB)

The volume of sound in the space occupied by the participant.

High noise levels can reduce concentration, increase anxiety or even damage a person’s eardrum

Participants took readings at certain intervals throughout the day using the app on their smartphone. They recorded the readings in their daily questionnaire.

Light and sound

Light meter apps • Android – My Mobile Tool Lux Meter (Light Meter): https://play.google.com/store/apps/details?id=com.tsang.alan.lightmeter&gl=GB • Apple – Lux Light Meter Pro: https://apps.apple.com/us/app/lux-light-meter-pro/id1292598866 Sound meter apps • Android – Abc Apps Sound Meter: https://play.google.com/store/apps/details?id=com.gamebasic.decibel&gl=GB • Apple – NIOSH Sound Level Meter: https://apps.apple.com/us/app/niosh-sound-level-meter/id1096545820 Table 5 Light and sound meter apps: metrics

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SCENARIOS Four different physical environments were conceived for the participants to spend their working day in throughout the study. Each scenario was designed to elicit a different response from the test subjects, and was based on a few key variables.

The number of variables was kept to a minimum so as not to add too many different stimuli into the mix. The scenarios focused on the addition or removal of a connection to nature (both externally and internally) as well as a connection to people (in terms of both sociability and disturbance).

A

B

C

The four environments included a cubicle-like environment, a standard open-plan office, a biophilic working environment and the participant’s home-working environment (Figure 6).

The home-working scenario was included as a response to the changes in working situations because of the COVID-19 pandemic. The amount of home working is expected to increase in the future, and this study hopes to shine a light on the differences in conditions, whether positive or negative, between specially designed workplaces and those created by individuals at home.

Figure 6 The location of, the open-plan office (scenario A), the cubicle-like environment (scenario B) and the biophilic working environment (scenario C) in PLP Architecture’s offices

SCENARIO A – OPEN-PLAN OFFICE Scenario A was a standard open-plan desk in the main space of PLP Architecture’s offices (Figure 7).

• Biophilia – There were few or no biophilic elements, such as plants, within view inside but a few were visible outside.

• Views out – The workspace offered good views out of the office as it was near to the external wall, which has roughly 40% glazing. The view was primarily of the sky and buildings.

0

• Interaction – There was plenty of opportunity for interaction, with other workspaces on all sides and being near to the main walkway through the office.

1

2

3

4

5

1

2

3

4

5

Biophilia Views out Interaction

• Lighting – The workspace was both artificially and naturally lit. The workspace was near the window and received ample natural light.

Lighting Ventilation

• Ventilation – The workspace used the office’s mechanical ventilation.

Figure 7 Scenario A – open-plan office

SCENARIO B – CUBICLE Scenario B was set up in one of PLP Architecture’s small meeting rooms to mimic a cubicle-like environment (Figure 8).

• Biophilia – There were no biophilic elements.

• Views out – There were no views out, as the blinds were lowered. The internal glazed walls were also blocked out using photography paper.

• Interaction – Participants in this scenario were asked to limit their interaction with others where possible, and were seated alone in the room.

0 Biophilia

• Lighting – The room was artificially lit. The lowered blinds let in very little natural light.

Views out Interaction

• Ventilation – The workspace used the office’s mechanical ventilation.

Lighting Ventilation Figure 8 Scenario B – cubicle

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SCENARIO C – BIOPHILIC OFFICE Scenario C was set up in PLP Architecture’s eastern wing. This part of the office has more extensive views outwards, and is a bit quieter but still allows for interaction. The area also has a range of plants, and more were added for the purpose of the study (Figure 9).

• Biophilia – There were many plants in the area. Participants’ desks were filled with a range of plants. According to work at the RMIT University, the optimum purification and wellbeing benefits is 10 plants per 20 m2.46

Different types of plants provide various ecological value and environmental benefits,47, 48 and the plants for this scenario were specifically chosen with the aim of providing a multi-sensory biophilic experience. The following types of plants were chosen: – Green plants with extensive foliage – These were chosen to give the participant a biophilic visual stimulus, with much of their view being taken up by green plants.

0

1

2

3

4

5

1

2

3

4

5

Biophilia

– Air-filtering plants – Plants were specifically chosen for their ability to filter the air and thus provide more oxygenated air for the participants.

Views out Interaction Lighting

– Coloured plants – Bright blue and purple plants were chosen for their ability to increase sensations of comfort, relaxation and cheerfulness, which can enhance the physiological functions and improve the psychological relaxation of office workers.49

Ventilation Figure 9 Scenario C – biophilic office

– Aromatic plants – Certain plants, in particular white jasmine, were chosen for their scent, which can help to reduce stress and anxiety.50

0 Biophilia Views out

• Views out – There were extensive views out, with 40% glazed external walls on three sides.

Interaction Lighting

• Interaction – There was plenty of opportunity for interaction, with other workspaces in the immediate vicinity. However, the area was relatively quiet, due to there being fewer workspaces and it being separated from the main office space.

Ventilation Variables vary from home to home

Figure 10 Scenario D – working from home

• Lighting – The workspace was both artificially and naturally lit. The workspace was near the window and received ample natural light.

• Ventilation – The workspace used the office’s mechanical ventilation.

There were two near-identical variants for this scenario, to accommodate the number of participants. Both were constructed using the same concepts and resources. However, as the scenarios were located in a functioning office they had to be spaced a couple of rows away from each other. Both had exactly the same levels of biophilia, views out, interaction, lighting and ventilation.

SCENARIO D – WORKING FROM HOME There were two variants for this scenario, to accommodate the number of participants. As these were the participants’ homes, the variants differed in a number of ways. However, participants were asked to record what their home environments were like in order to allow for a degree of comparison and analysis (Figure 10).

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THE IMPACT OF THE CORONAVIRUS PANDEMIC

INITIAL RESULTS AND RECOMMENDATIONS

The research and planning of this pilot study began before the coronavirus pandemic swept the world. The impact that this had on the study was huge, for a number of reasons.

The Flourish framework was applied, and the snapshot outcomes of each scenario plotted on the wheel diagrams.26 Although we were only able to conduct the first week of the pilot study, the information obtained is rich and provides insight into how workplace settings influence an individual’s physical, mental and social wellbeing. Combined with diaries and interviews, the wearable is a vital tool for designers to obtain empirical evidence in order to understand human‑centric outcomes. This pilot study also explored how to take advantage of these outcomes and communicate the value of good design (wellbeing valuation) to potential clients.

The first felt impact was concerned with the practicalities of conducting a workplace pilot study in the midst of a series of national and local lockdowns. After numerous last-minute postponements, the team was able to conduct the study, albeit a more condensed version than was initially planned, in a safe and thorough manner during a brief window of time when PLP Architecture’s offices were being used at a reasonably high capacity.

Due to the experimental nature and the lockdown disruption, we present the average value of the results, and accept that there is a limitation on the reliability of the data due to missing information, the small sample size and the short window of the testing period (Figure 11). Key points are summarised below.

The second impact was the changes in perception of what the workplace was for, what form it took and how people’s routines changed during the pandemic. It is widely considered that working from home will now be, at least in part, a continuing part of people’s working week. As such, the pilot study was adjusted to include a home-working scenario in order to study occupants’ health and wellbeing in their own environment. In addition to this, the requirements of the office environment changed. Extra precautions taken to prevent the spread of COVID-19 included increased spacing between workstations, making temperature checks of personnel on entry, the adoption of space-sanitising robots and a reduction in the number of people in the office at any one time.

GENERAL OBSERVATIONS • The open-plan office and one of the biophilic scenarios have the most positive outcomes overall, and working from home also generated good wellbeing values when natural light and indoor plants were present.

• The cubicle scenario was an enclosed solitary workspace without views out and no greenery. Although this had no impact on the subject’s physical activeness or posture, the data suggests that it negatively affected their moods and emotions.

Thirdly, there was a widespread increase in the general public’s awareness of how places, particularly our places of work, impact our health. Within the office industry, this idea is already well known, and all those participating in the study have been striving for many years to create healthier, more productive and more creative places to work. Suddenly, however, halfway through this study, the general population became concerned with how healthy their workplaces are. Now, it will not just be health-conscious designers who are pushing for healthier workplaces, but it will also be employees, tenants, investors, clients and developers. The health of the workplace will be a concern for new talent, and organisations with the healthiest environments, and ways to measure this, will attract the best of the talent.

• Perceived environmental conditions, such as aesthetics, access to light, thermal comfort and air quality, have a strong correlation with the level of valence and arousal (recorded twice a day). For example, the more satisfied the subject felt about the space, the more frequent positive emotions they experienced.

• All participants were healthy individuals, and their heart and breathing rates are mostly within the recommended range. Using physiological changes as a proxy to measure, health in a real-life POE is an exciting approach which is now actively being developed.

• Most of the participants improved their UPRIGHT GO 2 scores towards the end of the week. Some found that the device bothered them initially, but not later on. Thus it appears that some types of wearables require an adaptation period. This is further confirmed by the work done by Prisca Winata at UCL (see Appendix 2).

To summarise, it is technically feasible for designers to employ wearables in the POE process to collect snapshot or longitudinal data, but careful planning, including a trial period, and specific research questions to compare well-defined work settings are the two most important considerations in the process.

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3 – Good

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Scenario B – cubicle

Figure 11 Flourish model plot of the diary, wearable and building sensor measurements

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3 – Good

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Scenario C1 – biophilic office

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Scenario C2 – biophilic office

Figure 11 – continued Flourish model plot of the diary, wearable and building sensor measurements

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Scenario D2 – working from home

Figure 11 – continued Flourish model plot of the diary, wearable and building sensor measurements

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PHYSICAL ACTIVENESS, SLEEP SCORE AND POSTURE

No new ergonomic or active furniture was introduced as part of this study; therefore, it was assumed that the posture score (upright versus slouch) was mainly influenced by awareness and change in behaviour. The results from the UPRIGHT GO 2 wearable showed that the study participants working from home had largely consistent scores of below 80% upright. Although these scores improved towards the end of the week for both those working at home and those in the other scenarios, the poor score revealed that the home office setting may not be supporting good workplace ergonomics for participants. All participants in the workplace scenarios achieved a score above 85% upright over the entire testing period. Although it is likely that people working at home are more active, as it is convenient to get up for refreshments or to take a local stroll, the COVID-19 working mode tends to increase their screen time due to end‑to‑end online meetings.34, 51

The perceived physical activeness was similar in all six scenarios except the cubical scenario. It seems that the participant in the cubicle felt they were physically disconnected from their colleagues.

Travelling to and from work is an important opportunity to be active during the work day. It also has an impact on the mood of participants when they arrive at work in the morning. It was noticeable that the participants who travelled by tube felt more negative compared with those who travelled by foot (5 km) or using their own vehicle.

Although night-time is outside of office hours for most of the workforce, the quality of a person’s sleep may be impacted by their experience during the day. Quality of sleep affects how we feel when we wake up to start the day. The sleep score (based on duration, deep sleep, light sleep, REM sleep and heart rate) of those working from home was similar to the scores for those working in the workplace, but the results appear to show better sleep quality for those working from home.

Fitbit also provided some useful benchmarks for various physical activities and the sleep score. However, currently it has more comprehensive data from the USA than major European cities. Although it is not specific to the workplace context, it is worthwhile to compare the POE result with the larger Fitbit data set (Figure 12).

Figure 12 Fitbit Health & Activity Index, February 2021

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MOOD AND EMOTIONS

More positive emotions were reported in one of the biophilic and one of the working-from-home scenarios. Although the data is not conclusive, more positive emotions were reported by the participant where new plotted plants were introduced; the same participant also walked to the office from home. This initial finding is in line with another GPS smartphone study on transportation-related mood tracking.52 The participant in the open-plan office reported positive emotions overall, but was affected by glare and excessive sunlight in the afternoon.

Although this participant’s mood was positive in general, their alertness was decreased during the hours when their visual comfort was not optimal. The participant in the cubicle reported low mood and boredom, which was worse in the afternoon.

In the pilot study the emotional states of the participants were established through diary records and questionnaires (Figure 13). Alternatively, this could be achieved using the mood-log app from Fitbit (subjective) or an EEG brainwave headset (objective). In this study the circumplex model of affect33 and a well-established question format45 were used to measure the two dimensions of mood (valence) and alertness (arousal) in the morning and afternoon. Tracking emotion through a wearable in a POE process is still an emerging area, but a similar method has been employed in a recent real-world case study to evaluate the stress of construction workers.34

I can see my plants all day, I love it. I have also some on my desk and in the rest of the room

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Figure 13 A mood dashboard for the six scenarios, recorded in the morning and afternoon

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WELLBEING VALUATION

seen as a comparative value, and does not necessarily represent a true cost in this initial analysis. Therefore, the figures have been rounded up.‡ Even though the concept of social value is long-standing, it is still an emerging area for designers to apply this new way of thinking to the built environment.55 More information about wellbeing valuation and the HACT’s social value calculation is given on page 14.

For the wellbeing valuation a cost–benefit analysis38, 41 was applied. The analysis was based on a set of life-satisfaction questions from the Warwick Edinburgh Mental Well-being Scale (WEMWBS),43 which served a different purpose from the diary recording of emotions (valence and arousal).45 Instead of using a questionnaire, wearables could be used to collect unobstructed data of wellbeing and productivity levels. For example, EEG has been used to detect the wellbeing effects of viewing flowering plants in a workplace setting.49

Although this was only a four-day pilot study, the results aligned with other recent research projects that demonstrated the benefits and trade-offs of the new working from home model during the pandemic,56–58 and that it could work to the advantage of organisations if appropriate measures were introduced. In this pilot study, overall wellbeing was not compromised in the working-from-home scenario.

For example, the result suggests that the water intake† of the participants working from home tended to be higher than for the participants in the workplace scenarios, although participants’ posture§ appeared to be worse in the home setting.

The wellbeing valuation showed a promising initial result, confirming that the life-satisfaction question and the diary recording of emotions arrived at a similar outcome.* The open‑plan office and one of the biophilic scenarios had the highest score, while the cubicle scenario was the least satisfying.

Further investigation into the valuing aspect shows that the biophilic and working-from-home scenarios delivered the highest net social impact (Table 6). The investment in introducing plotted plants is relatively small (approximately £200 overall), but the initial outcomes suggest that the net social impact of the biophilic scenario (£14,000) is more than double that of the cubicle scenario (£6,000). The impact takes into account the attribution, deadweight and the cost to deliver the biophilic intervention. The final value indicates that the overall wellbeing of home working is comparable to that of working in PLP Architecture’s offices. Introducing some indoor greenery may have boosted satisfaction and yielded the highest wellbeing value.

Wellbeing valuation using a monetised social value can provide a strong argument for the non-financial benefits of good-quality design. However, it can be confusing for many architects and workplace designers to apply the calculation as there are many models, such as the National Social Value Measurement (National TOMs) framework and the Social Return on Investment (SROI). These methodologies were not selected for this pilot study, but they are credible ways to ‘add value’ through planning and procurement (see the BCO report Measuring the Social Value of Offices2 and UKGBC’s recent publications on this subject59–61).

The purpose of this valuation is to provide comparable values for the six study scenarios. The monetised value in pounds was

P6

P5

P4

Working from home The Warwick–Edinburgh Mental Well-being Scale (WEMWBS) (total points) Wellbeing valuation (HACT and Simetrica) Attributiona

(%)

P3 Biophilic

Net social impact

P1 Open-plan office

24

23

20

29

18

30

£23,000

£23,000

£18,000

£25,000

£12,000

£25,000

58%

50%

80%

50%

50%

50%

Deadweightb (= 1 – 0.27) (%) Minus the total costs to deliver the intervention

P2 Cubicle

73% £0

£0

£100

£100

£0

£0

£10,000

£9,000

£11,000

£10,000

£5,000

£10,000

a Attribution

is an assessment of how much of the outcome was caused by factors other than the current activity or intervention. It is calculated as a percentage, i.e. it is the proportion of the outcome that is attributable to the organisation. In this study, participants were asked to rate on a scale of 0% to 100% how much of their mood changes were due to the workplace design (rather than other factors).

b Deadweight

is a measure of the proportion of the outcome that would have happened even if the activity had not taken place. It is calculated as a percentage.

Table 6 Wellbeing valuation of the six scenarios, based on the indicative figures in the HACT’s Social Value Bank41

* Life satisfaction is different from emotions. Life satisfaction refers to subjective wellbeing; an individual’s personal judgement of wellbeing and quality of life based on their own chosen criteria,53 it stands for happiness. Emotion is more instant, and can be defined as a complex reaction pattern, involving experiential, behavioural and physiological elements.54 Both life satisfaction and emotions can be used to evaluate occupants’ satisfaction in the workplace. However, only emotions can be detected by wearables, through the evaluation of a bio-marker. For example, stress has a direct impact on heart rate and blood pressure. † Water intake was defined as the number of cups/glasses of water. However, the actual volume was not quantified in this pilot study.

‡ Cubicle (P2 in Table 6): £12,255 (WEMWBS 18 points) × 50% (attribution) = £6,128.

Biophilic (P4 in Table 6): £17,561 (WEMWBS 20 points) × 80% (attribution) – £100 (cost of the intervention) = £13,949.

The difference between the cubicle and the biophilic scenarios is £13,949 – £6,128 = £7,821. § Posture was measured as the percentage of upright to slouch, as measured by the UPRIGHT GO 2 wearable.

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To summarise, the difference in the wellbeing value between the biophilic (best case) and cubicle (worst case) scenarios during the pilot period is huge. The initial outcomes suggest that the social value of the biophilic scenario is more than double that of the cubicle scenario. This indicates that the investment in a natural-based solution can be small but a large positive impact can be achieved by a good biophilic design strategy. Although this value proposition is an indicative amount, as it is not a direct cost to the organisation, because PLP Architecture is a RIBA Chartered Practice it can be used as part of the corporate social responsibility (CSR) reporting.

The practice needs to demonstrate its policy and impact on wellbeing for both individuals and society at large. Social value can also be used by PLP Architecture to tender for publicly funded projects. For example, Procurement Policy Note 06/20 states that when awarding central government contracts account must be taken of social value, and this should encourage more companies to start quantifying their ‘social good’ activities in a consistent way. The value of wellbeing to its employees and opportunities to bid for publicly funded work could give PLP Architecture an incentive to look at a more biophilic workplace as well as a flexible working-from-home arrangement moving forward.

• There is a growth in the number of emotion and stress tracker products that can be used commercially and with little expertise (e.g. those produced by Empatica and EMOTIV). As this market develops, there is no doubt that we will start to see a new range of products that can be easily used to help conduct an occupant health and wellbeing analysis in the workplace.

TIME The time available for this pilot study was constrained, particularly as a result of the coronavirus pandemic. However, in a workplace that will be occupied long-term, it would be beneficial to run a study for a much longer period. Once set up, it is easy to conduct continual POE in conjunction with data analytic software.

EXPERTISE • At present, a base level of understanding of the health metrics and technologies is needed to run a study such as this.

• As the adoption and commercialisation of these technologies increases, companies will need less and less specialised help.

CONCLUSIONS

• As user interfaces and customer service improves, it will become easier to run a study like the pilot study report here.

The pilot study reported here is an example of a methodology using wearable technologies that could be used to conduct an occupant health and wellbeing assessment in an office. The study aimed to use easily accessible, affordable and reliable equipment that was simple for participants to use. There are, however, many other avenues that could be explored by those with different levels of expertise, time and resources.

OTHER CONSIDERATIONS • It can be confusing and time consuming for designers to analyse the data obtained from a questionnaire and various environmental sensors, and then link them with data from wearables, but advanced analytical tools are available.

RESOURCES

• The Flourish framework provides a holistic platform with which to review the scenarios.

• There is a wide range of fitness trackers at both lower and higher price levels.

• Design consultants often do not have access to staff and human resources data on end-users.

• Cheaper devices sometimes come with a trade-off between price, performance and accessibility to analytics.

• Linking self-report outcomes and wearable measurements to design (social) value can be vital to inform commercial decisions and to demonstrate the benefits of a particular workplace setting. ■

• More expensive devices have more features that are nice to have for daily life, but they have few extra features that would aid in a study of this type.

• Above the high-end commercial wearables are the research‑grade ones. These provide an extremely in-depth range of real-time physiological data, but may require specialised personnel to set up and to analyse the results.

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FUTURE HORIZONS In terms of the user, we will see:

Equipment

• Greater user awareness. With the power to monitor their own health and wellbeing vital statistics throughout the day, users will become more conscious of how each environment and each task that they conduct affects them. Over time, they will learn – and user interfaces will be able to teach them – which environments and conditions are optimum for each of their various tasks throughout the day.

In terms of the wearables used, there are many alternatives that could be tried, and each year there are more possibilities.

If budget is a concern, there is a range of fitness wristbands that come at a low price. There is, however, often a trade-off: the reliability of less well known brands may be unknown, the analytics are likely to be less comprehensive and the user experience may not be as good. That said, there are many good brands available at low prices and that come with good services.

• Greater user control. The power to adapt the workspace may transfer to the individual rather than lie with the employer. Greater user awareness means that people will be accurately informed on how their spaces impact them, and will be educated enough to adapt these spaces to their needs.

Flexibly designed spaces can accommodate this.

If there is more room to play with in terms of budget, there is a whole host of other wearables that could be explored. Just one example is the smart watch range from Fitbit, or similar models by Garmin. These have many features that, while not necessarily useful in this pilot study, could be used to reveal other health and wellbeing trends. These higher-end products can also be used for a range of other daily activities not related to a health and wellbeing assessment, and thus may be a good way to encourage employees to adopt this technology in the first place, especially those with little interest in fitness.

• Healthier working from home. People’s home-working environments will, over time, become more customised to meet their health and wellbeing needs. Office environments are tuned to cater for the health and wellbeing of a group of people; homes can be tuned to suit the needs of the individual.

Above the high-end commercial equipment, there is also a wide range of research-grade equipment that can be adopted for this kind of study. For example, the medical grade E4 wristband from Empatica provides an extremely in-depth range of realtime physiological data, but may require specialised personnel to set up and to analyse the results. Another company, EMOTIV, produces EEG headsets for monitoring brain activity, and these were identified as a useful tool in this report. Again, these may require specialists who are not currently in your organisation to undertake the set up and to analyse the data produced. Having said that, companies like Empatica, EMOTIV and a host of others are increasingly developing products that can be used commercially and with little expertise. As this market develops, there is no doubt that we will start to see a new range of products that can be easily used to help conduct an occupant health and wellbeing analysis in the workplace.

• Integration of insurance. Tools such as Fitbits will be increasingly linked to insurance plans, so insurers can offer incentives and different costs based on the activity of those who are insured. We are already seeing the start of this.

In terms of the design(er), we will see: • More flexible and less prescriptive workplaces. When users are aware of how spaces affect them personally, they must then be able to adapt or change their environments as they see fit. Designs must accommodate this.

• More responsive workplaces. Alternatively, instead of workplaces that the user can adjust, the workplace itself could be programmed to respond to the individual’s health and wellbeing needs. Integrated smart technologies can allow for this. This creates a symbiosis between the building and the user.

Time

• Demand from users for healthier places. Greater awareness of the impact of spaces on our health has already led to a huge surge in demand for healthier environments. However, this has most often come from investors, designers, planners or developers. Greater individual awareness, driven by wearable data, will lead to an acceleration in the evolution of office design, this time led by the people who use the spaces.

Time is another variable which many companies will have to consider when running a health and wellbeing study. This pilot study was constrained by time, particularly as a result of the coronavirus pandemic. However, in a workplace that will be occupied long-term, it would be beneficial to run the study for a much longer period. Once the study is set up, is easy to conduct continual POE using wearables in conjunction with data analytic software.

• More focused office redesigns. By establishing which factors are most important to their employees’ health and wellbeing, in the future organisations will be able to be a lot more selective in how they adapt or renovate their workplace. It will be possible to make drastic changes to workplaces with minimal intervention, less demolition, less new-build and, ultimately, less waste and damage to the environment.

Expertise At present, some expertise is needed to run a study such as the one reported here, even if it is just an underlying understanding of the health metrics and the technologies.

However, as the adoption and commercialisation of these technologies increases, companies will need less and less specialised help. Wearables already come with easy to understand interfaces, and the Airthings IEQs used in this study came with a very committed and helpful customer service team that helped to set up and configure all the equipment required. We will start to see these services grow, and as a result it will be easier for companies or building managers to run a study like the one reported here. ■

• Performance-based procurement. There will be more outcome-driven contracts that require designers and contractors to provide a performance guarantee, such as energy performance. Wellbeing metrics can become part of the criteria as the real-estate industry becomes more employee and health and wellbeing focused.

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In terms of the employer, we will see: • Greater ability to assess health and wellbeing. Workplaces will easily be able to run office-wide health and wellbeing assessments of their employees to see how to modify their environments accordingly.

People

Biomarkers and perception

• Health and wellbeing wearables being offered to employees to monitor their own vital statistics. Employees who are more aware of their health can take positive steps to improve it, which in turn will lead to lower costs for the employer in the form of less absenteeism, short-/long-term illness, etc. The cost of the wearables will be less than the savings made.

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• Insurance. It has become a trend that health insurance companies are collecting data from wearables. For example, more companies are introducing reward systems ‘for being healthy’, and they may offer a gym membership if 30,000 steps are achieved by the individual. The data for measuring this are collected by means of a smart watch. The employer will be able to reduce their liability by actively promoting health within the workplace setting.

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• Health as an attractor of tenants and talent. As the health of buildings becomes easier to measure, occupants will be able to demand that employers and building managers prove the health of the spaces that they use. Healthier buildings will be more attractive to potential tenants and employees.

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Figure 14 The opportunity for designers to conduct POE using wearables to understand the long-term performance of people (occupants), building and organisation

• Robotics. The applications of robots are increasing rapidly.

With the improvements in both these and wearables, we will see greater interaction between the two, and ultimately human–robot conversation.

In terms of the technology, we will see: • Complete packages. Complete kits that include wearables and environmental sensors will likely be available for workplaces to run a health and wellbeing assessment.

Whereas today individual items need to be bought with different interfaces, technology companies will likely bridge this gap and offer comprehensive packages for employers.

• Embedded body sensors. We will start to see greater adoption of sensors embedded in our bodies and for a wider range of uses. Embedded sensors that monitor glucose levels are already commercially available, and a wide range of products, including brain implants, are in early development. Products such as these may ultimately help with processes such as accurate memory recall.

• Greater accessibility. Data and tools to assess health and wellbeing will be far more accessible to people who do not necessarily have the expertise. The products, user interfaces and client services of the wearables companies will be able to guide employers through the process.

• Neuroscience. As we sense the environment, this stimulates various parts of the brain. So, the emerging sensors that measure brain activity open up the possibility that eventually we will be able to use neurosensory mapping to see the impact of the environment on people. ■

• Greater interaction with surroundings. We will start to see wearables that can interact with sensors embedded in objects or structures around them, giving more informed data on performance.

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An architect’s point of view – how this study is meaningful to the design process Measuring the human

Empowering the user

As architects it is crucial for us to be able to convey to our clients how important building design is to the health and wellbeing of its occupants. A study like the one conducted for this report gives us new tools to be able to pass on this message.

What is also interesting about this pilot study is the perspective that it brings to a building occupant’s day‑to‑day life. Through this, we are giving them the tools to check in on themselves, read the results and act accordingly. It is about empowering building users to have greater control over their health and their habits. How this translates back into design and building management will be interesting to watch.

The growing use of standards like the WELL Building Standard has, of course, helped move this along, but even when achieving these standards we look to metrics that show the performance of the building, not the biological performance of the human. To be able to put quantifiable metrics on the how people are physically and mentally impacted by the building is hugely useful. What this study does is define a way that we can open up a whole new range of data.

Guaranteeing building performance The study also provides a new way for building owners to be able to guarantee performance to their tenants. It is all very well to claim that your building is good for the health of its inhabitants, but being able to show tangible metrics and prove it is a huge real estate asset. And, from the opposite perspective, tenants or employees can hold their landlords or employers accountable for the quality of the spaces that they are providing. ■

With The Edge in Amsterdam, which PLP Architecture designed, the building was able to collect a huge amount of data through the 28,000 embedded sensors. However, what we found most interesting was that people loved going to work there. Whatever was causing this was social and spatial, something that could not be measured through the building’s smart system. What this pilot study does is create a way that we could use the people to measure the spaces in the building that really work.

USE OF WEARABLES IN THE OFFICE A Review and Examples in Practice

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APPENDIX 1 ERICSSON CONSUMERLAB STUDY: KEY FINDINGS ABOUT WEARABLES Wearable technology is evolving rapidly, and wearables are changing the way consumers interact with their environment. Furthermore, the popularity of wearables is growing. A 2016 consumer insight report from Ericsson ConsumerLab62 indicates that ownership of wearables among smartphone users in Brazil, China, South Korea, the UK and the USA had doubled since a similar analysis in 2015. However, the wearables market is still in the early phases of expansion, and is currently dominated by health, wellness and activity tracking devices.

Key findings Wearables become the most personal devices • Two in five users of wearables said they felt naked when not wearing their device, with a quarter even sleeping with it on.

• Despite this, a quarter of those who had bought wearables in the past three months said their expectations had not been met.

Consumers predict the wearables inflection point to be beyond 2020 • 6 out of 10 smartphone users were confident that wearables will have uses beyond health and wellness.

The Ericsson report explores consumer views on if, how and when wearables might break beyond health and wellness scenarios and cover more diverse needs (Figure A1.1). The key findings of the report are given in the box. ■

• Consumers predicted that most wearables would only become mainstream beyond 2020. However, current users of wearables believed the development will be much faster.

Wearables manufacturers as personal data brokers

Glucose and blood pressure monitoring

48%

• 70 percent of users of wearables perceived wearables manufacturers to be very serious about protecting their data. In fact, users of wearables were more likely to share their data with wearables manufacturers than with doctors, insurance companies and internet companies.

Car/house keys

48%

A new role for smartphones in the wearables future

50%

Watches and clocks

GPS and navigation devices

46% 43%

Smartphones Identification documents

42%

Internet-of-things (IoT) future shaped by wearables

40%

Hand-held cameras

• 74 percent believed multiple wearables and sensors will help them interact with other devices and physical things around them, whilst 1 in 3 smartphone users believed they will wear at least 5 wearables beyond 2020. ■

38%

TV remote

37%

Wallets Music players (iPod, etc.)

34%

Source: Ericsson ConsumerLab (2016)62

24%

Tablets Streaming media players (Apple TV, Amazon, etc.)

19%

Connected TVs

19%

Video gaming consoles (Xbox, PlayStation, etc.)

• 43 percent of those surveyed believed smartphones will be replaced by wearables, while 40 percent of smart watch users already interacted less with smartphones.

As wearables get smarter, the smartphone may become a secondary screen.

43% say that smartphones are likely to be replaced by wearables

17%

19% believe that connected TVs are likely to be replaced in the future

Figure A1.1 Gadgets and items that wearables are likely to replace in the future Source: Ericsson ConsumerLab (2016)62

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APPENDIX 2 STUDY BY PRISCA WINATA, UCL: WEARABLES IN IMPROVING SPINAL POSTURE* METHOD

Commercial devices that can measure and monitor spinal posture began to be developed to improve musculoskeletal disorders (MSDs) and they are now popular in the working population. Wearables that monitor spinal posture provide a gentle vibration to alert the user when it detects a sustained poor posture. This enables the user to correct their posture and acquire good posture habits.64, 65

A pilot study was undertaken to assess the potential of current posture wearables in improving spinal posture problems and MSDs among adults working from home. Six people (2 men, 4 women) were recruited. The study was done in two stages: monitoring phase and post-monitoring phase. In the monitoring phase, participants wore a posture wearable (UPRIGHT GO 2, Upright Technologies) on their upper back during the typical working hours in a week. On the first day, the participants were asked to turn off the vibration mode, to assess the baseline of daily posture. The app installed on participants’ mobile phones allowed them to see the percentage of time they stayed in an upright position while working.

During days 2–4, participants turned on the vibration mode to train their upright posture. The device vibrates gently when

Table A2.1 compares the most popular commercial posture wearables. The devices are typically paired with applications in smartphones, which enables a real-life postural analysis and personal engagement. However, the lack of standardised objective measurements continues to be a barrier, as good and bad posture are very subjective measures and depend on an individual’s circumstances.66

Battery life (hours)

Cost

Real-time vibrotactile feedback

96

£80

Android and iOS apps

Real-time vibrotactile feedback

240

£100

Upper back

Android and iOS apps

Real-time vibrotactile feedback

35

£85

3D accelerometer, 1D gyroscope

Lower back

iOS-based apps

No real-time feedback system

N/A

£1,350

Posture tracking and upright posture coaching programme

Accelerometer

Around the neck

Android and iOS apps

Real-time vibrotactile feedback

70

£142

Prana

Monitors the effect of posture on breathing pattern

3D accelerometer

Waist

Android-based apps

No real-time feedback system

168

£150

Lumo Back

Posture tracking

Accelerometer

Lower back

Android and iOS apps

Real-time vibrotactile feedback

120

£130

IMUs

Sensor location

System incorporation

Device

Measurements

Lumo Lift

Posture tracking, step counting, travel distance, calories burned

3D accelerometer, 3D gyroscope, 3D magnetometer

Worn under clothes under the clavicle

Android and iOS apps

Sense-U

Daily energy expenditure, posture, sleep quality, falling events

Accelerometer, gyroscope, magnetometer

Clavicle

UPRIGHT GO 2

Posture tracking and upright posture coaching programme

Accelerometers, gyroscope

ViMove (dorsaVi)

Body movement, speed, posture tracking

Alex+

Feedback system

Table A2.1 Summary of current posture wearables66–68

* Prisca Winata is an architect, interior designer and green building consultant. Her interest in wellbeing and sustainable buildings led to her taking an MSc in Health, Wellbeing and Sustainable Buildings at UCL. This appendix is based on her MSc thesis: Assessing the Effectiveness of Wearables in Improving Spinal Posture and Musculoskeletal Conditions in Adults Working from Home.63

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poor posture or a slouched position is detected. On the last day, the vibration mode was switched off again to see how much participants’ posture had improved compared to day one.

Each day of the study, after participants finished working they captured the statistics page of the app. The data includes the average proportion of upright posture during the total duration of device training.

Post-monitoring interview questions 1. On average, how long did you keep your GO 2 device on your back each day?

2. How often did the device vibrate, comparing the first day and the last day?

Post-monitoring interviews were performed online, using Microsoft Teams to gather additional information and insights into participants’ experience of wearing the device, their perception of the posture wearable and to evaluate the study.

3. Have you noticed any improvement in your posture so far?

4. Do you feel that you are having less pain after using the device for five days?

5. Do you find any issue while using this wearable? (How to attach it, any discomfort, connection to mobile phone, etc.)

UPRIGHT GO 2 POSTURE TRAINER

6. Would you consider using a wearable of this type in the future?

Table A2.1 (see previous page) compares the most common posture wearables that are both used in medical settings and are commercially available. Lumo Lift and UPRIGHT GO 2 are easy to wear and are the most affordable devices in the UK. Although the Lumo Lift device has more inertial measurement units (IMUs) and is able to detect steps, travel distance and calories burned, the UPRIGHT GO 2 posture trainer was selected for this study because it is readily available in the UK. Also, the Lumo Lift device is worn under clothes near the collarbone, which depends on the thickness and looseness of the clothes and makes the tracking accuracy unreliable.69

7. Additional comments. ■

The UPRIGHT GO 2 posture trainer was launched in 2019. It is the second version of a commercial wearable, UPRIGHT GO, which aims to promote upright posture habits with its ‘training’ and ‘tracking’ mode. The device gives real-time vibrotactile feedback when it detects slouching positions in ‘training’ mode. The progress statistic only tracks the angle of posture in ‘tracking’ mode. The dimensions of the device make it convenient to attach to the upper back using a hypoallergenic adhesive, which is made from medical-grade silicone.

Participants were asked to set the vibration delay time to one‑minute to allow for more flexible posture variation and prevent stiffness over the spine. The vibration pattern and strength can be adjusted according to personal preferences.

The UPRIGHT GO 2 app is available in Android and iOS versions, which are very convenient for general public use. It can be synchronised to the app via a Bluetooth connection to show the daily progress report, including the percentage of time in an upright posture and the total time in a slouched and upright position.

The UPRIGHT 2 GO device Source: https://uprightpose.uk/products/upright-go-2

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RESULTS

100%

Among the six test participants, four reported improved posture after five consecutive days wearing the UPRIGHT GO 2 device while working at home. Two participants did not report any significant difference in the tracking results. One person reported feeling less pain in their upper back after the observation.

90% 80% 70% 60% 50% 40%

Figures A2.1 and A2.2 show the progress of the posture state and the average duration of wearing the posture wearable during the study. It can be seen that the percentage of time in an upright position improved by 10–30% after wearing the device for more than 3 hours a day on average for five working days. The posture improvement was not significantly changed among participants who had an upright posture and were physically active, as they easily achieved 90% upright position during the study. One participant reported that they had upper back pain due to a prolonged sitting position. After wearing the device for at least 4 hours a day for five consecutive days, they felt less upper back pain because they regularly corrected their posture as soon as the device vibrated. Participants who had poor posture and slouched most of the time while working at the computer at home reported that the device helped them to practice an upright position.

30% 20% 10% 0%

Day 2

Day 3

Day 4

Day 5

1

91%

93%

93%

92%

90%

2

28%

49%

51%

68%

38%

3

32%

34%

51%

42%

49%

4

65%

97%

99%

90%

5

30%

36%

86%

37%

6

93%

97%

90%

95%

60%

Figure A2.1 The percentage of time in an upright position over 5 working days while using the UPRIGHT GO 2 device

All participants became extremely aware of their position during the study and maintained their upright position as much as they could. On the first day, one participant reported that she was frustrated with the intensive vibration because she slouched a lot. There was also a comment about how tiring it was to maintain an upright position consistently for a long time. However, compared to the first day, all participants reported that the device vibrated less frequently throughout the end of the testing period.

8 7.5

7

Average duration (h)

6

However, there were issues about synchronisation and detection accuracy. One participant stated that it was tricky to attach the device in a correct angle on their back by themself.

Another participant said that they wore the device for at least 4 hours a day while working at the laptop, but the application only recorded 2.5 hours on average. They commented that there must be a problem with the Bluetooth connection that prevented it from synchronising correctly. A similar comment was made by another participant, who also found it difficult that they had to carry their phone all the time for the device to synchronise to the app.

5.9

5 4

4.4 3.8

3

3.5

2.5

2 1 0 1

Despite a temporary upright sitting habit from wearing an UPRIGHT GO 2, a concern about the long-term effect was raised by one participant, who commented that they might revert to bad posture habits when no longer wearing the device.

USE OF WEARABLES IN THE OFFICE A Review and Examples in Practice

Day 1

2

3 Participant

4

5

6

Figure A2.2 The average duration of wearing the UPRIGHT GO 2 device

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DISCUSSION

Whether at the office or at home, satisfaction with the working environment was likely to be related to wellbeing and happiness. This study provides support for the notion that people are able to adapt to their environment in any situation. Creating an optimum working environment requires a collaborative discussion with many stakeholders – not just architects and designers, but also building managers, building owners and the workers themselves. It is essential to ensure that the workplace is safe by adjusting the indoor environmental conditions and workstation equipment to match personal preferences. Thus, a health impact assessment should be done regularly in the workplace.

According to progress statistics and interview results, the UPRIGHT GO 2 was useful in improving posture problems by wearers developing a good posture habit. However, in contrast to earlier findings,70 there was minimal evidence in this study that the use of postural wearables reduces musculoskeletal pain.

The improvement in posture is affected in part by the vibration interval. The one-minute interval was set to remind the participant whenever they slouched for more than one minute.

This helped participants to become more aware of the deviant position and to correct their posture immediately. In the long‑term, wearers may develop a new habit of sitting upright as their muscles become gradually trained to sit upright. The habit will also likely improve physiological and psychological health outcomes, such as improved confidence level, mood, happiness and work productivity.71

These study findings will be beneficial to improving the design of posture wearables, and to developing ergonomic guidelines for workstation design and the use of wearable sensors during working time. The posture wearable provides insight and increases awareness to improve health. It is important to develop an understanding of the risk factors of posture problems and MSD to create a preventive strategy to reduce these among people working for prolonged periods in a sitting position.

It is essential to understand the risk factors for posture problems and MSDs to find opportunities for prevention.

The detection of an upright posture in the app depends on the wearer’s activity and position (standing, sitting, walking).

Unfortunately, the variation in activities was not tracked by the device.

This study provided some evidence that posture-tracking wearable devices like the UPRIGHT GO 2 encourage users not to slouch and to develop better postural habits. The UPRIGHT GO 2 and similar posture-tracking devices are beneficial for people who slouch too much, even when the device is used for only a short period. Nevertheless, there was insufficient evidence from the study that wearing the UPRIGHT GO 2 improves musculoskeletal problems, as the device only detects upper-body movement.

The limitations of the UPRIGHT GO 2 device were, first, it was difficult to compare the results between days because the angle of the device was different every day and the results depend on the wearer’s activity. Second, it is necessary to do a proper calibration each time the device is attached at the beginning of the day, and participants could recalibrate the device if their slouch and upright positions were not correctly identified.

Third, some people find it hard to reach their upper back and attach the device, which may result in inaccurate detection.

Fourth, relying on Bluetooth connection and battery life is inconvenient because the wearer’s phone needs to always be close to the device to keep it synchronised.

Furthermore, there is an issue with the availability of posturetracking devices. These devices can detect movement in different parts of the body by attaching sensors to the trunk, lower back, arms and legs. However, devices like this are expensive, and currently are only used in medical settings or athlete training programmes. There is a need for more tracking devices like the UPRIGHT GO 2 that are compact and easy to use, so that people are more likely to purchase them and benefit from their use.

Another issue that emerges from these findings is that wearables are only available to those who can afford the devices and a connectable smartphone, and this could lead to greater health inequalities. To minimise this, it is recommended that employers subsidise the cost of devices and applications that monitor fitness and health for employees.72

IMPLICATIONS FOR POLICY AND PRACTICE The COVID-19 pandemic has accelerated the trend for homeworking, and has fostered the opportunity for a mass experiment of remote working. These study findings have important implications for developing a new way of designing a workplace and a remote working scenario. Different work tasks require different environments. To maximise working performance and increase workers’ wellbeing it is essential to distinguish the tasks that can be done individually at home and those that require a collaborative approach in the office.

USE OF WEARABLES IN THE OFFICE A Review and Examples in Practice

In the future, wearables may become a feature of healthcare services, and the data they provide may be used to assist in consultations with health practitioners. Practitioners and researchers should work together to create a standardised device and validation programme. It is also important to work with the government and healthcare providers to discuss how to integrate and protect this valuable data.

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RECOMMENDATIONS FOR FUTURE RESEARCH

Based on the limitations of this study, further studies should include a larger sample size with a wide distribution of age.

Such studies should be done for a minimum of two weeks, as suggested by Upright Technologies. In future investigations, the inclusion of a matched control group would make it easier to quantify and compare results. Further research should also include long-term follow-up assessments of a prolonged slouched sitting position on posture and MSDs.

There are still many unanswered questions about the relationship between multiple interconnected variables. It is impossible to assess employee wellbeing and productivity only on the basis of posture problems and MSDs. Social interaction and job satisfaction also play significant roles in establishing better wellbeing. Further research should be undertaken to investigate the use of a comprehensive multisensory approach in assessing work type and physiological and psychological factors in order to identify other cofounding variables that are difficult to separate.

Wearable companies should keep innovating to produce a more affordable device with higher accuracy for public use.

The way in which posture-tracking wearables are attached to the body requires further research in order to provide more accurate tracking data (e.g. sensors embedded in clothing or even the body). It would also be interesting to develop a smart desk chair that can work as a posture trainer by detecting the positions of parts of the upper and lower body.

In addition, further studies are needed to identify the relationship between the different parts of the musculoskeletal system, not just the upper body parts. Furthermore, this study focused on the effect of physical health outcomes on wellbeing, and it would be interesting in future research to focus on other outcomes (mood, quality of life, confidence level, social interaction, etc.).

USE OF WEARABLES IN THE OFFICE A Review and Examples in Practice

If wearable devices are to be integrated in healthcare systems, more work is needed on validation programmes and the training required for healthcare practitioners, in order to ensure a greater degree of accuracy in the data collected. ■

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