Although Silicon Valley and similarly innovative employers have made them sleeker or more outwardly playful and inventive, open office configurations are hardly novel. The practice of housing most or all of the workers at an office in one communal space, at their own desks or cubicles or at common tables with no reserved spaces, dates back to the 1950s. The idea was—and still is—that this setup should encourage communication and generate new ideas. It doesn’t hurt that doing away with individual, enclosed offices is also a huge money saver. Today, at least 70 percent of American offices use an open configuration, and the trend seems to be growing.
Predictably, open offices have come under repeated waves of scrutiny over the past several decades. The enduring consensus seems to be that such layouts may perhaps help to build a sense of common company identity, purpose, and approachability between teams or management levels, as intended. However, critics note that they are definitively distracting and uncomfortable for many workers, and can foster such a sense of lost control or ownership of space that they ultimately, and substantially, increase workers’ stress and hurt their productivity.
For all the research conducted on the impact of open office configurations on workers over the decades, though, academics and critics have paid surprisingly little attention to how they might affect people’s health. According to a literature review conducted last year, only four studies undertaken since the millennium have meaningfully and directly explored the link between open offices and illness—and few of them were especially robust. But we do know enough about how pathogens spread, how stress affects human bodies, and how people interact with their workplaces to say that open offices likely pose a more substantial health risk to workers than closed, individual offices, if office managers don’t take active steps to mitigate this layout’s unique complications.
Two of the most influential and widely reported studies on the relationship between open offices and health explored the different number of sick days workers in different office layouts took over time. One published in 2011, using a national survey from Denmark, found that workers in open offices took 62 percent more sick days than those in fully enclosed offices; the other, from Sweden, circa 2014, found that those in several types of open offices took significantly more short-term sick leave than those in private offices.
Two lesser-reported studies looked into self-reported health. One, published in 2015, examined a small cadre of Swedes as they moved over the course of 12 months from private offices to an open plan and found that they believed their health had deteriorated. Another, published in 2016, looked at a couple hundred Germans working in similar jobs but different office layouts and found that, based on their answers to an online survey, those in more open layouts reported worse general health and wellness.
These studies make for compelling headlines, and may seem like a clear-cut case against open offices on health grounds alone. However, Ann Richardson, the University of Canterbury public health expert who co-conducted the 2017 literature review on this topic, points out that none of these studies established causation, showing what about open offices might lead to increased risks of illness. At best, they speculated about easier exposure to germs and the possible role of stress.
Sick days taken can be misleading because people take sick days for a variety of reasons beyond actual illness, notes Kelly Reynolds, an expert on disease transmission at the University of Arizona who has studied illnesses in offices. It is entirely possible that general dissatisfaction with open offices, rather than negative health outcomes, led workers to call in sick more often. Likewise, self-reported surveys—capturing self-perceptions of or proxy measures for health—might be biased by general glumness about open office conditions, without reflecting real ill health.
Despite the paucity of clear studies on the topic, Reynolds says that open offices still logically seem like they would lead to more health risks for workers. The increased interaction fostered in an open office, she says, just means “you’re also going to increase workers’ contact potential and that they’re going to be in each other’s spaces. That’s a clear route of germ transmission.”
Likewise, private offices may have their own ventilation systems. But “with the open area,” Reynolds says, “you have the same air going across” everyone’s cubicles or desks or other work spaces. This one pool of shared, forced air can increase disease transmission risks as well. Reynolds also suspects that, in open offices that use a "hot desking" system where no one has a permanent workspace, employees may feel less responsibility for keeping their office space clean. This may lead to less rigorous basic hygiene maintenance, and thus more germ buildup.
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The well-documented increased stress many workers experience in open offices, whether due to distractions, a lack of personal space, or any other factors, could easily wear away at their health, too. “We have done studies,” Reynolds says, “with high stress occupations like nurses and we absolutely know that increased stress levels lead to an increased vulnerability to infections and diseases,” even if the exact mechanisms of that link are not absolutely clear.
Studies on stress in open offices have also suggested that anxious workers’ posture suffers, which may lead them to develop more musculoskeletal disorders down the line. We also know that many open office workers report working late so they won’t be the first person seen leaving, especially if their boss has a clear line of sight to them. This clashes miserably with findings that working over 10 hours a day can increase risks of heart complications over time.
None of this tells us anything about how much higher the risk of illness, or long-term health issues, might be in an open than an enclosed, private office setup. Reynolds notes that even private offices often have a common room, which most employees visit. If just one sick person comes to work, her research demonstrates, at least half of that space and other common use surfaces will be contaminated by lunchtime. It is unclear how much increased common space and air would goose up that near-universal office illness risk, or how open office stress might nudge the dial on health risks. But open offices likely carry at least some increased health risks.
That doesn’t mean these risks and subsequent illness are unavoidable, though. Just as open office advocates argue that company culture can control the variables that can lead to lowered productivity in such a workspace—say, by creating and policing norms about noise levels, when and where to take calls, and respecting personal space—Reynolds believes strong values and simple initiatives can control the variables increasing workers’ risks of illness in such offices.
“The impact of just basic hygiene and wellness interventions, where the employer just provides, like, surface disinfection wipes and hand sanitizer, and education about, ‘don’t forget to wash your hands, this is good for your health,’” Reynolds says, “have resulted in up to an 80 percent reduction in different illnesses in the offices we’ve studied,” regardless of their layout.
“For the real transmission of germs factor,” not the stress or mental factors that may play into increased risks of illness, Reynolds says, “it doesn’t really matter how a space is designed, if you’re intentional about implementing hygiene controls,” even basic ones like these.
Company culture may also help to eliminate risk factors beyond germ transmission routes. Controlling behaviors that lead to stress could reduce some potential for increased illness in workers while they’re in or out of the office. So could creating a culture, says Reynolds, in which employees feel free to leave and work from home, or take sick days, as soon as they feel ill without worrying about any form of implicit or explicit penalization. (At least a fourth of American office workers currently go to work sick, according to one recent study.)
If people only come to work when they are healthy, she stresses, then the risk of spreading illness should be equally low in either enclosed, private, or entirely open office layouts. The freedom to work from home if one is feeling sickly-stressed in an open office setup could also reduce personal illness risks.
Every office should try to create a culture that promotes personal hygiene and cleanliness and that allows workers the flexibility to avoid the office if they’re feeling too stressed or ill, Reynolds says. Those running open offices just “have to understand that control has to come with a greater degree of intentionality,” given the vague but likely increased risk factors at play in their workplaces.
That sort of vigilance doesn’t seem like a huge imposition. But we won’t fully understand how much effort open offices need to sink into maintaining health for their employees relative to offices with private, enclosed spaces until we conduct more robust studies on how much each potential risk factor in an open layout can impact workers’ wellbeing. From there, businesses can calculate if the benefits of cost-saving and culture they see in open offices still outweigh the cost of the health risks they lead to, and of avoiding them.
This article originally appeared on Tonic.