Participants in interviews and baseline characteristics in questionnaires

In total, 77 unique participants (73% women, 27% men) aged 30–63 participated in the interviews. Of the total 77 participants, 62 were employees and 15 were managers. Among the 62 employees, 19 persons participated in more than one interview, and five of the 15 managers participated in more than one interview.

Of the respondents to the questionnaire, 67% were women, and 26% were managers. At baseline, 51% of participants rated their health as “very good” or “excellent”, while 23% reported discomfort in the neck and shoulders either “often” or “all the time” (Table 1).

Table 1 Baseline characteristics of participants (N = 152)Results from interviews and questionnaires

The qualitative results drive the presentation of the data. Where applicable, quantitative findings from questionnaires are interwoven. The qualitative analysis resulted in two themes. The first theme, reorganising Occupational Health and Safety management, includes the subthemes needing new processes and clarification of responsibilities and managers navigating the new environment. The second theme, one size does not fit all, includes the subthemes managing the body in a shared environment and challenges of different needs in the workforce. Themes, subthemes, and categories are presented in Table 2. Further description and clarification of themes and categories are unfolded in the text.

Table 2 Themes, subthemes, and categories based on interview data, analysed by qualitative content analysisReorganising occupational health and safety management

In this theme, the results highlight how Occupational Health and Safety (OHS) management needed to be reorganised in the AFO, how managers strived to adapt to the new environment, and the challenges these adaptations entailed.

Needing new processes and clarification of responsibilities

In the category unclear roles, rules, responsibilities, and routines, it was described as unclear who had the overall responsibility for the work environment and who was responsible for the processes involved in making changes to the work environment. Neither managers nor employees knew how OHS management was organised or who was responsible for what. Informants described how the shared environment created the need to handle OHS in new ways, with more complex coordination of stakeholders. As an example of the ambiguities in responsibility, employees described it as unclear how to report deficiencies in the work environment, and it was also unclear who was responsible for solving the problem. Employees found this frustrating and annoying, while others expressed a sense of resignation.

In an environment like this, it becomes even more important to be clear. We cannot act as individual islands anymore. It requires more cooperation, better structure, and professionalism. (Manager, interview 5)

The category a need for restructured safety inspections describes the changed prerequisites for carrying out safety inspections. Before relocation, regular safety inspections were held by managers and safety officers in each department. Eighteen months after relocation to the new premises, no safety inspection had been held, and it was still unclear who was responsible for initiating and leading the development of new routines. Informants discussed the challenge in finding new ways to carry out safety inspections, both concerning which stakeholders should be represented, and how to create updated routines and protocols.

“Safety representatives ought to be independent from organisational divisions. The safety representative should represent the whole workplace, regardless of who is sitting where.” (Employee, Focus group 12, 18 months)

In the category digital solutions are needed for the flex office to be used as intended, informants explained that the perception of the office’s functionality depended on work tasks and to what extent digitalised work processes were implemented in departments. Employees working with non-digitalised work processes did not perceive the AFO to be supportive. As an example, employees who mainly worked with papers and binders described how they spent more time packing, unpacking, and carrying work materials. Regarding the possibility of storing work material, some perceived the available cabinets to be sufficient, while others found them to be too small. The use of the cabinets seemed to work well for employees who mainly worked in digitalised processes, while employees working with paper and binders were more critical of the cabinets’ storage capacity.

“I work with mail and paper and registration. My desk is full of papers. I cannot keep moving around. I feel rootless, a little stressed, I have to find a place for my papers.” (Employee, Focus group 3, 6 months)

“I usually work with digital processes and have been forced to become even more digital. It works really well.” (Employee, Focus group 6, 6 months)

Questionnaire data showed that 80% of participants reported having enough space for work material at baseline. This decreased to 38% at follow-up (Table 3).

Managers navigating the new environment

In the category new strategies come without guidance, managers described how the AFO imposed difficulties when it came to handling their subordinates’ work environment issues. After relocation they found it more complicated to help their subordinates with workplace adaptations, as there were no clear guidelines or policies to follow. They tried to support their subordinates and to solve problems as they went along, but due to the shared premises across departmental boundaries, combined with a lack of clear processes and responsibilities, managers perceived that there were limited opportunities to act, leading to frustration among both managers and their subordinates. Managers received some support from human resource departments when they needed help on individual cases, but often they had to come up with solutions themselves.

“My picture is that individuals with special needs are dealt with case-to-case. It’s done in a positive spirit.” (Manager interview 4)

In the category imbalance between responsibility and mandates, managers described it as more complicated to take responsibility for their subordinates´ work environment, due to an imbalance between their responsibilities and their mandate to address issues with the workplace environment. They describe situations where they wanted to make adaptations for a subordinate but did not receive any response from top management regarding their inquiries on how they could and should proceed. This led to difficult situations for managers, since they had a responsibility to adapt the work environment according to their subordinates´ needs, but at the same time, they had limited mandates to decide on changes in the shared environment. This imbalance created worse conditions for managers, especially among first-line managers.

One size does not fit all

This theme explores how the physical work environment, both upsides and challenges, was perceived after relocation to the AFO. Results also describe how the AFO was perceived in relation to a variation of needs.

Managing the body in a shared environment

In the subcategory individual preferences for temperature and lighting, the indoor environment was reported to be satisfying overall with very good air quality. On the other hand, premises were also described as cold, and informants explained that they often felt cold and used more clothing to keep warm. Temperature differed within the office, and small rooms were perceived as warmer. The office area was perceived as bright, and access to daylight was perceived to be satisfactory, especially on the top floor. Lighting was perceived as unevenly distributed, where some places were perceived as ‘dark’ (desk booths), and participants desired individual desk lights at workstations. The automated lighting was perceived as problematic. It was difficult to understand how to use the light switches, and when turning on a light switch, several areas of the office were affected.

“The indoor air is fantastic here!” (Employee, Focus group 5, 6 months)

“And then these light switches, you can’t find them, and you don’t know which button to press. And then, suddenly, you turn the light off…” (Employee, Go-along interview 5, 6 months)

“…everything works well except that the light is uneven…as I am getting old and need a lot of light.” (Employee, Go-along interview 6 months)

In the questionnaires, access to daylight was rated lower after relocation (p < 0.001). The perceptions of lighting quality showed no change after relocation for the whole group (p = 0.119), but employees ≥40 years (p = 0.031) of age reported worse lighting after relocation, while employees 20–39 years did not (p = 0.397) (Table 3).

Table 3 Results for space for work material, daylight, and lighting at baseline and 18 months after relocation

In the category time, space, and equipment as barriers for good ergonomics, employees described the ergonomic conditions as being generally good, with great possibilities for variation between sitting, standing, and walking. At the same time, they perceived office ergonomics to be deteriorated and less of a priority than before, and there were some concerns expressed about what the ergonomic consequences might be in the long run. Some thought it was difficult and time-consuming to adjust the chairs and often they choose not to. Instead, they chose to stand up while working, use another chair, or sit at the front edge of the chair. There were also employees who reported that they always took the time to set up their workstation; i.e., due to previous experience with poor ergonomics or problems with musculoskeletal symptoms.

”It takes time to adjust the chair, it’s hard. And you twist and twist and they are hard, and it probably takes 20 minutes. And I must look at the instruction manual every time…” (Employee, Focus group 11, 18 months)

“I always adjust my workstation. I try to be aware of this because I have problems (musculoskeletal symptoms)” (Employee, Focus group 11, 18 months)

“It’s difficult, I can only encourage them to stand up and try to vary their work posture. But from what I hear, many do not have the patience to adjust the workstations. You make some small adjustments, raise and lower the desk a little, move the monitor arm a little, but I’m not sure how much you can really customise it to your own needs”. (Manager interview 6)

Overcrowding and lack of workstations also affected office ergonomics, and informants explained that they did not always find an ergonomically suitable workstation and were forced to work on a sofa, or in the breakroom or other shared spaces, without any possibility of adjusting their chair or table or connecting the laptop to an external monitor. For example, sitting on the sofa working on a laptop led to forward bending of the neck. Other obstacles mentioned were that the technical settings on the computer could be spoiled when switching workstations if the computer had not been docked. This made employees remain at the same workstation instead of switching.

“… you only use the sofas if there’s no other workstation available.” (Employee, Go-along interview 2, 6 months)

Ratings for sit comfort and work posture decreased significantly after relocation. This decrease seemed to be driven by older employees, persons with neck- and shoulder symptoms at baseline, and women (Table 4 and Supplementary Table 2).

Table 4 P-values for perceived changes in sitting comfort, working posture, and musculoskeletal symptoms at baseline compared to 18 months after relocation in the whole group and different subgroups

In the category, pain and how to handle the new environment, some employees report that they had more problems with headaches and back, neck, and shoulder discomfort or pain after relocation. They believed that the increase was due to difficulties adjusting the workstation. Their symptoms were triggered when the current workstation was not adjusted correctly, or when working mainly on a laptop. Informants also mentioned that they tended to sit closer to the laptop screen when doing high-concentration work.

Employees report different strategies for managing discomfort and pain in the new office. Some used the treadmills in the office to relieve back pain, while others appreciated the daily digital prompts for exercise programs. Other informants, however, felt exposed when using the exercise program in the open office environment. To achieve good ergonomic conditions and avoid discomfort and pain, individual responsibility and self-care were mentioned as being more important in the new office environment. To achieve a sustainable situation, some employees claimed a personal room or described leaving their things at the same workstation to ‘keep’ the workstation for the whole day.

“I’ve got more problems with my neck, shoulders, back, and everywhere. I’m sitting badly. I’ve had problems before and then my chair and table were adjusted to my needs. Now it’s hard to adjust all the settings every morning…” (Employee, Focus group 6, 6 months)

“…instead, I have become more selfish and pick a quiet workplace or a room of my own as quickly as I can, and don’t bother to change during the day.” (Employee, Focus group 11, 18 months)

The questionnaires showed a significant increase in reported neck and shoulder discomfort between baseline and 18 months (p < 0.007) in the whole group (Supplementary Table 3). Subgroup analysis revealed that the increase in reported neck and shoulder pain seemed to be driven by younger employees; employees that reported to never, seldom, or sometimes experience neck and shoulder symptoms at baseline; and by women (Table 4). Those who reported musculoskeletal discomfort and muscular tension at 18 months after relocation also reported fewer possibilities to adjust their workstation ergonomically compared to those who did not (Supplementary Table 4).

Challenges of different needs in the workforce

In the category, various needs and preferences depending on work tasks, employees described that the type of work tasks affected the extent to which they took advantage of the new office. Employees who mainly worked on stationary screen-based work found no incentives to change workplaces during the day. In contrast, those attending many meetings needed to find new workstations between meetings, which could be a challenge, due to crowdedness. Employees with high-concentration work tasks complained that they spent time finding secluded rooms or a quiet place so they could concentrate. The possibility of arriving early at the office to secure a suitable workstation was described as a problem, as it was not possible for everyone to arrive early.

In the category various needs depending on cognitive and physical disabilities, there was a critique that individual adaptation needs were not mapped and considered sufficiently before relocation. It was emphasised that this should have been considered already during the planning phase, to be able to account for and accommodate the premises for various needs. Furthermore, it was perceived as difficult—for both employees and managers—to decide when an individual adaptation was needed, and in what cases the individual could handle their individual adaptation in the shared office environment without a targeted adaptation.

Employees perceived it to be more complicated to obtain individual ergonomic aids in the new office environment after the relocation. The reasons for this could be that they did not receive any response from management, or that they simply did not know how to go about requesting an adaptation. Some also felt hesitant about expressing their needs due to concerns about feeling singled out or stigmatised; for example, if a personal room was desired. Furthermore, it was described as easier to ask for equipment and support for physical problems than for psychological issues. Another barrier that was mentioned in the interviews was that it could be burdensome to carry around physical aids (e.g., chairs, armrests, mice, etc.) and that it took time to install them.

“The basic mistake is the insufficient mapping of needs (depending on various work tasks)…The needs vary. I think that a mix of activity-based and cell offices had been better. But the perfect office does not exist…” (Employee, Focus group 10, 18 months)

”It has to be equal for everybody, but we are all different.” (Employee, Focus group 7, 6 months)