NIOSH Scientists Examine Key Areas in Which Obesity, Occupational Safety Intersect

INCREASING evidence indicates that being obese or overweight may be related to and interact with work, and strategic research is needed to better understand and address those potential relationships and their implications for occupational health.

These are the key findings by 11 NIOSH scientists and an outside colleague in an article in the March issue of the American Journal of Public Health.

The article discusses the potential links between work, obesity and health, describes findings from scientific research to date, and notes current uncertainties that would need to be addressed for a clearer understanding of this complex issue.

According to the article, "Work, Obesity, and Public Health," nearly two-thirds of U.S. adults are considered to be overweight as classified by their "body mass index," a factor of height and weight. Given this public health concern, research aimed at understanding the relationship between obesity and occupational safety and health, and designing potential interventions to address both issues together, is increasingly important.

"Traditionally, practitioners have looked at 'wellness' and 'health promotion' in isolation from occupational health concerns arising out of work itself," said NIOSH Director John Howard, M.D. "Increasingly, however, in the face of spiraling medical costs, health professionals and scientists recognize that it makes sense to address health issues holistically."

Howard noted that the challenge of obesity as a national health concern is an area that presents an intriguing opportunity for occupational health and safety research. "The new article presents a strong case that continued research by NIOSH and others is warranted in this area, as a basis for determining whether, for example, there is any particular advantage to workplace interventions in addressing the prevalence of obesity in the United States," Howard said.

The article addresses key areas in which work, obesity, and occupational safety and health may intersect, according to available scientific evidence.

Association of work and work conditions with obesity and body weight

Little research has examined this issue to date, the article found. From the research that has been done, findings differ, as often occurs with early studies on complex questions. For example, of eight studies that looked to see if, statistically, an association existed between job stress and incidence of obesity in people employed in jobs involving high demand and low control, four studies showed a positive statistical association, and four did not.

In a review paper cited in the AJPH article, it was hypothesized that work may promote weight gain in three ways:

  • Job stress may be linked with alcohol consumption and sedentary leisure activity.
  • Psychological strain could lead to modification of hormonal factors related to weight gain.
  • Long work hours, shift work and overtime could result in fatigue, decreasing the amount of time that the individual may spend in physical activity off the job.

Potential impact of obesity on work-related disease and injury

According to NIOSH, there is some evidence that obesity may increase the risk of some occupational diseases, including musculoskeletal disorders, asthma and vibration-induced injury. Obesity also may alter the way the body responds to potentially neurotoxic chemicals and to challenges to the immune system.

The article noted that body weight and other variables related to physical characteristics may affect the utility of personal protective equipment, such as the ease with which a worker may use a respirator and the fit of fall-protection devices. However, it said little research exists on the potential impact of obesity specifically.

While scientists explore opportunities and needs for research to better understand the issues relating to work, health, and obesity, employers and others may find it useful to consider selective strategies that address work-related risk factors and obesity together, the article suggested. In doing so, decision-makers will face the challenge of addressing work, health, and obesity "without using approaches that are prejudicial, discriminatory, stigmatizing, or punitive," the article acknowledged. Such challenges may be met by designing work-site interventions that benefit all workers, such as diversifying food choices in cafeterias and snack machines, increasing opportunities for exercise, or reducing work-related stress for all employees, researchers stated in the article.

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