Prevalence of obesity by occupation among US workers: the National Health Interview Survey 2004-2011

Prevalence of obesity in religious clergy in the United States: A systematic review and meta-analysis

OBJECTIVE

This systematic review aims to summarize the current body of evidence concerning the prevalence of obesity among clergy (i.e., the officially designated leaders of a religious group) in the United States.

METHOD

From November 2022 to February 2023, five databases, one data repository, and gray matter were searched for articles and data sources. The search was restricted to articles published or raw data collected from 2001 to 2021. Study quality was assessed with a template, and heterogeneity was assessed using the I 2 statistic. The protocol for this review was registered with PROSPERO (CRD42022376592).

RESULTS

Forty-seven studies of clergy obesity involving 35,064 individuals were eligible. The pooled prevalence estimate of obesity across studies was 34.8% (95% confidence interval [CI]: 32.5-37.2). Obesity prevalence was found to be increasing over time and to vary considerably between clergy from different religious traditions. Compared to national estimates, from 2005 onwards, obesity prevalence was higher than in the US adult population.

A randomized comparison of recruitment messages for a weight loss clinical trial targeting men working in trade and labor occupations

Background

Engaging diverse populations in clinical trials is vital to research. This study evaluated the effects of varying recruitment messages for a clinical trial.

Methods

The messages were evaluated in a randomly assigned, factorial design that tested enhanced trust (vs. standard) and participant endorsement (vs. standard) messaging.Four postcards were developed and randomly assigned to 4000 potential participants' addresses. Except for the messages of interest, the cards were identical, and participants were directed to four identical study websites and screening forms. Outcomes include unique website visits, visit conversion rate, screening forms completed, and participants randomized into the parent study.

Results

Study websites received 74 visits (range by message type 9 to 34). There was no significant difference by message type (p = 0.79). Online screening forms were completed by 15 participants (range by message type 0-6), representing a conversion rate of 20.3% of website visits. Seven participants were randomized into the study in response to the postcards (range by message type 0 to 3; 46.7% of screenings). Overall, 0.2% of individuals who received a postcard were randomized into the study.

Conclusion

Despite developing recruitment messages with participant input, the enhanced messages did not yield a greater response than standard messages. However, this method of evaluating recruitment messages shows promise.

A Comprehensive Evaluation of Occupational Epidemiology in Western Iran: A Cohort Study in Ravansar Noncommunicable Diseases

OBJECTIVE

The present study aims to evaluate the prevalence of noncommunicable diseases (NCDs), biochemical and anthropometric indicators, and lifestyle among 10 occupational groups.

METHOD

The sample included 4818 men aged 35 to 65 years. The occupational group is based on the International Standard Classification of Occupations.

RESULT

The highest prevalence of cardiovascular diseases and type 2 diabetes mellitus was observed in managerial occupational groups (18.62%) and technicians and associate professionals ( 14 %), respectively. Musculoskeletal disorders were more in skilled agricultural, forestry, and fishery workers, as well as craft-related trades workers, and elementary occupations. The highest body mass index was related to the managers.

CONCLUSIONS

Noncommunicable diseases were higher in managers, while musculoskeletal disorders belonged to farmers and workers. Finally, lifestyle modification can help reduce NCDs and improve biochemical markers by increasing physical activity.

Weight Status and Binge Drinking Among Male and Female Florida Firefighters

OBJECTIVE

The aim of the study is to examine the association between weight status and binge drinking among Florida firefighters.

METHODS

Health survey data collected between 2015 and 2019 among Florida firefighters participating in the Annual Cancer Survey were analyzed for weight class (healthy, overweight, obese) and binge-drinking behaviors. Binary logistic regression models were fit and stratified by sex while controlling for sociodemographic and health characteristics.

RESULTS

Among 4002 firefighter participants, 45.1% binge drink, 50.9% are overweight, and 31.3% are obese. Among male firefighters, being overweight (adjusted odds ratio = 1.34; 95% confidence interval = 1.10-1.64) or obese (1.29; 1.04-1.61) was significantly associated with binge drinking compared with healthy weight counterparts. In female firefighters, being obese (2.25; 1.21-4.22) was significantly associated with binge drinking but being overweight was not.

CONCLUSIONS

Being overweight or obese is selectively associated with binge drinking among male and female firefighters.

Examining the effect of parent participation in an adult weight management program on changes in children's weight

Children of parents participating in weight management programs (WMPs) are more likely to adopt their parents' weight control practices. Little is known about the weight outcomes of children who have a parent participating in a WMP. This study aimed to assess this relationship. Children 2-17 years of age with a parent who participated in a WMP were included in the study. Multilevel linear mixed-effects regression models were used, stratified by child weight status at the time of parental WMP participation (healthy weight, overweight/obesity) to determine change in children's BMIz from before to after parents WMP participation, including covariates of parent BMI and parental feeding practices. Parents (N = 77) were mostly white (76%) and female (84%). Children (N = 114) had a mean age of 10.5 ± 4.6; 47% had overweight or obesity. Children with overweight or obesity prior to their parent's WMP had a decrease in BMIz (-0.68) after the WMP while children with a healthy weight had no significant change. Children with overweight or obesity had a decrease in BMIz from before to after parent's participation in a WMP. Further research is needed to understand changes in family eating practices that occur during and after parent WMP participation.

Primary Prevention of Weight Gain Among New Bus Operators: Results of the "Success & Health Impacts For Transit operators during Onboarding" (SHIFT Onboard) Pilot Study

OBJECTIVE

This study aimed to test the feasibility and efficacy of an enhanced onboarding intervention to prevent weight gain and support the early job success of new bus operators.

METHODS

Control participants ( n = 9) completed usual practice new employee training and onboarding. Intervention participants ( n = 14) completed five supplemental trainings and four online challenges during their first year. Primary outcomes were body weight, dietary behaviors, physical activity, and sleep duration/quality. Early job success was evaluated with measures of newcomer adjustment.

RESULTS

The difference between intervention and control participants in body weight change at 12-month was -6.71 lb (Cohen's d = -1.35). Differences in health behavior changes were mixed, but newcomer adjustment changes favored the intervention group.

CONCLUSIONS

Results support the feasibility of enhanced onboarding for bus operators to prevent worsening health while simultaneously advancing their success as new employees.

Prevalence and associated risk factors of overweight and obesity among adult population in Dubai: a population-based cross-sectional survey in Dubai, the United Arab Emirates

OBJECTIVE

To study the prevalence of overweight and obesity and determine the associated risk factors among adults in Dubai.

DESIGN AND SETTING

A cross-sectional survey with a multistage, stratified random sampling design was conducted in the Emirate of Dubai in 2019.

PARTICIPANTS

The study included 2142 adults aged 18+ years in the Emirate of Dubai.

RESULTS

The overall prevalence of obesity, which was defined as body mass index (BMI) ≥30 kg/m², was 17.8%. The highest obesity rates were reported among women (21.6%) and the United Arab Emirates (UAE)-nationals (39.6%). Moreover, 39.8% of the population was overweight (BMI ≥25-29.9 kg/m²). Multivariate logistic regression showed associations between obesity and age, sex, nationality, hypertension and occupation. Obesity increases with age, with the highest risk at age group 50-59 years (OR 4.30; 95% CI 1.57 to 11.78) compared with the reference group (18-24 years). Females had a higher risk of obesity than males (OR 1.62; 95% CI 1.10 to 2.38). Compared with those in the reference group (Western and others), UAE nationals, other Arabs and Asians were more likely to be obese ((OR 2.08; 95% CI 1.18 to 3.67), (OR 3.61; 95% CI 2.41 to 5.44) and (OR 1.98; 95% CI 1.12 to 3.50), respectively). Clerical and service workers (OR 4.50; 95% CI 2.54 to 8.00) and elementary and unskilled occupation categories (OR 2.57; 95% CI 1.56 to 4.25) had higher risks of obesity than the reference group (professionals), p<0.01). Hypertensive individuals had a higher risk of obesity than normotensive individuals (OR=3.96; p<0.01).

CONCLUSIONS

Obesity and overweight are highly prevalent among adults in Dubai and are remarkably associated with sociodemographic and behavioural risk factors. Comprehensive strategic initiatives are urgently needed to control obesity in the high-risk populations in the Emirate of Dubai.

Association of alcohol use and dietary lifestyle of commercial drivers during the COVID-19 pandemic in Nigeria

BACKGROUND

Alcohol intake, particularly to cope up with stress and depression experienced by commercial drivers during the peak of the COVID-19 pandemic, is alarming as a rise in sales has been reported in certain countries during the quarantine. Alcoholism leads to malnutrition, either because those involved consume an insufficient amount of essential nutrients or because alcohol and its metabolism prevent the body from properly absorbing, digesting, and using those nutrients. This study was carried out to assess the association of alcohol use and dietary lifestyle of commercial motor drivers during the pandemic.

RESULTS

The anthropometric studies revealed that 69.5% of the respondents fall within the range of 18.5-24.49 indicating that they have normal weights. 63.5% reported daily consumption of alcohol, and 51% claimed that it does not affect their appetite, while 64.5% of the respondent stated that alcohol does not present them with any health problems. There was no significant association between the consumption of alcohol and nutritional status (p > 0.05), but a significant association between dietary lifestyle patterns and the nutritional status of participants was recorded (p < 0.05).

CONCLUSION

It is, therefore, essential that commercial drivers are given adequate information and guidance on improving their dietary lifestyle.

Metabolic and Obesity Phenotype Trajectories in Taiwanese Medical Personnel

The distribution of metabolic and obesity phenotypes in Taiwanese medical personnel is unknown. In this study, trajectory analysis with repeated measurements was used to explore the development and associated risk factors of different metabolic and obesity phenotypes in hospital staff from a Taiwanese medical center. The results demonstrated that metabolically unhealthy workers presented with a higher body mass index (BMI) compared with their metabolically healthy counterparts. Male and aged > 40 years hospital workers were more likely to be in a deleterious metabolic/obesity state. Meanwhile, profession and working hours were not significantly associated with the development of certain phenotypes in our study. These results shed light on the necessity of adequate data retrieval regarding working hours, and a nuanced examination of working conditions among different professions. Our findings are helpful for the development of advanced guidance regarding health promotion in hospital workers.

"Abdominal panniculectomy: Identifying complications and potential risk factors"

BACKGROUND

The abdominal panniculectomy is a common procedure that patients choose to undergo for the purpose of restoring hygiene, reducing infection, and improving personal esthetic. A panniculectomy is often indicated after bariatric surgery, which defines a high-risk patient population. This study sought to better establish the association of known risk factors that can complicate the postoperative care of the panniculectomy patient, and whether or not bariatric surgery plays a role in the development of these complications.

METHODS

Patients that underwent a panniculectomy between 2010 and 2018 were identified in PearlDiver, a national insurance-claims database, and identified by CPT code 15,380. Patient demographics and associated medical problems were elucidated, and various complications were then identified. Descriptive statistics as well as a multivariate analysis were used to evaluate the association of risk factors and complications.

RESULTS

A total of 8,282 panniculectomy patients were identified. Of these, 1,420 underwent bariatric weight loss surgery prior to their panniculectomy, whereas the remaining 6,869 underwent a panniculectomy alone. Obesity, tobacco use, and diabetes were significant in developing a surgical site infection, wound disruption, and the need to undergo reoperation. Charlson Comorbidity Index greater than one (CCI>1), male gender, age greater than 60, COPD, and HTN identified as potential risk factors in developing various complications. Although patients with prior weight loss surgery had a history significant for prior comorbidities, the overall postoperative complication rate was decreased compared to those who did not undergo preoperative bariatric surgery.

CONCLUSION

In the face of the obesity epidemic, the incidence of undergoing a panniculectomy has increased significantly, particularly following bariatric surgery. Identifying potential risk factors in this patient population could better help identify postoperative complications following a panniculectomy and perhaps allow for targeted intervention and medical optimization prior to surgery.

[Health risk behaviors by occupation in working population in Spain]

OBJECTIVE

This study aims to analyze the variations in the prevalence of different health risk behaviors according to occupation in working population in Spain.

METHOD

Cross-sectional study with data from the Spanish National Health Survey of 2017. The analysis includes adults between 18 and 65 years with employment at the time of the survey. Health risk behaviors are obesity, physical inactivity in free time, tobacco consumption and excessive alcohol consumption. The primary explanatory variable is the occupation, using the National Classification of Occupations of 2011. Sociodemographic characteristics are gender, age, country of birth and educational level. The prevalences (P) of risk behaviors have been calculated, as well as the odd and adjusted odds ratios (aOR).

RESULTS

The highest figures of obesity are observed in operators of installations and machinery and assemblers (P: 20.0%; ORa: 1.26; A95%CI: 1.04-1.52). The higher level of physical inactivity during free time appears in elementary occupations (P: 83.4%; ORa: 1.70; A95%CI: 1.45-1.99). Tobacco consumption is higher in operators of installations and machinery and assemblies (P: 37.4%; ORa: 1.22; A95%CI: 1.05-1.43). Excessive alcohol consumption appears to a greater extent on skilled workers in the agricultural sector, livestock, forestry and fisheries (P: 3.9%; ORa: 1.51; A95%CI: 0.83-2.75).

CONCLUSIONS

The results indicate a greater relationship between risk behaviors for health and manual or lower-skilled occupations.

Obesity impacts on task performance and perceived discomfort during seated foot target reaches

This study examined obesity impacts on task performance and perceived discomfort during seated foot target reaches. Three independent variables, participant group, movement distance, and, movement direction, were considered. The task performance measures employed were reaction time, movement time and task performance time. Perceived discomfort was measured using a modified Borg CR-10 scale. Statistical analyses revealed that: obesity was associated with increases in movement time, reaction time and performance time; movement distance significantly affected the three task performance measures and discomfort rating; and, movement direction significantly affected movement time, performance time and discomfort rating. The obesity impacts observed are thought to reflect the decelerating effects of the extra fat mass in the obese body during foot reaches and possibly obesity-related physiological and cognitive changes. Design improvements of foot-operated systems, such as reducing distances to targets, increasing target sizes and avoiding forward foot reaches, may help counteract the observed obesity impacts. Practitioner Summary: This study empirically investigated the obesity impacts on task performance and perceived discomfort during seated foot target reaches. Obesity was found to be associated with increases in movement time, reaction time and performance time. The observed obesity impacts seem attributable to the anthropometric, motor and cognitive characteristics of the obese.Abbreviations: ANOVA: analysis of variance; BMI: body mass index; ROM: range of motion; Borg CR-10: Borg's category ratio 10 scale.

Bus Operators' Body Weight Changes During Their First 2 Years of Work: A Retrospective Survey

OBJECTIVE

To empirically assess retrospective reports of weight changes during bus operators' first years on the job, and to investigate experienced and desired training topics for new operators.

METHODS

Bus operators (n = 261) completed an online survey on topics of early weight changes and training experiences.

RESULTS

Operators reported gaining an average of 7.64 lb (SD = 16.36) during their first year. Further weight gain was not reported during the second year. Most operators reported that health-related topics were not addressed during their initial training. Stress management and healthy eating were the operators' two most desired topics to be included in their initial training.

CONCLUSION

Bus operators reported medically meaningful weight gain during their first year of work and a desire for more health-related training. Objective research to document the magnitude of this hazard, and contributing working conditions, is needed.

Improving the Dietary Intake of Healthcare Workers Through Workplace Dietary Interventions: A Systematic Review and Meta-Analysis

The workplace has been identified as a potential location for dietary intervention delivery due to the amount of time spent and the meals eaten in this setting. It is recommended that interventions are tailored to specific occupational groups, and to date, there is limited synthesis of the evidence relating to healthcare workers. This review characterises and evaluates the effectiveness of dietary interventions in healthcare workers to aid the design and implementation of interventions. The MEDLINE database was searched to September 2020. The reference list of an umbrella review was hand searched for additional titles against inclusion criteria. The search included i) population, ii) intervention and iii) work environment. Studies were assessed for risk of bias. Harvest plots and Forest plots were created to display study quality, direction and size of effect of selected primary (energy, fruit and vegetable and fat intake) and secondary outcomes (weight, body mass index, blood pressure and serum cholesterol levels). Thirty-nine articles assessing thirty-four interventions were eligible for inclusion. Intervention types most commonly used were environmental, educational, educational plus behavioural, and behavioural. Due to the heterogeneity in study design and intervention type, results were largely inconclusive. For dietary outcomes, interventions produced small-moderate favorable changes in fruit, vegetable and fat intake. Decreased fat intake was mainly observed in environmental interventions and increases in fruit and vegetable intake were observed when an educational or/and behavioral component was present. Interventions producing weight loss were mostly non-randomised trials involving education and physical activity. Total and low-density lipoprotein cholesterol decreased in interventions involving physical activity. Meta-analyses revealed significant decreases in energy intake, weight, blood pressure, total cholesterol, and LDL cholesterol in non-randomised trials where data were available. Much more research is needed into strategies to promote diet quality improvement in healthcare workers. Statement of significance: It is recommended that workplace dietary interventions are tailored to specific occupational groups. To our knowledge, this is the first review to examine the effects of dietary workplace interventions in healthcare professionals. Small-moderate favourable changes in fruit and vegetable intake can be achieved when an educational or/and behavioural component is included in the intervention. For weight loss, interventions involving nutrition education and physical activity in addition to a dietary component show benefit. In the studies reviewed, a high level of heterogeneity was evident and insufficient information reported to ascertain potential bias.

Influence of Nutrition, Food and Diet-Related Interventions in the Workplace: A Meta-Analysis with Meta-Regression

OBJECTIVE

To review the scientific literature on the influence of verified nutrition, food and diet interventions on occupational health.

METHOD

This study involved a critical analysis of articles retrieved from MEDLINE (via PubMed), Embase, Cochrane Library, PsycINFO, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS) and Medicina en Español (MEDES) using the descriptors "Diet, Food, and Nutrition" and "Occupational Health" and applying the filters "Clinical Trial", "Humans" and "Adult: 19+ years"; the search was conducted on 29 May 2021.

RESULTS

A total of 401 references were retrieved from the bibliographic databases, with an additional 16 identified through a secondary search; among the studies retrieved, 34 clinical trials were selected after applying the inclusion and exclusion criteria. The interventions were grouped into seven categories: (1) dietary interventions associated with exercise or educational programs; (2) individual environmental interventions or other educational actions; (3) educational interventions oriented toward lifestyle, dietetics, physical activity and stress management; (4) economic incentives; (5) multicomponent interventions (combination of mindfulness, e-coaching and the addition of fruits and vegetables); or dietary interventions (facilitating greater food supply in cafeterias); or interventions focused on physical exercise.

CONCLUSIONS

Given that most people spend a large part of their time in the workplace and, therefore, eat at least one of their daily meals there, well-planned interventions-preferably including several strategies-have been demonstrated, in general, as useful for combating overweight and obesity. From the meta-regression study, it was observed that the interventions give better results in people who presented high Body Mass Index (BMI) values (obesity). In contrast, intervention 2 (interventions related to workplace environment) would not give the expected results (it would increase the BMI).

Dying for the job: police mortality, 1950-2018

Purpose –

This study is a mortality assessment on police officers (68-years, 1950-2018) and includes all causes of death.

Design/methodology/approach –

The authors investigated 1,853 police deaths (1950-2018) using sources of mortality that included the National Death Index, NY State, and available records from the Buffalo NY police department. Standardized Mortality Ratios were calculated. Death codes were obtained from 8th and 9th International Classification of Disease revisions in accordance with the year of death.

Findings –

Compared to the US general population, white male police officers from 1950-2018 had elevated mortality rates for some causes of death, including diseases of the circulatory system, malignant neoplasms, cirrhosis of the liver, and mental disorders. Black and female officers had lower mortality rates for all causes of death compared to the general population.

Research limitations/implications –

The findings of elevated risk for chronic disease among police need to be studied in relation to stress, lifestyle, and exposure to chemical and physical agents. There is a special need to further study officers from minority populations as larger samples become available.

Practical implications –

The results of this study will provide police and occupational health practitioners with objective evidence to determine the health impact of work on law enforcement officers.

Originality/value –

This study is longest running mortality assessment on police officers ever conducted (1950-2018) and includes white, black, and female officers.

Obesity and Work-Related Injuries Among Farmers in Kentucky, Tennessee, and West Virginia

BACKGROUND

Obesity is a recognized risk factor for work-related injuries (WRI). Despite the inherent safety hazards associated with farm work, research on obesity among farmers is limited giving little guidance to occupational health providers on obesity as a risk factor in farm WRI. This study evaluated the association between obesity and farm WRI.

METHODS

Cross-sectional data were collected from farmers (n = 100) in Kentucky, Tennessee, and West Virginia. Data included a survey (demographic data, farm factors, health indicators, occurrences of work-related injuries consistent with the definition of Occupational Safety and Health Administration [OSHA] recordable injuries) and direct anthropometric measures (height, weight, and waist circumference). Logistic regression was used to model any work-related injury, injuries consistent with the definition of OSHA recordables (herein called OSHA-recordable injuries), and recurrent injuries occurring during farm work performance on body mass index (BMI) and waist circumference.

FINDINGS

Twenty-five percent of the participants reported any injuries, and 18% reported OSHA-recordable injuries. Farmers with a BMI ≥30 kg/m² had 3 times the risk for OSHA-recordable injuries and 5 times the risk for recurrent injuries. No significant relationship was identified between waist circumference and farm WRI.

CONCLUSION

This study provides evidence that increased BMI is a safety risk for farmers. Prospective studies with a larger sample are needed. Occupational health nurses and providers should educate farmers on the potential safety risk of obesity and implement weight management programs addressing obesity in farmers.

Health-Related Exposures and Conditions among US Fishermen

Commercial fishing is a high-risk occupation, yet there is a lack of surveillance documenting health conditions, health behaviors, and health care coverage among US fishermen. We used publicly available data sources to identify exposures and health outcomes common among fishermen. We utilized the National Institute for Occupational Safety and Health-Worker Health Charts to estimate the prevalence of general exposures, psychosocial exposures, health behaviors, and health conditions from the national surveys National Health Interview Survey - Occupational Health Supplement (NHIS-OHS, 2015) and Behavioral Risk Factor Surveillance System (BRFSS) (2013-2015). We compared fishing workers with both agricultural workers and all-workers. Fishermen commonly reported general exposures, psychosocial exposures, non-standard work arrangements, frequent night shifts, and shift work. The prevalence of musculoskeletal conditions such as carpal tunnel syndrome (33%) and severe low-back pain (27%) was also high. Smoking (45%) and second-hand smoke exposure (25%) were widespread, and 21% reported no health care coverage. National household surveys such as NHIS-OHS, and BRFSS can be utilized to describe the health status of fishermen. This workforce would benefit from increased access to health care and health promotion programs. More comprehensive evaluations of existing data can help to identify occupation-specific health challenges.

Work Characteristics, Body Mass Index, and Risk of Obesity: The National Quality of Work Life Survey

OBJECTIVES

To examine work characteristics in relation to body mass index (BMI) and risk of obesity.

METHODS

We analyzed data from 1150 participants working 20+ h week-1 from the 2014 National NIOSH Quality of Work Life Survey, based on a representative sample of US workers. We used multiple linear regression for BMI and multiple logistic regression for obesity to estimate associations with 19 different work characteristics plus one set of occupational categories controlling for age, gender, race/ethnicity, education, marital status, job physical exertion, and television watching.

RESULTS

We found significant positive linear associations between BMI and night shift (versus day shift) schedule (B = 2.28, P = 0.008) and blue-collar (versus management/professional) work (B = 1.75, P = 0.008). Night shift schedule [odds ratio (OR) = 2.19, P = 0.029], sales/office work (OR = 1.55, P = 0.040), and blue-collar work (OR = 2.63, P = 0.006) were associated with increased risk of obesity versus 'healthy weight'. No other statistically significant associations between work characteristics and BMI or obesity were observed.

CONCLUSIONS

Night shift schedule and blue-collar work were related to increased BMI and obesity risk in US workers in 2014. Identifying risk factors in blue-collar work and redesigning jobs to reduce those risk factors, and reducing night shift work, could play a role in reducing the prevalence of obesity in the USA.

Associations between Daily Work Hassles and Energy-Balance Behaviors in Female African American Workers: An Ecological Momentary Assessment Study

Objective

Despite their high rate of labor force participation, African American women earn less and are overrepresented in service jobs that tend to have fewer benefits, longer work hours, and less flexibility. The aim of our study was to examine associations between work-related daily hassles and energy balance behaviors among female African American workers.

Design

A secondary analysis of a 7-day intensive longitudinal study using ecological momentary assessment (EMA).

Setting

Metropolitan area of Chicago, Illinois, United States; July 2012 through January 2013.

Participants

A convenience sample of 70 female African American workers.

Methods

EMA was used to collect information over seven days on work hassles and energy balance behaviors: empty calorie food intake; moderate-to-vigorous physical activity (MVPA); sedentary behavior; sleep duration; and sleep disturbance. Within-person associations between daily work hassles and each of these daily energy balance behaviors were analyzed using person fixed-effects regression.

Results

A total of 334 person-day observations from 70 female African American workers were included in the final analysis. Reporting at least one daily work hassle was associated with same-day higher empty calorie food intake (OR: 2.2, 95% CI: 1.0, 4.6) and more daily minutes of sedentary behavior (b: 35.8, 95% CI; .2, 71.3). However, no significant associations were found between prior-day work hassles and either food intake or sedentary behavior. Daily work hassles were not related to MVPA, sleep duration, or sleep disturbance.

Conclusions

Our study showed that daily work hassles were associated with female African American workers' empty calorie food intake and sedentary behaviors. Strategies to eliminate daily work hassles may help to improve their energy balance behaviors.

Sex and occupation are salient factors associated with lateral ankle sprain risk in military tactical athletes

OBJECTIVES

To assess the risk of lateral ankle sprain (LAS) in male and female tactical athletes across different military occupations in the US military.

DESIGN

Retrospective cohort.

METHODS

The Defense Medical Epidemiology Database was queried for the number of individuals with ICD-9 diagnosis codes 845.00 (sprain of ankle, unspecified) and 845.02 (calcaneofibular ligament sprain) on their initial encounter from 2006 to 2015. Relative risk (RR) and chi-square statistics were calculated assessing sex and occupational category on LAS risk.

RESULTS

272,970 enlisted males (27.9 per 1000 person-years), 56,732 enlisted females (34.5 per 1000 person-years), 24,534 male officers (12.6 per 1000 person-years), and 6020 female officers (16.4 per 1000 person-years) incurred a LAS. Enlisted females in all occupational groups were at significantly higher risk for LAS than their male counterparts (RR 1.09-1.68; p<0.001), except for Engineers (p=0.15). Female officers had consistently higher risk for LAS in all occupational groups (RR 1.10-1.42; p<0.001) compared with male officers, except Ground/Naval Gunfire (p=0.23). Contrasted with Infantry, enlisted tactical athletes in the Special Operations Forces, Mechanized/Armor, Aviation, Maintenance, and Maritime/Naval Specialties were at lower risk (RR 0.38-0.93; p<0.001), Artillery, Engineers, and Logistics Specialties were at higher risk (RR 1.04-1.18; p<0.001), and Administration, Intelligence, and Communications were no different (p=0.69). Compared with Ground/Naval Gunfire officers, Aviation officers were at significantly lower risk (RR, 0.75; p<0.001), and Engineers, Maintenance, Administration, Operations/Intelligence, and Logistics officers were at higher risk (RR, 1.08-1.20; p<0.001).

CONCLUSIONS

Sex and military occupation were salient factors associated with LAS risk.

Occupational distribution of metabolic syndrome prevalence and incidence differs by sex and is not explained by age and health behavior: results from 75 000 Dutch workers from 40 occupational groups

INTRODUCTION

This study examines the association between 40 occupational groups and prevalence and incidence of metabolic syndrome (MetS), separately for male and female workers, and whether age and health behaviors can explain the association.

RESEARCH DESIGN AND METHODS

Data from 74 857 Lifelines Cohort and Biobank Study participants were used to regress occupational group membership, coded by Statistics Netherlands, on the prevalence and incidence of MetS using logistic and Cox regression analyses. MetS diagnosis was based on physical examinations, blood analysis, and recorded medication use. Information on age, smoking status, physical activity, diet and alcohol consumption was acquired using questionnaires.

RESULTS

Baseline MetS prevalence was 17.5% for males and 10.6% for females. During a median 3.8 years of follow-up, MetS incidence was 7.8% for males and 13.2% for females. One occupational group was associated with an increased MetS risk in both sexes. Six additional occupational groups had an increased risk for MetS among men, four among women. Highest risks were found for male 'stationary plant and machine operators' (HR: 1.94; 95% CI 1.26 to 3.00) and female 'food preparation assistants' (HR: 1.80; 95% CI 1.01 to 3.22).

CONCLUSIONS

Findings suggest that occupational group matters for men and women in MetS development, and that differences in MetS prevalence across occupations are not merely a reflection of selection of metabolically unhealthy workers into specific occupations. The striking sex differences in the occupational distribution of MetS indicate that preventive measures should, with some exceptions, target men and women separately.

Nurse Health: The Influence of Chronotype and Shift Timing

Extreme chronotype and circadian disrupting work hours may increase nurse disease risks. This national, cross-sectional study of nurses (N = 527) had three hypotheses. When chronotype and shift times are incongruent, nurses will experience increased likelihood of (1) obesity, (2) cardiovascular disease/risk factors, and (3) obesity or cardiovascular disease/risk factors when theoretically linked variables exist. Chronotype mismatched nurses' (n = 206) average sleep (6.1 hours, SD = 1.2) fell below 7-9 hours/24-hours sleep recommendations. Proportion of male nurses was significantly higher chronotype mismatched (12.3%) than matched (6.3%). Analyses found no direct relationship between chronotype match/mismatch with outcome variables. Exploratory interaction analysis demonstrated nurses with mismatched chronotype and above average sleep quality had an estimated 3.51 times the adjusted odds (95% CI 1.52,8.17; p = .003) of being obese. Although mechanism is unclear, this suggests sleep quality may be intricately associated with obesity. Further research is needed to inform nurses on health risks from disrupted sleep, chronotypes, and shift work.

Hidden danger: A 22-years analysis of law enforcement deaths associated with duty-related illnesses (1997-2018)

Purpose –

Law enforcement is a dangerous profession not only due to assaults, accidents and homicides but also due to health risks. This study examined trends in the national frequency and rate of law enforcement jobrelated illness deaths in the United States over a 22-year period (1997-2018).

Design/methodology/approach –

Data were obtained from the National Law Enforcement Officers Memorial Fund (NLEOMF) on death frequencies related to health issues at work. Death rates were based on the total number of police officers in the United States [rate = (frequency/population at risk) × 100,000]. Trends were examined using standardized regression.

Findings –

A total of 646 deaths were attributed to job-related illness. There was a significant upward trend in overall job-related illness deaths (frequency analyses: β = 0.88, p < 0.0001; rate analyses: β = 0.82, p ≤ 0.0001) mainly driven by a significant increase in 911 cancer deaths (frequency analyses: β = 0.88, p < 0.0001; rate analyses: β = 0.88, p ≤ 0.0001). Nearly 82 percent of circulatory deaths were from a heart attack, with an average death age of 46.5 years.

Research limitations/implications –

Deaths were not included if they failed to meet medical requirements of the NLEOMF. The data are descriptive, do not estimate risk and should be interpreted cautiously.

Practical implications –

Police wellness programs may help to reduce the danger of deaths associated with job-related illness.

Originality/value –

This is among the first studies to examine frequency and rate of police health-related deaths due to job exposures.

Body mass index trajectories among the Canadian workforce and their association with work environment trajectories over 17 years

OBJECTIVE

To determine the number of latent body mass index (BMI) trajectories from 1994 to 2010 among working Canadians and their association with concurrent trajectories in work environment exposures.

METHODS

Data of employed individuals from the longitudinal Canadian National Population Health Survey were used. Group-based trajectory modelling was used to determine the number of latent BMI trajectories and concurrent psychosocial work environment trajectories. A multinomial logistic regression of BMI trajectory membership on trajectories in work environment dimensions (skill discretion, decision latitude, psychological demands, job insecurity, social support, physical exertion) was then explored.

RESULTS

Four latent BMI trajectories corresponding to normal, overweight, obese and very obese BMI values were found. Each trajectory saw an increase in BMI (~2-4 kg/m²) over the 17-year period. A higher decision authority trajectory was associated with lower odds of belonging to the overweight and obese trajectories when compared with the normal weight trajectory. A decreasing physical exertion trajectory was associated with higher odds of belonging to the very obese trajectory when compared with the normal weight trajectory.

CONCLUSIONS

Four BMI trajectories are present in the Canadian workforce; all trajectories saw increased body weight over time. Declining physical exertion and lower decision authority in the work environment over time is associated with increased likelihood of being in overweight and obese trajectories.

Association between Occupational Characteristics and Overweight and Obesity among Working Korean Women: The 2010-2015 Korea National Health and Nutrition Examination Survey

Associations between several occupational characteristics and obesity are not fully elucidated in Korean working populations, especially in females. This study investigated associations between occupational characteristics and overweight/obesity among Korean women. Data on 2090 female workers (the mean age was 38.8 ± 0.2 years), extracted from Korean National Health and Nutrition Examination Surveys in 2010-2015, were analyzed and showed that 6.8% of subjects were underweight, 50.8% had normal weight, 20.1% were overweight, and 22.2% were individuals with obesity. Multiple regression analysis was performed to examine associations between occupational characteristics and overweight/obesity, after controlling for demographic, behavioral, and health-related characteristics. The reference group was normal weight. Working hours were strongly associated with overweight/obesity. The odds ratio (OR) of obesity in women who worked for ≥60 hours per week was 2.68 (95% confidence interval: [CI] 2.13-3.36) compared with those who worked for <40 hours. Night/shift workers were 1.21 times (95% confidence interval: [CI] 1.01-1.45) more likely to experience obesity than day or evening workers. In conclusion, obesity rates increase among female workers with longer working hours and those who work at night or in shifts. Occupational characteristics should be considered in the prevention of obesity among working women.

Overweight, underweight, and obesity among male long-distance professional drivers in Iran

OBJECTIVE

Long-distance professional drivers, as an occupational group, are hypothesized to have a higher risk of overweight and obesity. The aim of this study was to estimate the prevalence and risk factors of overweight, underweight, and obesity in long-distance professional drivers.

METHODS

A cross-sectional study was conducted on 36 625 male long-distance professional drivers age ≥20 years, from April 2013 to Sept. 2016. Drivers were interviewed and underwent clinical and laboratory examinations including measures of blood pressure (BP), blood tests, anthropometric data, and visual and hearing acuity. The mean (standard deviation [SD]) age of participants was 41.9 (10.2) years with a mean (SD) duration of a professional driving of 15.3 (9.6) years and mean (SD) body mass index (BMI) was 25.7 (4.0) kg/m2 .

RESULTS

The prevalence of overweight and obesity was 39.1% (95% confidence interval (CI) 38.6, 39.6) and 10.8% (95% CI 10.5, 11.1), respectively. A total percentage of 2.7 (95% CI 2.5, 2.9) were underweight. A total percentage of 10.6 had BMI 30-40 kg/m2 and 0.2% had BMI ≥40 kg/m2 . Using a stepwise binary logistic regression model for overweight, underweight, and obesity, age had a significant independent relationship with underweight, overweight, and obesity. Duration of work, BP, fasting plasma glucose, triglyceride, and cholesterol had significant independent positive association and smoking had a negative association with overweight/obesity when other covariates were considered.

CONCLUSIONS

These findings indicate that overweight and obesity are prevalent among long-distance professional drivers in Iran and appears to be similar to the general population.

Advanced Age Is a Risk Factor for Complications Following Abdominal Panniculectomy

BACKGROUND

Widespread adoption of bariatric surgery in the treatment of obesity has led to greater numbers of patients seeking panniculectomy, including aged patients, who represent a rapidly growing proportion of the U.S population. Although the quality of life and functional benefits of abdominal panniculectomy have been established, its safety in patients 65 years and older has not been evaluated.

METHODS

The American College of Surgeons National Surgical Quality Improvements (ACS-NSQIP) database was used to identify patients undergoing panniculectomy between 2010 and 2015. Age 65 years and older was the risk factor of interest, and primary outcomes included 30-day wound complications, overall complications, reoperation, readmission, and mortality. Multivariate regression was performed to control for confounders.

RESULTS

Review of the database identified 7030 patients who underwent abdominal panniculectomy. When stratified by age, 6455 (91.8%) of patients were younger than 65, and 575 (8.2%) were 65 or older. Multivariate regression analysis demonstrated that age over 65 was a significant independent risk factor for wound complications (OR = 1.81; 95% CI 1.35-2.42; p < 0.001) and all complications (OR = 1.46; 95% CI 1.15-1.87; p = 0.002). BMI, smoking, diabetes, and partial or total dependence were also identified as significant independent risk factors for wound and all complications.

CONCLUSION

Our analysis demonstrates that advanced age is an independent risk factor for wound and overall complications following abdominal panniculectomy. These results highlight the importance of preoperative evaluation and optimization of modifiable preoperative risk factors as well as close postoperative follow-up for safe outcomes in patients 65 and older.

What Do Workers Do to Reduce Their Sitting Time? The Relationships of Strategy Use and Workplace Support With Desk-Based Workers' Behavior Changes in a Workplace-Delivered Sitting-Reduction and Activity-Promoting Intervention

OBJECTIVE

To explore workers' sitting-reduction and activity-promoting strategy use following an intervention targeting these changes, and whether strategy use and perceived workplace support impacted on 3-month sitting and activity outcomes.

METHODS

This secondary analysis in desk-based workers (n = 83) utilized data collected on questionnaire-derived strategy use and workplace support, and activPAL3-derived sitting (total; prolonged, ≥30 minutes) and activity (standing; stepping) at work.

RESULTS

Fourteen strategies were commonly used during the intervention. Increased usage of some strategies were significantly (P < 0.05) associated with beneficial changes in prolonged sitting or stepping only. Workplace support was significantly beneficially associated with changes in sitting, prolonged sitting, and stepping; these associations were largely independent of strategy use changes.

CONCLUSIONS

Strategies were highly used, with increased use associated with some behavioral improvements. Workplace support appears essential for improving sitting and activity in the workplace.

Direct, Absenteeism, and Disability Cost Burden of Obesity Among Privately Insured Employees: A Comparison of Healthcare Industry Versus Other Major Industries in the United States

OBJECTIVE

To compare obesity-related costs of employees of the healthcare industry versus other major US industries.

METHODS

Employees with obesity versus without were identified using the Optum Health Reporting and Insights employer claims database (January, 2010 to March, 2017). Employees working in healthcare with obesity were compared with employees of other industries with obesity for absenteeism/disability and direct cost differences. Multivariate models estimated the association between industries and high costs compared with the healthcare industry.

RESULTS

Obesity-related absenteeism/disability and direct costs were higher in several US industries compared with the healthcare industry (adjusted cost differences of $-1220 to $5630). Employees of the government/education/religious services industry (GERS) with obesity (BMI of 30 or greater) had significantly higher odds of direct costs at the 80th percentile and above (odds ratio vs healthcare industry = 2.20; P < 0.05).

CONCLUSIONS

Relative to the healthcare industry, employees of other industries, especially GERS, incurred higher obesity-related costs.

Effects of age and obesity on trunk kinetics and kinematics during dominant side one-handed carrying

The proportions of older and obese people are increasing in both the general and working populations worldwide. Older and obese individuals are more susceptible to work-related musculoskeletal disorders (MSDs) in comparison with healthy, younger individuals. Manual material handling (MMH) is associated with the development of work-related MSDs. Although previous research has suggested that one-handed carrying is a particularly undesirable method of MMH, the effects of one-handed carrying on trunk kinetics and kinematics among older and/or obese people have not been adequately studied. The objective of this study was to examine the effects of age and obesity on trunk angles and moments during dominant side one-handed carrying of various load magnitudes. Twenty (20) participants divided into four groups with respect to age (young and older) and obesity (obese and non-obese) carried different loads (No-load [0 kg], Light [5.67 kg], and Heavy [10.21 kg]) in their dominant hand for approximately 6 m. Three-dimensional (3D) trunk angles and moments approximately about the L4/L5 vertebral segment were calculated using Visual3D. The findings indicated that while carrying a load in the dominant hand plays an important role in changing trunk kinematics and kinetics, the results were not dependent on age and/or obesity category. Absolute moments were greatest among participants in the obese groups; however, these moments were mitigated when normalized to body weight and height (%BW * Ht). Age did not exacerbate the effects of load magnitude on trunk kinetics and kinematics.

Obesity in the Workplace: Impact, Outcomes, and Recommendations

OBJECTIVE

To conduct a comprehensive literature review to develop recommendations for managing obesity among workers to improve health outcomes and to explore the impact of obesity on health costs to determine whether a case can be made for surgical interventions and insurance coverage.

METHODS

We searched PubMed from 2011 to 2016, and CINAHL, Scopus, and Cochrane Registry of Clinical Trials for interventions addressing obesity in the workplace.

RESULTS

A total of 1419 articles were screened, resulting in 275 articles being included. Several areas were identified that require more research and investigation.

CONCLUSIONS

Our findings support the use of both lifestyle modification and bariatric surgery to assist appropriate patients in losing weight.

Impact of Obesity on Work Productivity in Different US Occupations: Analysis of the National Health and Wellness Survey 2014 to 2015

Objective:

The aim of this study was to quantify the relationship between workers’ body mass index and work productivity within various occupations.

Methods:

Data from two administrations (2014 and 2015) of the United States (US) National Health and Wellness Survey, an Internet-based survey administered to an adult sample of the US population, were used for this study (n = 59,772). Occupation was based on the US Department of Labor's 2010 Standardized Occupation Codes. Outcomes included work productivity impairment and indirect costs of missed work time.

Results:

Obesity had the greatest impact on work productivity in Construction, followed by Arts and Hospitality occupations. Outcomes varied across occupations; multivariable analyses found significant differences in work productivity impairment and indirect costs between normal weight and at least one obesity class.

Conclusion:

Obesity differentially impacted productivity and costs, depending upon occupation.

Planning, Development, and Implementation of a University-Led, Low-Cost Employee Wellness Program in a preK-12th-Grade Public School District

BACKGROUND

A healthy preK-12th-grade school environment is critical to student well-being and success. As role models, school employees play a significant part in creating a healthy environment. Research suggests that employee wellness programs (EWPs) may help school employees adopt healthier lifestyles and, therefore, be healthier, more productive, and serve as healthy role models for students. This article describes the process by which a school district in central Texas partnered with a local university to plan, develop, and implement an affordable EWP.

METHODS

A university-led leadership team sought input from employees, including administrators, and conducted a 4-week trial. These resulted in an EWP that provided health risk appraisals, fitness testing, group exercise classes, education seminars, online wellness resources, and blood draws/analysis.

RESULTS

During the first 4 years, membership ranged from 107 to 384 (10-37%), and the annual cost of the program ranged from $49 to $116 per participating employee.

CONCLUSIONS

University-led EWP programs can support, at a low cost, the health of school employees. Despite low employee engagement, need was demonstrated and feedback was positive. Challenges identified include time demands and lack of principals' support. Future considerations include targeting principals, utilizing the Human Resources Office, and strategically building a culture of health.

Associations between adiposity measures and 25-hydroxyvitamin D among police officers

OBJECTIVE

Studies show that serum levels of 25-hydroxyvitamin D (25(OH)D), a biomarker for vitamin D status, are lower in persons with higher adiposity levels and that police officers have been found to have a high prevalence of obesity. The purpose of this study was to examine relationships between several adiposity measures and 25(OH)D, and also compare those measures to determine the best one that predicts insufficiency of 25(OH)D (<20 ng/mL) among police officers in the Northeast area of the United States.

METHODS

Participants were 281 police officers (71.5% men) from the Buffalo Cardio-Metabolic Occupational Police Stress Study (2011-2016). Associations of body mass index (BMI), abdominal height (AbHt), waist circumference (WC), WC-to-height ratio (WCHtR), percent body fat (PBF), and fat mass index (FMI) with 25(OH)D were obtained using multiple regression models after adjustment for age, race/ethnicity, season, multivitamin supplement use, and high-density lipoprotein cholesterol. The area under the curve (AUC) was used to evaluate the predictive ability of each adiposity measure to identify insufficient 25(OH)D concentrations.

RESULTS

The prevalence of obesity (BMI ≥ 30) was 50.7% in men and 21.3% in women. Mean levels of 25(OH)D were 32.4 ng/mL in men and 34.4 ng/mL in women. After adjustment for covariates, PBF and FMI among men were inversely associated with 25(OH)D: PBF (β ± SE = -2.40 ± 1.01, P = .018); FMI (-2.21 ± 0.93, .018). Among women, no adiposity measure was associated with 25(OH)D. PBF was the best predictor of insufficient 25(OH)D concentrations regardless of gender (AUC = 0.878).

CONCLUSION

Adiposity measures were inversely associated with 25(OH)D, but differed between female and male officers.

Eating Habits of Professional Firefighters: Comparison With National Guidelines and Impact Healthy Eating Promotion Program

OBJECTIVE

Firefighters' eating habits may be an additional risk factor for metabolic diseases. We assessed eating habits of firefighters, compared them with national guidelines, and evaluated the impact of a prevention program.

METHODS

Twenty-eight professional firefighters from a Swiss airport benefited from a healthy-eating program. Food intake, eating behavior, and anthropometric data were collected at baseline and 1-year follow-up using an electronic food record, questionnaires, and bio-impedance.

RESULTS

Participants had unbalanced diets with low-quality food choices associated with low intakes of fibers and micronutrients compared with national guidelines. Intervention did not impact eating habits or anthropometrics data at the group level, but changes were measured in sub-groups. Main reported barriers for healthy eating were lack of motivation, prioritization, or time.

CONCLUSIONS

Intensive and culturally tailored prevention interventions targeting nutritional behaviors are needed at the individual, group, and organizational levels.

Overweight and Obesity Among School Bus Drivers in Rural Arkansas

INTRODUCTION

Obesity is a major public health concern. Compared with other occupational groups, transportation workers, such as school bus drivers, have higher rates of obesity. However, little is known about the body weight and related health behaviors of these drivers, and opportunities for intervention are undetermined.

METHODS

We collected multilevel data from school bus drivers working from 4 school bus garages in Little Rock, Arkansas, and their work environment from January through July of 2017. Data on weight, height, sociodemographic characteristics, work factors, weight-related behaviors, and psychosocial variables were collected from 45 drivers. Analyses explored associations between body mass index (BMI; weight in kg/ height in m2) and sociodemographic characteristics, work factors, weight-related behaviors, and psychosocial variables. Two focus groups with a total of 20 drivers explored drivers' perspectives about healthy weight. Observational data at the bus and garage levels were collected through 2 "ride-alongs" and an environmental scan.

RESULTS

Drivers in our sample were predominately overweight or obese (91.1%), and most did not meet dietary or physical activity guidelines. Drivers who were currently dieting had higher BMIs (36.4; standard deviation [SD], 8.2) than drivers who were not dieting (28.5; SD, 7.7); drivers who reported eating less to lose weight had higher BMIs (38.1; SD, 8.5) than those who did not report eating less (29.5; SD, 6.0). Drivers who did not meet physical activity recommendations had higher BMIs (36.5; SD, 9.8) than those who met recommendations (30.9; SD, 4.8). Structural barriers and work stress were significant barriers to achieving a healthy weight. Resources for healthful eating and physical activity were limited in the garage.

CONCLUSION

Our study provides preliminary data on the prevalence, risk factors, and perceptions of overweight and obesity among school bus drivers. Study data on drivers' body weight, health-related behaviors, and psychosocial characteristics could serve as a basis for worksite interventions to improve drivers' health.

Sleep, Obesity, and Injury Among US Male Career Firefighters

OBJECTIVE

The aim of this study was to determine the role of obesity on the association between sleep and on-duty injury among male career firefighters.

METHODS

Data on 1419 male career firefighters for this cross-sectional study came from two firefighter cohorts from 2008 to 2013. On-duty injury within the past 6 to 12 months was the dependent variable and getting enough sleep was the independent variable. A multivariable, mixed effect logistic regression model stratified by body mass index (BMI) categories was created to examine the presence of effect measure modification.

RESULTS

Only obese firefighters who did not get enough sleep were twice as likely to have an on-duty injury than those who got enough sleep. This association was not significant among normal or overweight firefighters.

CONCLUSIONS

Future studies into on-duty injury and sleep should examine body composition as an effect modifier among career firefighters.

The prevalence of overweight and obesity among Iranian military personnel: a systematic review and meta-analysis

Background

The overweight and obesity among military personnel, as an occupational group, beside the health issues, might affect their military performance. A systematic review and meta-analysis were conducted to estimate the pool prevalence of overweight and obesity among Iranian military personnel.

Methods

The national databases including Science Information Database, MagIran, and the following international databases; Web of Science, Medline via PubMed, and Scopus were searched, up to December 2017, for relevant published studies without time limitation.

Results

Totally,1431 studies were reterived and 10 studies included in meta-analysis. The pooled prevalence of overweight and obesity were 41% (95%CI:26, 57%) and 13% (95%CI:10, 17%), respectively. In the subgroup analyses, a lower and higher prevalence of overweight was reported in the ground (12%) and Navy (69%) forces military, recpectively. For the obesity, the air forces had the lowest prevalence (11%) and the ground and Navy forces military had highest prevalence (15%). The prevalence of overweight and obesity were slightly higher in studies conducted after 2014.

Conclusion

Our findings suggest a high prevalence of overweight and obesity in the military personnel as a high-risk occupational group. Owing to the high observed heterogeneity among the included studies, large representative studies are needed to estimate the prevalence of overweight and obesity in the military personnel.

Abdominal Panniculectomy: Determining the Impact of Diabetes on Complications and Risk Factors for Adverse Events

BACKGROUND

The prevalence of obesity along with bariatric surgery and massive weight loss requiring panniculectomy is increasing in the United States. The effect of diabetes mellitus on outcomes following panniculectomy remains poorly defined despite its prevalence. This study aims to evaluate the impact of diabetes mellitus on complications following panniculectomy and determine risk factors for adverse events.

METHODS

The American College of Surgeons National Surgical Quality Improvement Program database was used to identify patients undergoing panniculectomy between 2010 and 2015. Patients were stratified based on diabetes status.

RESULTS

Review of the database identified 7035 eligible patients who underwent panniculectomy, of which 770 (10.9 percent) were diabetic. Multivariate regression showed that diabetes mellitus was a significant risk factor for wound dehiscence (OR, 1.92; 95 percent CI, 1.41 to 3.15; p = 0.02). Obesity was a significant risk factor for superficial (OR, 2.78; 95 percent CI, 1.53 to 3.69; p < 0.001) and deep (OR, 1.52; 95 percent CI, 1.38 to 3.97; p = 0.01) incisional surgical-site infection. Smokers were also at an increased risk for superficial (OR, 1.42; 95 percent CI, 1.19 to 1.75; p = 0.03) and deep (OR, 1.63; 95 percent CI, 1.31 to 2.22; p = 0.02) incisional surgical-site infection.

CONCLUSIONS

Diabetes mellitus is an independent risk factor for wound dehiscence following panniculectomy. Obesity and smoking were significant risk factors for superficial and deep incisional surgical-site infection. These results underscore the importance of preoperative risk factor evaluation in patients undergoing panniculectomy for safe outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Risk, II.

White Sweet Potato as Meal Replacement for Overweight White-Collar Workers: A Randomized Controlled Trial

Overweight and obesity are a global concern. Meal replacements (MRs) are portion- and calorie-controlled meals, which make the food environment part of an individual’s weight loss regimen. White sweet potato (WSP; Ipomoea batatas L.), used in traditional medicine in Brazil, Japan, and Taiwan, is a healthy carbohydrate source. In this randomized controlled trial, we assessed the effects of a WSP formula on body weight management in 58 white-collar workers through MR to elucidate the effects of this WSP-MR on factors leading to overweight. The participants consumed either two packs a day for a total of 132 g of WSP (WSP-MR group) or a normal diet daily (non-WSP group) for eight weeks. After eight weeks, body weight, body fat, body mass index, wrist circumference, thigh circumference, calf circumference, mid-arm circumference, and triceps skinfolds decreased significantly in both the groups. Moreover, the WSP-MR group demonstrated a 5% decrease in body weight, body fat, body mass index, and mid-arm circumference and a 3.5% decrease in glycated hemoglobin levels (p < 0.05). The treatment was well tolerated, without side effects or adverse events. Thus, our WSP formula as an MR can facilitate individual weight loss and thus has commercial application in the food industry.

The association between long work hours and leisure-time physical activity and obesity

Obesity affects approximately one-third of all U.S. adults, presenting a large economic and public health burden. Long work hours may be contributing to the rising obesity problem by reducing time for physical activity, particularly for individuals working in sedentary occupations. This study sought to investigate the association between long work hours, leisure-time physical activity (LTPA), and obesity across levels of occupational activity in order to identify potentially vulnerable groups. Cross sectional analysis was performed in 2017 using data from the 2015 Georgia Behavioral Risk Factor Surveillance System and prevalence ratios were estimated across work hour and occupational activity groups. Ability to meet guidelines for LTPA did not differ significantly across work hour categories overall. Those working in low activity occupations were more likely to meet aerobic guidelines for LTPA compared to those in intermediate and high activity occupations (χ2: 19.3; P-value: <0.01). Results of interaction assessment demonstrate that the effects of work hours on obesity risk and meeting aerobic guidelines are significantly different across OA categories, indicating OA to be an effect modifier of the relationship between long work hours and obesity (χ2: 13.33; P-value: <0.001; χ2: 4.42; P-value: <0.05). Employees in intermediate activity occupations working long hours were found to be at the greatest risk for obesity. Further research is required to better understand the mechanisms impacting the relationship between long work hours, domains of physical activity, and obesity risk as well as to identify effective intervention and prevention programs for employees in intermediate activity occupations.

Prevalence and Perception of Risky Health Behaviors Among Construction Workers

OBJECTIVE

This study aimed to evaluate construction workers' health behaviors, attitudes, and perceptions of health risks from work related and non-work related hazards.

METHODS

Construction workers completed a survey that assessed hazardous health behaviors (such as alcohol and tobacco use), attitudes toward health, and health risk perceptions. We compared construction workers' health behaviors to general population data from the behavioral risk factor surveillance system (BRFSS).

RESULTS

Construction workers reported greater smoking and drinking compared with their age-adjusted white man counterparts in Missouri. While there was a high awareness of work-related health and safety risks, concerns about general health risks did not correspond with risks from relevant health behaviors.

CONCLUSION

Educational efforts have created awareness of work-related safety and health issues in this population; similar efforts are needed to address disparities of general health behaviors.

Disparities in cancer screening by occupational characteristics

Cancer screening patterns according to occupation characteristics in the United States are not well known, but could be used to help inform cancer control efforts. We examined cervical (CC), breast (BC) and colorectal cancer (CRC) screening prevalence and prevalence ratios (PR) by occupational characteristics in 2010, 2013 and 2015 National Health Interview Surveys (NHIS) among eligible US workers (CC women 21-65years; n=20,997), (BC women ≥40years; n=14,258) and (CRC men and women ≥50years; n=17,333). Cervical, breast and colorectal cancer screening prevalence among US workers was 84.0%, 68.9%, and 56.8%, respectively. Unadjusted prevalence ratios for cervical (PR=0.92, 95%CI 0.90, 0.94), breast (PR=0.86, 95%CI 0.83, 0.90) and colorectal cancer screening (PR=0.83, 95%CI 0.80, 0.87) were lower among workers in small (<25 employees) compared to large organizations (≥500 employees). People in food service, construction, production, and sales occupations were 13-26%, 17-28% and 9-30% less likely to be up to date with cervical, breast, and colorectal cancer screening, respectively, compared to healthcare professionals. Adjustment for socioeconomic factors and insurance status eliminated most associations. Disparities in cancer screening by occupational characteristics were mostly attributed to lower socioeconomic status and lack of insurance. These findings underscore the need for innovative public health strategies to improve cancer screening in vulnerable populations.

Promotion of alternative-sized personal protective equipment

INTRODUCTION

With more diversity in the workforce, companies are producing PPE such as hard hats, safety glasses, coveralls, foot protection, and safety harnesses for a larger range of body shapes and sizes. However, gray literature reports suggest that barriers exist to getting alternate sized PPE from the manufacturer to the workers who need it. The purpose of this study is to determine the extent to which alternative-sized PPE is marketed.

METHOD

A web-based review of seven major manufacturers of PPE was conducted to determine: (a) whether or not they offer alternative-sized products, (b) if these products are clearly labeled, and (c) if images used to display PPE are representative of a diverse workforce.

RESULTS

Of the seven PPE manufacturers investigated, six had at least one product that was marketed as gender and/or size alternatives however, alternative sizes were more common for larger body types. Alternative-sized products rarely included size charts, and the models used to display PPE were overwhelmingly white males of average size.

CONCLUSIONS

Despite the growing availability of alternative-sized PPE, it can be difficult to find these products, which suggests that they are rarely promoted or labeled as alternative-sized. Our study indicates that companies should expand their product lines and more aggressively market and promote these items. Guidance on how to properly fit their products would also be extremely helpful to the end-user.

PRACTICAL APPLICATIONS

Manufacturers could improve the availability of alternative-sized PPE and increase their promotion of these products on their websites and in their catalogs. Individual companies and safety professionals may assist in this process by demonstrating demand for alternative-sized PPE.

One-year weight change and long-term sickness absence in professional firefighters

BACKGROUND

Little is known about the association between weight change (particularly moderate weight loss, 5-10% in initial weight) and long-term sickness absence (LSA) in working populations.

METHODS

Three hundred and forty professional firefighters reported their current and past (1 year ago) weights in a cross-sectional survey, along with their LSA experience due to a severe accident, injury, or illness during the previous 12 months.

RESULTS

The prevalence of LSA was 14.7%. In the non-smoking male firefighters, the prevalence of LSA was 3.4% in those with moderate weight loss over the past year; 13.3% in those who maintained their weight; and 21.7% in those who gained their weight moderately: gamma coefficient, 0.44 (95%CI: 0.05, 0.66). The linear association remained significant after further controlling for age and alcohol consumption. And it was similar across the adiposity strata (normal weight, overweight, and obesity) of the firefighters 1 year ago.

CONCLUSIONS

One-year weight loss was associated with decreased risk of LSA in professional firefighters.

A socioecological framework for research on work and obesity in diverse urban transit operators based on gender, race, and ethnicity

Urban transit (bus and rail) operators, totaling nearly 700,000 persons, are one of the heaviest occupational groups in the United States (US). Little is known about occupational risk factors for weight gain and obesity and their interrelationship with health-related behaviors, particularly among female minority (African Americans and Hispanics) transit operators who are at greater risk for obesity. As a step towards developing successful obesity interventions among urban transit operators, this paper aims to present a new socioecological framework for studying working conditions, chronic strain, health-related behaviors, weight gain/obesity, and obesity disparity in diverse urban transit operators based on gender, race, and ethnicity. Our framework is a synthesis of several different theories and disciplines: the resource-work load model (work stress), occupational ergonomics, the theory of intersectionality, and worksite health promotion. The framework was developed utilizing an extensive literature review, results from our on-going research on obesity, input from focus groups conducted with Los Angeles transit operators as well as interviews and meetings with transit operator stakeholders (management, unions, and worksite transit wellness program), and ride-along observations. Our hypotheses highlighted in the framework (see Fig. 1) are that adverse working conditions, largely characterized as a combination of high demands and low resources, will increase the risk for weight gain/obesity among transit operators directly through chronic strain and hypothalamic dysfunction (hyper-and hypo-activations), and indirectly through health-related behaviors and injuries/chronic severe pain. We also hypothesize that the observed increase in adiposity among female minority operators is due to their greater exposure to adverse occupational and non-occupational conditions that reflect their intersecting social identities of lower social class and being a minority woman in the US. Our proposed framework could greatly facilitate future transit worksite obesity studies by clarifying the complex and important roles of adverse working conditions in the etiology of weight gain/obesity and obesity disparity among transit operators and other working populations.

Frequency and Risk of Occupational Health and Safety Hazards for Home Healthcare Workers

Given the increased prevalence of chronic disease and health care costs, more individuals are treated in the home, which has augmented the demand for more Home Healthcare Workers (HHCWs) in the field. HHCWs face multiple hazards with injury rates being more than double the national average; however, current studies on HHCWs have provided limited understanding of their occupational safety & health experiences and exposures. The aim of this study was to assess the frequency and risk of exposures through perceptions of HHCWs. The results of this study provide an initial picture of the different risks that HHCWs face daily. These findings show that studies involving HHCWs occupational safety need to be job-specific, and the proposed interventions will also likely need to be tailored by HHCWs type.