Obesity Increases Risk For Occupational Injury?

Earlier this week, I posted on the increased risk for severe ultra-low-velocity knee injuries associated with severe obesity.

A study by Ian Janssen and colleagues from Queen’s University, Kingston, Ontario, published in the Journal of Obesity, examines the relationship between occupational injury and obesity in the canadian workforce.

These authors have previously described a biophysical framework on the possible determinants of increased risk in obese individuals:

“… obesity is associated with (1) a number of risk factors for unintentional injury (increased comorbidities, increased use of psychotropic medications, altered gait and balance, increased forces involved in falls, lower neural sensitivity, greater extremity friction, and sleep apnea and fatigue) as well as (2) some protective factors that will help prevent injury (greater bone density and increased cushioning during falls from excess fat).”

In their analysis of data in a representative longitudinal sample of 7,678 adult Canadian workers obese workers were about 40% more likely to report any occupational injuries and almost 50% more likely to report serious occupational injuries than normal-weight workers.

These relationships were more pronounced for sprains and strains (80% higher risk), injuries to the lower limbs (2-fold higher risk) or torso (almost 2.5-fold higher risk), and injuries due to falls (2-fold) or overexertion (2-fold).

Female workers, workers ≥40 years, and workers employed in sedentary occupations were particularly vulnerable.

Importantly, while this association was found for obese individuals, risk for overweight workers was not increased.

Nevertheless, regarding population attributable risk (PAR), the authors point out that:

“If the relationships under study are accurate and causal in nature, the PAR estimates indicate that approximately one in ten occupational injury events in the Canadian workforce are directly attributable to obesity, with up to one in five occupational injuries being attributable to obesity in susceptible population subgroups.”

Thus, the authors have the following suggestions for employers:

“…employers should consider how obesity impacts and interacts with other salient and modifiable risk factors for workplace injury such as job and task design, physical environments, and social factors. For example, workstations can be designed to be ergonomically sound for heavier persons and not just the average person.

In addition:

“…employers should consider adopting or expanding workplace wellness initiatives aimed at improving physical activity and eating behaviours in their workforce.”

The authors also note that:

“Although the medical services associated with workplace injury in Canada are covered by our public health care system and not the employer or its insurance provider, employers need to recognize that investments into workplace wellness initiatives could still have a favourable impact on the bottom line by reducing absenteeism and lost productivity.”

Is your workplace ‘safe’ for obese employees? How can it be made safer?

All suggestions are appreciated.

AMS
Duchesnay, Quebec

Janssen I, Bacon E, & Pickett W (2011). Obesity and its relationship with occupational injury in the canadian workforce. Journal of obesity, 2011 PMID: 21773008