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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

7 Comments

  1. I do worry that studies such as these work to increase stigma and discrimination, if they are interpreted as a reason to not hire larger people, rather than follow the recommendations in the article regarding improving safety for larger people in the worksite.

    Worksite wellness programs also need to be as inclusive as possible, not only for the “fit and well” but for people of all sizes who are not getting sufficient physical activity (especially if their job requires them to sit at a computer). If people who take the stairs are then laughed at for being out of breath when they get to their floor, they will choose the elevator instead — the culture of the worksite plays an important role as well.

    Programs that encourage walking during breaks, provide adequate, flexible time for physical activity during the day, having refrigerators nearby and access to healthful foods, a psychologically healthy worksite culture, encouraging people to take time to get preventive care, offering vaccinations at the worksite, and offering programs not only for the runners but also for the walkers and swimmers and first-time exercisers can do a whole lot to improve wellness.

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  2. I’m behind a lot of your recommendations, AcceptanceWoman. For example, if I worked in a large facility in a remote place (a suburb or out in the country), then it might be convenient to have a gym at work. Your recommendations on access to heathy food and fridges is right on, too. For example, if there’s a company cafeteria then it should have a balanced menu. If there are snack machines, there should be healthy options for people with different nutritional philosophies (i.e. fruit, nuts, pretzels…)

    On the other hand, I really dislike it when I feel that employers are trying to interfere in my choices about what I eat and how/where I exercise. I just think that’s none of their business, and will generally opt out of work-based “wellness” programs in favor of picking out my own exercise routine away from the office and choosing how I, personally, want to eat. I devote enough time and energy to my work. As long as I’m doing my job, employers do not have a say in how I manage my body or on what I do during the time when they’re not paying me. I’m an employee who does a job in exchange for money, not a child or a slave. When I’m going to the gym or exercise studio regularly, I don’t necessarily discuss it at work, not is it any of my employer’s concern. If an employer pressured me to diet, then I would look for another job. Even though I believe strongly in the health benefits of regular exercise, I don’t think it’s my employer’s place to comment on my level of fitness either – not unless it directly interferes with my work.

    Concerning the post…
    Most fat people are either yo-yo dieters and/or are alienated from their bodies. People who diet, for the most part, lose muscle every time they lose weight and often have the weight come back, differently distributed, as fat. I wonder if the greater injury rates for heavier people are partly due to that.

    I also suspect that fat people who stay at a relatively stable weight and are physically active know where the edges of their bodies are, do not have balance issues, and would tend to be strong enough to avoid falls and other types of injuries.

    I’d love to see the results of that study controlled for level of fitness and weight variance; maybe even some measurement of fat percentage vs. BMI.

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  3. … yes, this is a “reason not to hire larger people” as Acceptance woman says.

    However, employers will do their best to hire and keep talent.

    If an employee has the health and safety drawbacks of being obese (not merely overweight), he/she will need to have excellent talent to be hired and excellent job results to be kept employed, to balance out the extra costs to the employer.

    It’s all about the employer getting value for the money they spend overall, including salary, hiring costs, costs of sickness and injury etc. An obese person could very well have better job results than a skinny co-worker, that’s all that will matter to the employer.

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  4. If an employee has the health and safety drawbacks of being a extreme sports person, he/she will need to have excellent talent to be hired and excellent job results to be kept employed, to balance out the extra costs to the employer. After all, these employees re often injured and preoccupied with their sport activities.

    It’s all about the employer getting value for the money they spend overall, including salary, hiring costs, costs of sickness and injury etc. An obese person could very well have better job results than a skinny co-worker, that’s all that will matter to the employer.

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  5. Anonymous, your post is frightening in its indifference to this type of discrimination. An obese worker could also be healthier and less accident-prone than a thin worker. There will not necessarily be any extra costs to the employer. Your post illustrates how this type of study – and the way it’s reported in the media – can increase prejudice and job discrimination. This is a prime example of how the weight-based paradigm is absolutely poisonous.

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  6. “…the weight-based paradigm is absolutely poisonous”. Well put, DeeLeigh. Bravo!

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  7. I am an obese woman and I admistor WCB claims at my company. Being obese or even significantly out of shape and age does affect people’s level of injury and their recovery rate. Ask any therapist. The jury is out on whether clusiness (falling down) is due to being obese or if because coordination is required for many activities, people who become obsese did not develop a love of active lifestyles. People who are having issues with their weight or who smoke or who drink too much live in a place of denial that what they are doing does not affect their health in a negative way. We are in a competative world and I must take this into account when I do hiring. WCB and disability cost continue to increase and there is very little and employer can do to eliminate it. Even when people get a clear sign, that their health is impacted for example sore knees, feet, and backs we still do not want to believe that we are to blame for some of the health issues and look to blame someone else. I do have lower back problems and I do attribute this to being overweight and out of shape. If I were to slip at work and strain my back I see that I am to blaim for the strain(someone in shape would not strain their back in this way). Should I expect my company to give me a bigger chair for my bigger behind. No. If I think I need one – I should get it. Do I know how to loose weight. Yes. You would have to be completely oblivous to not understand that eating less and excersing more would have a positive impact. Not everyone is this intuitive. I once had a gentleman making a WCB claim who is at least 70 pounds overweight at his middle section – state to me that his back problems must be due to working here because he did not have back problems 5 years ago when he started working here.

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