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Occupational Medicine Advance Access published online on January 18, 2008
Occupational Medicine, doi:10.1093/occmed/kqm153
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Obesity and risk of job disability in male firefighters

Elpidoforos S. Soteriades1, Russ Hauser1, Ichiro Kawachi2, David C. Christiani1,3 and Stefanos N. Kales1,4

1 Harvard School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, MA, USA
2 Harvard School of Public Health, Departments of Epidemiology and Society, Human Development and Health, Boston, MA, USA
3 Massachusetts General Hospital, Pulmonary/Critical Care Unit, Harvard Medical School, Boston, MA, USA
4 The Cambridge Health Alliance, Harvard Medical School, Employee Health and Industrial Medicine, Cambridge, MA, USA

Background Obesity is a major public health problem and a workplace epidemic in Western societies. However, little is known about the association between obesity and job disability in specific occupational groups.

Aim To examine the association between obesity and risk of job disability among firefighters.

Methods A prospective cohort study design was employed in following 358 Massachusetts firefighters enrolled in a statewide medical surveillance program. We prospectively evaluated time to development of adverse employment outcomes >6 years of follow-up.

Results In multivariable-adjusted Cox proportional hazard models, we found that every one-unit increase in body mass index (BMI) was associated with a 5% increased risk of job disability. Compared to firefighters in the lowest tertile of BMI (BMI < 27.2), those in the highest tertile (BMI ≥ 30.2) had a significantly increased risk of an adverse employment event with a multivariable-adjusted hazard ratio (HR) of 1.98 (95% CI 1.06–3.72). There was also a significant dose–response relationship of increasing risk across tertiles, as well as a significant trend: HR 1.39 (95% CI 1.04–1.86). The highest categories of BMI had a 60–90% increased risk of job disability compared to the lowest or normal-weight categories, respectively.

Conclusions Obesity is associated with higher risk of job disability in firefighters. Additional research is needed to further explore our findings. Our study may have economic and public health implications in other occupational settings.

Keywords      BMI; firefighters; fitness for duty; job disability; obesity

Correspondence to: Elpidoforos S. Soteriades, 2 Antigonis Street, 2035 Strovolos, Nicosia, Cyprus. Tel: +357 99 410677; fax: +357 22316915; e-mail: esoteria{at}hsph.harvard.edu


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