Obesity and Occupational Injury: A Prospective Cohort Study of 69,515 Public Sector Employees

BACKGROUND Obesity and overweight are suggested to increase the risk of occupational injury but longitudinal evidence to confirm this is rare. We sought to evaluate obesity and overweight as risk factors for occupational injuries. METHODOLOGY/PRINCIPAL FINDINGS A total of 69,515 public sector employees (80% women) responded to a survey in 2000-2002, 2004 or 2008. Body mass index (kg/m(2)) was derived from self-reported height and weight and was linked to records of subsequent occupational injuries obtained from national registers. Different injury types, locations and events or exposures (the manner in which the injury was produced or inflicted) were analyzed by body mass index category adjusting for baseline socio-demographic characteristics, work characteristics, health-risk behaviors, physical and mental health, insomnia symptoms, and sleep duration. During the mean follow-up of 7.8 years (SD = 3.2), 18% of the employees (N = 12,204) recorded at least one occupational injury. Obesity was associated with a higher overall risk of occupational injury; multivariable adjusted hazard ratio (HR) 1.21 (95% CI 1.14-1.27). A relationship was observed for bone fractures (HR = 1.37; 95% CI: 1.10-1.70), dislocations, sprains and strains (HR = 1.36; 95% CI: 1.25-1.49), concussions and internal injuries (HR = 1.26; 95% CI: 1.11-1.44), injuries to lower extremities (HR = 1.62; 95%: 1.46-1.79) and injuries to whole body or multiple sites (HR = 1.37; 95%: 1.10-1.70). Furthermore, obesity was associated with a higher risk of injuries caused by slipping, tripping, stumbling and falling (HR = 1.55; 95% CI: 1.40-1.73), sudden body movement with or without physical stress (HR = 1.24; 95% CI: 1.10-1.41) and shock, fright, violence, aggression, threat or unexpected presence (HR = 1.33; 95% CI: 1.03-1.72). The magnitude of the associations between overweight and injuries was smaller, but the associations were generally in the same direction as those of obesity. CONCLUSIONS/SIGNIFICANCE Obese employees record more occupational injuries than those with recommended healthy weight.