title: Occupational risks associated with cigarette smoking: a prospective study.
abstract: BACKGROUND
  Studies have indicated that cigarette smokers have more occupational accidents and injuries and use more sick time and health benefits than nonsmokers, thereby producing sizeable costs for employers. However, they usually have not controlled for other possible sources of these costs. We analyzed occupational costs associated with smoking while adjusting for a number of potential confounders.
  
  
  METHODS
  We conducted a prospective, controlled study of the association between smoking and employment outcomes in 2537 postal employees, adjusting for age, gender, race, drug use, job category, and exercise habits.
  
  
  RESULTS
  For smokers, the relative risk for turnover was 1.01 (95% confidence interval [CI], 0.83-1.21); for accidents 1.29 (CI, 1.07-1.55); for injuries 1.40 (CI, 1.11-1.77); for discipline 1.55 (CI, 1.19-2.02). Their mean absence rate was 5.43% compared with 4.06% for nonsmokers.
  
  
  CONCLUSIONS
  Our study shows that cigarette smoking is associated with adverse employment outcomes after controlling for a number of possible confounders. This finding has implications for companies formulating smoking policies and considering the establishment of smoking cessation programs.
authors.affiliation: East Boston Neighborhood Health Center, MA.
authors.forename: J
authors.initials: J
authors.lastname: Ryan
authors.forename: C
authors.initials: C
authors.lastname: Zwerling
authors.forename: E J
authors.initials: EJ
authors.lastname: Orav
mesh_terms: D000041:Absenteeism; D000062:Accidents, Occupational / Q000706:statistics & numerical data; D000328:Adult; D001900:Boston / Q000453:epidemiology; D015986:Confounding Factors, Epidemiologic; D004647:Employee Discipline / Q000706:statistics & numerical data; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D016272:Occupational Health / Q000706:statistics & numerical data*; D009790:Occupations; D010563:Personnel Turnover / Q000706:statistics & numerical data; D011177:Postal Service; D016016:Proportional Hazards Models; D011446:Prospective Studies; D044469:Racial Groups; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology