title: Obesity and risk of job disability in male firefighters.
abstract: 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.
  
  
  OBJECTIVE
  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 >or= 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.
authors.affiliation: Harvard School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, MA, USA. esoteria@hsph.harvard.edu
authors.forename: Elpidoforos S
authors.initials: ES
authors.lastname: Soteriades
authors.forename: Russ
authors.initials: R
authors.lastname: Hauser
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
authors.forename: Stefanos N
authors.initials: SN
authors.lastname: Kales
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D005390:Fires; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications*; D016272:Occupational Health; D011446:Prospective Studies; D018635:Rescue Work; D012307:Risk Factors; D017751:Safety Management / Q000592:standards*; D013315:Stress, Psychological