Smoking habits and occupational disability: a cohort study of 14,483 construction workers.
OBJECTIVE
Although smoking causes a variety of diseases and both, a high smoking prevalence and permanent occupational disability are a great burden on the population level, data about the impact of smoking habits on occupational disability are sparse. The objective of this study was to examine the influence of smoking habits on occupational disability among construction workers, an occupational group with particularly high smoking prevalence.


METHODS
The association between smoking and occupational disability was examined during a mean follow-up of 10.8 years in a cohort of 14,483 male construction workers in Württemberg, Germany. The cohort was linked to the regional pension register of the German pension fund to identify workers who were granted a disability pension during the follow-up. HRs (Hazard Ratios) were calculated with non-smokers as reference by the Cox proportional hazards model adjusting for potential confounding factors such as age, nationality, type of occupation, alcohol consumption and body mass index.


RESULTS
Overall, 2643 cases of occupational disability were observed, with dorsopathy (21%) being the most common cause. Clear dose-response relationships were seen between smoking and occupational disability due to all causes, as well as occupational disability due to respiratory, cardiovascular and mental diseases, cancer and dorsopathy. Particularly strong associations were seen between heavy smoking (> or =20 cigarettes/day) and occupational disability due to mental and respiratory diseases (HR 3.25, 95% CI 1.93 to 5.46 and HR 3.26, 95% CI 1.69 to 6.27, respectively).


CONCLUSIONS
Smoking is associated with increased risk of occupational disability among construction workers, in particular occupational disability due to respiratory, cardiovascular and mental diseases, cancer and dorsopathy.
Claessen
Heiner
H
German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research, Bergheimer Strasse 20, 69115 Heidelberg, Germany.
Arndt
Volker
V
Drath
Christoph
C
Brenner
Hermann
H
D000328:Adult; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D004185:Disability Evaluation; D004812:Epidemiologic Methods; D005160:Facility Design and Construction; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology