Truck Drivers Top the Obesity List, Physicians Rank Last

Miriam E. Tucker

January 13, 2014

US truck drivers are among the most obese workers and physicians among the leanest, according to federal survey data collected in Washington State.

As the US workforce ages, chronic conditions related to obesity are predicted to cost $4.2 trillion annually by 2023. Despite recent public-policy efforts aimed at improving workplace wellness, few studies have focused on estimating the prevalence of obesity and health-related behaviors by occupation, say David K. Bonauto, MD, from the Washington State Department of Labor and Industries, Olympia, and colleagues. Their findings, from the Behavioral Risk Factor Surveillance System (BRFSS) from 2003 to 2009, were published online January 9, 2014, in Preventing Chronic Disease.

"Characterizing obesity prevalence by occupation may influence key stakeholders to develop workplace wellness programs, which help identify unique societal and occupational factors for effective intervention to modify obesity risk factors. It also allows for the allocation of public-health resources to high-risk worker groups that are most likely to benefit from such programs," Dr. Bonauto and colleagues write.

Wide Range in Obesity by Occupation

Of a total 37,626 workers in Washington State who had nonmilitary occupations listed in the BRFSS, were aged 18 to 64 years, and had a self-reported body mass index (BMI) of 18.5 or above, the overall prevalence of obesity (BMI > 30) was 24.6%.

The lowest prevalence, 11.6%, was seen among those with health-diagnosing occupations, including physicians, dentists, veterinarians, and optometrists.

At the other extreme were truck drivers, with an obesity prevalence of 38.6%. Other high-obesity occupations included transportation and material moving (37.9%), protective services (33.3%), and cleaning/building services (29.5%).

The high obesity rate among protective-services workers such as firefighters and police officers, despite their high levels of activity, may reflect the limitations of using BMI as a measure of obesity, the authors note.

Using health-diagnosing professions as the reference and adjusting for confounding variables, researchers found that the prevalence ratios (PRs) for obesity were 2.46 for protective services and 2.45 for truck drivers. In contrast, prevalence ratios for natural and social scientists, postsecondary teachers, and lawyers/judges were not different from the health-diagnosing professions.

The investigators also looked at obesity-related behaviors among workers, including levels of physical activity, smoking, and consumption of fruits and vegetables. Those who characterized their occupational physical-activity level as physically demanding were less likely to be obese than those who characterized their jobs as not physically demanding (PR = 0.83).

Nonsmokers were more likely to be obese than smokers (PR = 1.17), probably due to the appetite-suppressant effect of smoking, the authors note.

Workers who consumed adequate amounts of fruits and vegetables (5 or more servings a day) and had adequate physical activity (20 minutes or more per day for 3 or more times/week) were significantly less likely to be obese than were those who ate more and exercised less (PR = 0.91).

Workplace Initiatives Advised

"Evidence-based interventions suggest that employers identify the most effective interventions suitable to their specific workplace," Dr. Bonauto and colleagues say. They also "promote worker engagement in physical activity with economic incentives and introduce educational programs on healthier lifestyles, nutrition, and food-budget management.

"Comprehensive workplace health intervention programs must be promoted and implemented to protect workers against the obesity epidemic in Washington State and in the United States," they conclude.

The authors have reported no relevant financial relationships.

Prev Chronic Dis. Published online January 9, 2014. Article

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