• disability

The paper published by Robroek et al 1 estimates the incidence of work disability attributed separately and jointly to obesity and to high physical job demands in a large longitudinal cohort of Swedish construction workers. This cohort has been well described previously and has important strengths, including a large representative sample of male workers in this sector.

For construction workers who participated in a programme offering periodic health examinations, height and weight, measured directly, were obtained from a first examination. The mean age of the 328 743 men at the time of first examination was 32 years of age. Approximately 29% were overweight (body mass index (BMI) 25–29) and 4% were obese (BMI >30). Physical workload measures were imputed from a job exposure matrix. Information on self-reported exposures of the frequency of lifting heavy loads and the frequency of working in bent or twisted working postures was obtained from 77 000 construction workers over the period 1989–1992. From this information, 22 categories of construction occupations were assigned to one of three ordinal groups: low (14.7%), intermediate (28.0%) and high (57.4%) physical workload.

The study found an association between overweight and obese status and the receipt of a disability benefit over a mean follow-up of 22 years. (HR overweight: 1.21, 95% CI 1.19 to 1.23, HR obese: 1.70, 95% CI 1.65 to 1.76. Workers in occupations with higher …