Objectives: Although smoking causes a variety of diseases and both, a high smoking prevalence and permanent disability pension 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 disability pension among construction workers, an occupational group with particularly high smoking prevalence.
Methods: The association between smoking and disability pension 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. 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 (BMI).
Results: Overall, 2643 cases of disability pension were observed, with dorsopathy (21%) being the most common cause. Clear dose-response relationships were seen between smoking and disability pension due to all causes, as well as disability pension due to respiratory, cardiovascular and mental diseases, cancer and dorsopathy. Particularly strong associations were seen between heavy smoking (>= 20 cigarettes/day) and disability pension due to mental and respiratory diseases (hazard ratios with 95% confidence intervals: 3.25; 1.93-5.46 3.23; 1.92-5.43 and 3.26; 1.69-6.27 3.31; 1.73-6.36respectively).
Conclusion: Smoking is associated with increased risk of disability pension among construction workers, in particular disability pension due to respiratory, cardiovascular and mental diseases, cancer and dorsopathy.