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Overweight, obesity and risk of work disability: a cohort study of construction workers in Germany
  1. H Claessen1,
  2. V Arndt1,
  3. C Drath2,
  4. H Brenner1
  1. 1
    German Cancer Research Center, Division of Clinical Epidemiology and Aging Research, Heidelberg, Germany
  2. 2
    Workmen’s Compensation Board for Construction Workers, Occupational Health Service, Böblingen, Germany
  1. Dr Hermann Brenner, German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research (C070), Bergheimer Strasse 20, 69115 Heidelberg, Germany; h.brenner{at}


Objectives: Although obesity and permanent work disability impose a great burden on the individual and are very costly for society, data on the impact of being overweight on occupational disability are sparse, especially in men who work hard physically. The aim of this study was to investigate the association of body mass index (BMI) with work disability among construction workers.

Methods: The association between BMI and work disability was examined during a mean follow-up period of 10.8 years in a cohort of 16 875 male construction workers in Württemberg, Germany, who participated in routine occupational health examinations from 1986 to 1992. Hazard ratios were calculated with normal weight (20.0–22.4 kg/m2) as reference using the Cox proportional hazards model, after adjustment for potential confounding factors.

Results: Overall, a U-shaped association of BMI with all-cause work disability (total number = 3064 cases) was observed, with the lowest risk of disabilities at BMI levels between 25 and 27.4 kg/m2. Strong positive associations were observed between BMI and work disability due to osteoarthritis or cardiovascular diseases, whereas BMI was inversely related to work disability due to cancer, even after exclusion of the first 3 years of follow-up.

Conclusions: Moderate overweight is not associated with increased risk of work disability among construction workers, but obesity increases the risk of work disability due to osteoarthritis and cardiovascular disease.

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  • Funding: The data collection was supported in part by the Association of the Workmen’s Compensation Board for Construction Workers, Germany. The work of Heiner Claessen was supported in part by grants from the German Pension Fund (Deutsche Rentenversicherung Baden-Württemberg und Deutsche Rentenversicherung Bund, project number (0421/40-64-50-13)).

  • Competing interests: None.

  • Ethics approval: The study was approved by the ethics committees of the medical faculty of the university clinics of Heidelberg and Ulm and by the Baden-Württemberg state ministry of social affairs.