文章基本信息

标题：Work, Obesity, and Occupational Safety and Health
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作者：Paul A. Schulte ; Gregory R. Wagner ; Aleck Ostry 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2007
卷号：97
期号：3
页码：428-436
DOI：10.2105/AJPH.2006.086900
语种：English
出版社：American Public Health Association
摘要：There is increasing evidence that obesity and overweight may be related, in part, to adverse work conditions. In particular, the risk of obesity may increase in high-demand, low-control work environments, and for those who work long hours. In addition, obesity may modify the risk for vibration-induced injury and certain occupational musculoskeletal disorders. We hypothesized that obesity may also be a co–risk factor for the development of occupational asthma and cardiovascular disease that and it may modify the worker’s response to occupational stress, immune response to chemical exposures, and risk of disease from occupational neurotoxins. We developed 5 conceptual models of the interrelationship of work, obesity, and occupational safety and health and highlighted the ethical, legal, and social issues related to fuller consideration of obesity’s role in occupational health and safety. Workplace hazards continue to exact a large toll on society in terms of morbidity, mortality, and financial and social costs, which provides justification for the ongoing national commitment to the protection of the health of the workforce. 1 ^– 4 At the same time, obesity and overweight are increasingly becoming the focus of public health concern. 5 ^– 11 Nearly two thirds of US adults have a body mass index (BMI) higher than 25 kg/m² and are classified as overweight. 7 Obesity, defined as a BMI greater than 30 kg/m², is considered to be a national public health crisis. 7 ^, 8 Both obesity and occupational morbidity and mortality are global problems as well. 6 ^, 9 ^, 10 Employed adults spend a quarter of their lives at work, and the pressure and demands of work may affect their eating habits and activity patterns, which may lead to overweight and obesity. 12 ^– 17 These same pressures and other factors at work (such as exposures to harmful agents, physical forces, and psychosocial stress and strain) can also lead to occupational injury and illness. Obesity may affect both work opportunity and performance as well as modify the relationship between work-place exposure and health outcome. The nature of many of these interactions is not well studied or understood. Should the obesity–work relationship be a priority when one is planning for occupational safety and health research? Moreover, should workers’ obesity be given any more consideration than other modifiable risk factors such as smoking, blood pressure, blood glucose levels, alcohol use, and medication levels when one is addressing workplace issues? Is there any particular advantage to intervention in the workplace to affect the prevalence of obesity? We examined the nexus of obesity, work, and occupational disease and injury; identified information gaps and potential research leads; and highlighted ethical, legal, and social issues related to the intersection of these topics. In some instances, obesity and workplace risks (e.g., organizational factors and hazardous exposures) may be related, and obesity may represent an additional risk factor for particular diseases that result from workplace exposures. Better understanding of relationships between obesity and work may encourage identification of interventions to address both obesity and workplace disease and injury. Historically, these 2 areas have been considered separate domains. Obesity arises from complex social and biological phenomena, but is often perceived as the result of an individual’s behaviors. By contrast, occupational disease and injury prevention is primarily the responsibility of the employer. Strategies to combine protection from occupational risk with programs to encourage individual change to diminish health risk from obesity warrant consideration. Poorly done, such efforts may result in the individual workers being blamed for their obesity and may distract from the workplace contribution to injury or illness. Even if this shift does not occur, there is concern that scarce resources for reduction of risk from workplace hazards will be diluted or decreased by the focus on obesity in workers. Moreover, such attention to the individual’s behavior may shift focus from the more important social, cultural, and environmental causes of, and interventions for, obesity. 11 ^, 18 ^– 20 The following 4 sections focus on the relationships between work, work conditions and exposures, and obesity.