TUNCELI, KAAN, KEMENG LI, AND L. KEOKI WILLIAMS. Long-term effects of obesity on employment and work limitations among U. S. adults, 1986S. adults, to 1999S. adults, .Obesity. 200614:1637-1646. Objective: To determine the relationships between BMI and workforce participation and the presence of work limitations in a U.S. working-age population. Research Methods and Procedures:We used data from the Panel Study of Income Dynamics, a nationwide prospective cohort, to estimate the effect of obesity in 1986 on employment and work limitations in 1999. Individuals were classified into the following weight categories: underweight (BMI Ͻ 18.5), normal weight (18.5 Յ BMI Ͻ 25), overweight (25 Յ BMI Ͻ 30), and obese (BMI Ն 30). Using multivariable probit models, we estimated the relationships between obesity and both employment and work disability. All analyses were stratified by sex. Results: After adjusting for baseline sociodemographic characteristics, smoking status, exercise, and self-reported health, obesity was associated with reduced employment at follow-up [men: marginal effect (ME) Ϫ4.8 percentage points (pp); p Ͻ 0.05; women: ME Ϫ5.8 pp; p Ͻ 0.10]. Among employed women, being either overweight or obese was associated with an increase in self-reported work limitations when compared with normal-weight individuals (overweight: ME ϩ3.9 pp; p Ͻ 0.01; obese: ME ϩ12.6 pp; p Ͻ 0.01). Among men, the relationship between obesity and work limitations was not statistically significant.Discussion: Obesity appears to result in future productivity losses through reduced workforce participation and increased work limitations. These findings have important implications in the U.S., which is currently experiencing a rise in the prevalence of obesity.

Current adolescent overweight will likely lead to large future economic and health burdens, especially lost productivity from premature death and disability. Application of currently available medical treatments will not greatly reduce these future burdens of increased adult obesity.

Travel-associated outbreaks of legionnaires disease (LD) and combined outbreaks of LD and Pontiac fever (PF) are rarely identified. During one travel-associated combined outbreak at a hotel, a cohort study of potentially exposed persons and an environmental investigation were performed. Two LD and 22 PF cases were identified. Legionella pneumophila serogroup 6 (Lp6) isolates from the index patient and the hotel whirlpool spa were found to be identical by amplified fragment-length polymorphism typing. Disease occurred in 10 of 26 guests who were exposed to the spa versus 2 of 29 guests who were exposed only to the pool area (38% vs. 7%; P=.005). Immunoglobulin M (IgM) antibody to the outbreak Lp6 strain was more common among persons with PF (4 of 9) than among non-ill persons (2 of 32) (44% vs. 6%; P=.02). Spa exposure correlated with disease (P=.001) and IgM seropositivity (P=.007). New laboratory techniques facilitate outbreak investigation; to expedite outbreak interruption and measure the impact of travel-associated legionellosis, surveillance must be improved.