Conceptual heuristic models of the interrelationships between obesity and the occupational environment

Abstract

Pandalai SP, Schulte PA, Miller DB. Conceptual heuristic models of the interrelationships between obesity and the occupational environment. Scand J Work Environ Health. 2013;39(3):221-232. doi:10.5271/sjweh.3363 Objective Research and interventions targeting the relationship between work, its attendant occupational hazards, and obesity are evolving but merit further consideration in the public health arena. In this discussion paper, conceptual heuristic models are described examining the role of obesity as both a risk factor and health outcome in the occupational setting.Methods PubMed was searched using specific criteria from 2000 and onwards for evidence to support conceptual models in which obesity serves as a risk factor for occupational disease or an outcome of occupational exposures. Nine models are presented: four where obesity is a risk factor and five where it is an adverse effect.Results A broad range of work-related health effects are associated with obesity including musculoskeletal disorders, asthma, liver disease, and cardiovascular disease, among others. Obesity can be associated with occupational hazards such as shift work, sedentary work, job stress, and exposure to some chemicals. Conclusion Identification of combinations of risk factors pertinent to obesity in the occupational environmentwill provide important guidance for research and prevention.Key terms cardiovascular disease; diet; endocrine disruptor; intervention study; metabolism; musculoskeletal disease; occupational health; physical activity; risk assessment.1 National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA.Correspondence to: Sudha P Pandalai, MD, PhD, National Institute for Occupational Safety and Health Centers for Disease Control and Prevention, 4676 Columbia Parkway, Cincinnati, OH 45226, Obesity is increasing worldwide with the 2009-2010 prevalence among US adults surpassing one-third (1, 2). Obesity is associated with genetic, behavioral, occupational, and environmental factors (3-5) and has significant economic impact (6). It is also associated with various health problems including musculoskeletal disorders (MSD), asthma, liver disease, and cardiovascular disease (CVD) (7-10). Moreover, neurohormonal and endocrine pathway disruption has been associated with obesity (11,12). Work factors, including sedentary work and taskrelated biomechanics, have been reported as risks for obesity (13)(14)(15). Variables such as irregular work hours/ sleep schedules, job stress, workplace absenteeism, and reduced productivity also contribute (16)(17)(18)(19).Although the related literature is growing, obesity in the occupational environment requires more study, for example, regarding low-wage workers and genes or other factors (20,21). Body mass index (BMI), a measure of obesity, varies by population, race, gender, and socioeconomic class (22)(23)(24). Genetics may account for ≥40% of the variation in BMI (25), but such estimates can depend on the variability of environ...

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