Tag Archives: Obesity

Workers' Compensation, workplace injury, workplace safety

The High Cost of Fat

Today’s post comes from guest author Thomas Domer, from The Domer Law Firm.

We have reported regularly on the impact of obesity on workers’ compensation (see WFW October 2005 “Diabetes and Work Injuries” Alan B. King, M.D. and WFW Winter 2009 “The Rising Impact of Obesity on Workers’ Compensation” book review).

A recent study in the Journal of Occupational and Environmental Medicine, the official publication of the American College of Occupational and Environmental Medicine, in September 2016 reported that obese and overweight workers are more likely to result in higher costs related to workers’ compensation claims, especially for major injuries.

In a study analyzing 2,300 workers in Louisiana, Dr. Edward Bernacki of the University of Texas—Austin found that workers’ compensation costs and outcomes for obese workers (defined as a Body Mass Index of 30 or higher) incurred higher costs related to their workers’ compensation claim. This study noted that after three years about 10% of claims for significant injuries were still open, meaning the worker had not yet returned to work. Obesity and overweight did not play a role in the delayed return to work. However, for workers with major injuries, overweight was associated with higher workers’ compensation costs. In the group with the higher Body Mass Index, costs averaged about $470,000 for obese workers, $270,000 for overweight workers compared to $180,000 for normal weight workers (with a Body Mass Index between 25 and 30). The study made adjustments for other factors including the high cost of spinal surgeries and injections and, after making the adjustment for these factors, obese or overweight workers with major injuries were twice as likely to incur costs of $100,000 or more. Significantly, Body Mass Index had no effect at all on costs for closed claims or less severe injuries.

Previous studies (including a study in the Journal of Occupational and Environmental Medicine in 2015 linked obesity to a higher rate of workplace injuries and a longer time off. However, the cost effects were not studied until this recent assessment. The new results indicate obesity is a significant risk factor for higher costs in major workers’ compensation injuries.

One significant finding in the study was that more than three-fourths of the workers’ compensation claimants were overweight or obese. Further studies are planned. Previous studies include those from the National Council on Compensation Insurance, Inc. (NCCI) “How Obesity Increases the Risk of Disabling Workplace Injuries”. Editor’s Note:  According to most studies, there is a strong correlation between Body Mass Index and injuries such as ankle fracture severity and increase risk of osteoarthritis. For workers’ compensation practitioners, one wonders whether these studies are a prelude to an assault on the “as is” doctrine. Each of us in our own practice can recognize some of the wide-ranging effects in costs of obesity, from special procedures for hospital treatment of obese patients such as open MRIs and more extensive surgical procedures to a reduced fuel economy in commercial vehicles due to fat drivers. Additionally, the cost of treatment for obese patients with work-related injuries increases the work-related injury potential to medical staff (lifting, transferring, etc.). Increasing admissions of severely obese patients leads to a corresponding increase in medical workplace injuries related to lifting and maneuvering obese patients. Workers’ compensation practitioners may see obesity as yet another “pre-existing condition” to surmount in future causation and extent of disability battles.

Workers' Compensation

Obesity Prevalence by Occupation in Washington State

Truckers, movers, and police and firefighters are likeliest to be obese. Doctors, scientists and teachers are the healthiest.

Those are the results of a first-of-its-type study the Washington State Department of Labor & Industries sponsored connecting what you do for work with obesity. The study also examined the percentage of workers in specific occupations who smoke, have adequate fruit and vegetable servings, participate in leisure time exercise and report high physical demands of their job.

“This is the first state-level study using the Behavioral Risk Factor Surveillance System data to estimate occupation-specific obesity.” 

“The objective of the research was to identify occupations in need of workplace obesity prevention programs,” said Dr. David K. Bonauto, associate medical director for L&I’s research division. “Employers, policy makers and health practitioners can use our results to target and prioritize prevention and health behavior promotions.”

The study, “Obesity Prevalence by Occupation in Washington State, Behavioral Risk Factor Surveillance System,” was published earlier this year by the Centers for Disease Control and Prevention. The study was based on more than 88,000 participants the CDC contacted in the state in odd years from 2003-2009. It found that nearly 1-in-4 workers statewide were obese.

“We know obesity poses a threat to public health,” Dr. Bonauto said. “This is the first state-level study using the Behavioral Risk Factor Surveillance System data to estimate occupation-specific obesity. All states within the U.S. could have this data if questions about occupation and industry were added to many state and national health surveys.”

Truck drivers were the most obese, nearly 39 percent. The proportion of current smokers was highest also for truck drivers, who – with computer scientists and mechanics – had the lowest proportion of adequate servings of fruits and vegetables. “Truckers are likely influenced by the availability of food choices, such as fast food and convenience stores,” Dr. Bonauto noted.

The study has its limitations. Because researchers used self-reported height and weight, there might be an underestimate of obesity. Also, the body mass index results don’t distinguish between fat and muscle mass. Police and firefighters, for instance, had a high prevalence of obesity but also had the highest proportion of vigorous leisure time physical activity.

Those with less education and an income less than $35,000 had a significantly higher likelihood of being obese, according to the study. Workers who had regular servings of fruits and vegetables and adequate physical exercise were less likely to be obese.

 Photo credit: kennethkonica / Foter / Creative Commons Attribution-NoDerivs 2.0 Generic (CC BY-ND 2.0)