Ferrie Jane E, Head Jenny, Shipley Martin J, Vahtera Jussi, Marmot Michael G, Kivimäki Mika
Department of Epidemiology and Public Health, University College London Medical School, 1-19 Torrington Place, London WC1E 6BT, UK.
Obesity (Silver Spring). 2007 Jun;15(6):1554-64. doi: 10.1038/oby.2007.184.
To study BMI and change in BMI from age 25 as predictors of sickness absence.
Data were collected from 2564 women and 5853 men, who were British civil servants (35 to 55 years) on entry to the Whitehall II study (Phase 1, 1985 to 1988). Employer's records provided annual medically certified (long, >7 days) and self-certified (short, 1 to 7 days) spells of sickness absence. BMI at age 25 and Phase 1 were examined in relation to absences from Phase 1 to the end of 1998 (mean follow-up, 7.0 years).
After adjustment for employment grade, health-related behaviors, and health status, overweight (BMI = 25.0 to 29.9 kg/m(2)) and obesity (BMI > 30.0 kg/m(2)) at Phase 1 were significant predictors of short and long absences in both sexes; rate ratios (95% confidence intervals) ranged from 1.13 (1.05 to 1.21) to 1.51 (1.30 to 1.76) compared with a BMI of 21.0 to 22.9 kg/m(2). Additionally, a BMI of 23.0 to 24.9 kg/m(2) at Phase 1 predicted long absences in women, and underweight (BMI < 21.0 kg/m(2)) predicted short absences in men. Obesity at age 25 predicted long absences, and obesity at Phase 1 predicted short and long absences in both sexes. Chronic obesity was a particularly strong predictor of long absences in men, with a rate ratio of 2.61 (1.88 to 3.63).
Findings from this well-characterized cohort suggest that the obesity epidemic in industrialized countries may result in significant increases in sickness absence. Further research is needed to determine the underlying mechanisms. Policy to reduce sickness absence needs to tackle the problem of excess weight in the working population.
研究体重指数（BMI）及25岁起BMI的变化作为病假预测指标的情况。
数据收集自2564名女性和5853名男性，他们在进入白厅二期研究（1985年至1988年第一阶段）时是英国公务员（35至55岁）。雇主记录提供了每年经医学认证（长期，>7天）和自我认证（短期，1至7天）的病假时长。研究了25岁时及第一阶段的BMI与1998年底（平均随访7.0年）第一阶段后的病假情况之间的关系。
在对就业等级、健康相关行为和健康状况进行调整后，第一阶段超重（BMI = 25.0至29.9 kg/m²）和肥胖（BMI > 30.0 kg/m²）是男女短期和长期病假的显著预测指标；与BMI为21.0至22.9 kg/m²相比，率比（95%置信区间）范围从1.13（1.05至1.21）到1.51（1.30至1.76）。此外，第一阶段BMI为23.0至24.9 kg/m²可预测女性的长期病假，体重过轻（BMI < 21.0 kg/m²）可预测男性的短期病假。25岁时肥胖可预测长期病假，第一阶段肥胖可预测男女的短期和长期病假。慢性肥胖是男性长期病假的特别强的预测指标，率比为2.61（1.88至3.63）。
来自这个特征明确的队列的研究结果表明，工业化国家的肥胖流行可能导致病假显著增加。需要进一步研究以确定潜在机制。减少病假的政策需要解决工作人群超重的问题。
