Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
Department of Public Health, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Int Arch Occup Environ Health. 2019 Aug;92(6):855-864. doi: 10.1007/s00420-019-01422-7. Epub 2019 Apr 2.
Obesity and high physical workload are both associated with poor work ability, but the interaction between obesity and high physical workload on work ability is not yet fully understood. Obesity and high physical workload may share a common mechanical pathway, possibly leading to a synergistic negative effect on work ability. The purpose of this study was to investigate the effect of obesity on work ability in workers with high versus low physical work load.
A longitudinal study was conducted among 36,435 Dutch construction workers who participated in at least two periodic medical examinations during the years 2008-2015. Logistic regression analyses were used to investigate the effect of manual material handling and strenuous work postures in sports on the association between obesity and work ability. Work ability was measured using the self-reported Work Ability Index consisting of seven dimensions. Confounding effects were tested for age, educational level, smoking, vigorous physical activity, psychosocial work demands, and working hours. Additive interaction between obesity and physical workload on work ability was tested using the relative excess risk due to interaction (RERI).
Construction workers with overweight (OR = 1.09; 95% CI 1.02-1.16) or obesity (OR = 1.27; 95% CI 1.17-1.38) had an increased risk of poor/moderate work ability. Exposure to manual material handling (OR = 1.58; 95% CI 1.49-1.68) or strenuous work postures (OR = 1.80; 95% CI 1.70-1.90) also increased the risk of poor/moderate work ability. The effect of the combination of obesity with high physical workload was greater than the sum of the individual effects (strenuous work postures: RERI = 0.39; 95% CI 0.10-0.67; manual material handling: RERI = 0.26; 95% CI 0.02-0.51).
Obesity and high physical workload were associated with poor work ability and had a synergistic, negative effect on work ability. Interventions that prevent obesity and high physical workload might have a beneficial effect on work ability.
肥胖和高体力工作负荷均与较差的工作能力相关，但肥胖与高体力工作负荷对工作能力的相互影响尚不完全清楚。肥胖和高体力工作负荷可能具有共同的机械途径，这可能导致对工作能力产生协同的负面影响。本研究旨在调查高体力工作负荷与低体力工作负荷工人中肥胖对工作能力的影响。
对 2008 年至 2015 年期间至少参加过两次定期体检的 36435 名荷兰建筑工人进行了一项纵向研究。使用逻辑回归分析调查了手工搬运和剧烈运动姿势对肥胖与工作能力之间关联的影响。工作能力使用自我报告的工作能力指数进行测量，该指数由七个维度组成。为了测试混杂效应，测试了年龄、教育程度、吸烟、剧烈身体活动、心理社会工作需求和工作时间。使用交互超额相对风险（RERI）测试肥胖和体力工作负荷对工作能力的附加交互作用。
超重（OR=1.09；95%CI 1.02-1.16）或肥胖（OR=1.27；95%CI 1.17-1.38）的建筑工人工作能力较差/中等的风险增加。暴露于手工搬运（OR=1.58；95%CI 1.49-1.68）或剧烈工作姿势（OR=1.80；95%CI 1.70-1.90）也增加了工作能力较差/中等的风险。肥胖与高体力工作负荷相结合的影响大于单个因素的影响之和（剧烈工作姿势：RERI=0.39；95%CI 0.10-0.67；手工搬运：RERI=0.26；95%CI 0.02-0.51）。
肥胖和高体力工作负荷与较差的工作能力相关，对工作能力具有协同的负面影响。预防肥胖和高体力工作负荷的干预措施可能对工作能力产生有益影响。
