Joel Bender

Association of healthcare costs with per unit body mass index increase.

Objective: The objective of this study was to quantify the healthcare costs per unit increase in body mass index (BMI). Methods: This cross-sectional study included 35,932 employees and spouses in a manufacturing company who participated in an indemnity/PPO plan and one health risk appraisal during 2001 and 2002. Results: Within the BMI range of 25 to 45 kg/m2, medical costs and pharmaceutical costs increased

Assessing the burden of disease among an employed population: implications for employer-sponsored prevention programs.

119.7 (4%) and

Effect of health risk appraisal frequency on change in health status.

82.6 (7%) per BMI unit, respectively, adjusted for age and gender. The adjusted medical costs related to diabetes and heart disease increased by

AIRBORNE GLASS FIBER CONCENTRATIONS DURING INSTALLATION OF RESIDENTIAL INSULATION

6.2 and

The association of technology in a workplace wellness program with health risk factor reduction.

20.3 per BMI unit. The likelihood of having any medical claim increased 11.6% per BMI unit for diabetes and 5.2% for heart disease. Conclusions: Each unit increase in BMI is associated with higher healthcare costs and increased likelihood of having claims for most major diagnostic codes and for diabetes and heart diseases.

AIRBORNE GLASS FIBER CONCENTRATIONS DURING MANUFACTURING OPERATIONS INVOLVING GLASS WOOL INSULATION

Learning ObjectivesList the components of the DALY (disability-adjusted life year) and explain how DALYs are estimated.Recall the disease states that are the most frequent causes of DALYs and note any differences related to gender or employment status (hourly or salaried).Discuss the risk factors underlying the leading causes of DALYs and how they might be modified. Escalating healthcare costs have led employers to identify ways to assess the actual burden of disease among their employees. One such measure is the use of disability-adjusted life-years (DALYs). DALYs were calculated for the General Motors (GM) population for 1994 through 1998 using data from GM’s Mortality Registry, published life tables, and age- and sex-specific disease incidence and disability data from the U.S. Burden of Disease Study. Chronic diseases accounted for 45% (245,844 of 540,450) of total DALYs lost. Ischemic heart disease, stroke, lung cancer, and chronic obstructive pulmonary disease led the list for both men and women and accounted for 39% and 31%, respectively, of the top 10 DALYs lost. Disease burden among employees could be reduced through targeted interventions aimed at the risk factors associated with the leading causes of DALYs.

Two-Year Outcomes Show Effectiveness of The Prevention Program in Lowering Health Risks and Costs

Objective: To examine the association between repeat participation in health risk appraisal (HRA) and change in health status. If low-risk individuals get worse in their health status, the amount of cost increase tends to be greater than the amount of cost reduction when high-risk individuals improve their health status. Thus, “no change” in health status was considered a desired change along with “getting better” in this study. Methods: Longitudinal data (1997 to 2004) were used to measure change in health status and participation in HRAs and wellness programs. Results: Taking an HRA more than once between 2002 and 2004 was associated with a desired change in health status (staying no change or getting better) (P < 0.0001). Additionally, participation in wellness programs during the same time period was also positively associated with a desired change (P < 0.05). Conclusions: These results highlight the effect of continued engagement in health promotion activities on health status change. Combined with other education and intervention programs, HRAs can be useful tools in promoting and maintaining healthy lifestyles.

The economic value of automotive occupational health services: business metrics for performance management.

In an effort to better characterize airborne fiber levels associated with the installation of residential insulation and to determine the proportion of airborne fibers that are glass fibers, airborne fiber concentrations were measured during the installation of several Owens-Corning Fiberglas insulation products. Sample collection and fiber counting procedures followed National Institute for Occupational Safety and Health Method 7400 with some modifications to allow identification of the fiber type. The arithmetic mean concentration of total airborne fibers during installation of batt-type insulation was 0.22 fibers per cubic centimeter (f/cc) (95% confidence limits of 0.18–0.27 f/cc). Significantly, approximately 60% of these total fibers were glass fibers and approximately 20% were respirable glass fibers. For applications of blowing wool, the total airborne fiber concentrations were higher, with means of 1.0 f/cc (0.9–1.1) or 2.1 f/cc (15–2.7), depending on the product type. Glass fibers were 0.7 f/cc ...

Quantitative Risk Assessment for a Glass Fiber Insulation Product

Objective: Determine whether there is a relationship between level of engagement in workplace wellness programs and population/individual health risk reductions. Methods: A total of 7804 employees from 15 employers completed health risk appraisal and laboratory testing at baseline and again after 2 years of participating in their personalized prevention plan. Population and individual health risk transitions were analyzed across the population, as well as by stage of engagement. Results: Of those individuals who started in a high risk category at baseline, 46% moved down to medium risk and 19% moved down to low risk category after 2 years on their prevention plan. In the group that only engaged through the Web-based technology, 24% reduced their health risks (P < 0.0001). Conclusions: Engaging technology and interactive Web-based tools can empower individuals to be more proactive about their health and reduce their health risks.

The Use of Noncancer Endpoints as a Basis for Establishing a Reference Concentration for Formaldehyde

In order to better characterize airborne fiber concentrations arising in manufacturing operations that use glass wool insulation, and to determine the proportion of these fibers that are glass fibers, airborne fiber concentrations were measured in a number of different operations involving Owens-Corning Fiberglas insulation products. The operations sampled included those that fabricate or assemble metal building insulation, manufactured housing, pipe insulation, kitchen ranges, air-handling ducts, and water heaters. Some operations in which pipe insulation and ceiling boards were removed and discarded were also measured. Sample collection and fiber-counting procedures followed National Institute for Occupational Safety and Health Method 7400 procedures (phase contrast light microscopy), with some modifications to allow identification of the fiber type. The arithmetic mean concentration of total airborne fibers during 11 different manufacturing operations ranged from 0.02–0.2 fibers/cm3, of which typically...