Sara E. Luckhaupt

Prevalence of Obesity Among U.S. Workers and Associations with Occupational Factors

BACKGROUND Along with public health and clinical professionals, employers are taking note of rising obesity rates among their employees, as obesity is strongly related to chronic health problems and concomitant increased healthcare costs. Contributors to the obesity epidemic are complex and numerous, and may include several work characteristics. PURPOSE To explore associations between occupational factors and obesity among U.S. workers. METHODS Data from the 2010 National Health Interview Survey were utilized to calculate weighted prevalence rates and prevalence ratios (PRs) for obesity in relation to workweek length, work schedule, work arrangement, hostile work environment, job insecurity, work-family imbalance, and industry and occupation of employment. Data were collected in 2010 and analyzed in 2012-2013. RESULTS Overall, 27.7% of U.S. workers met the BMI criterion for obesity. Among all workers, employment for more than 40 hours per week and exposure to a hostile work environment were significantly associated with an increased prevalence of obesity, although the differences were modest. Employment in health care and social assistance and public administration industries, as well as architecture and engineering, community and social service, protective service, and office and administrative support occupations was also associated with increased obesity prevalence. CONCLUSIONS Work-related factors may contribute to the high prevalence of obesity in the U.S. working population. Public health professionals and employers should consider workplace interventions that target organization-level factors, such as scheduling and prevention of workplace hostility, along with individual-level factors such as diet and exercise.

Prevalence rates of work organization characteristics among workers in the U.S.: data from the 2010 National Health Interview Survey.

BACKGROUND Surveillance is needed to capture work organization characteristics and to identify their trends. METHODS Data from the 2010 National Health Interview Survey (NHIS) were used to calculate prevalence rates for four work organization characteristics (long work hours, non-standard work arrangements, temporary positions, and alternative shifts) overall, and by demographic characteristics, and industry and occupation of current/recent employment. RESULTS Data were available for 27,157 adults, of which 65% were current/recent workers. Among adults who worked in the past 12 months, 18.7% worked 48 hr or more per week, 7.2% worked 60 hr or more per week, 18.7% had non-standard work arrangements, 7.2% were in temporary positions, and 28.7% worked an alternative shift. CONCLUSIONS Prevalence rates of work organization characteristics are provided. These national estimates can be used to help occupational health professionals and employers to identify emerging occupational safety and health risks, allow researchers to examine associations with health, and use the data for benchmarking.

Prevalence and work-relatedness of carpal tunnel syndrome in the working population, United States, 2010 National Health Interview Survey.

BACKGROUND Patterns of prevalence and work-relatedness of carpal tunnel syndrome (CTS) among workers offer clues about risk factors and targets for prevention. METHODS Data from an occupational health supplement to the 2010 National Health Interview Survey were used to estimate the prevalence of self-reported clinician-diagnosed CTS overall and by demographic characteristics. The proportion of these cases self-reported to have been attributed to work by clinicians was also examined overall and by demographic characteristics. In addition, the distribution of industry and occupation (I&O) categories to which work-related cases of CTS were attributed was compared to the distribution of I&O categories of employment among current/recent workers. RESULTS Data were available for 27,157 adults, including 17,524 current/recent workers. The overall lifetime prevalence of clinician-diagnosed CTS among current/recent workers was 6.7%. The 12-month prevalence was 3.1%, representing approximately 4.8 million workers with current CTS; 67.1% of these cases were attributed to work by clinicians, with overrepresentation of certain I&O categories. CONCLUSIONS CTS affected almost 5 million U.S. workers in 2010, with prevalence varying by demographic characteristics and I&O.

Job insecurity, work‐family imbalance, and hostile work environment: Prevalence data from the 2010 National Health Interview Survey

BACKGROUND Little nationally representative information on job insecurity, work-family imbalance, and hostile work environments experienced by workers in the US is available. METHODS Prevalence rates from the 2010 National Health Interview Survey (NHIS) were calculated for three workplace psychosocial factors (job insecurity, work-family imbalance, bullying/harassment) using SUDAAN to account for the complex NHIS sample design. RESULTS Data were available for 17,524 adults who worked in the 12 months that preceded the interview. Overall prevalence rates were 31.7% for job insecurity, 16.3% for work-family imbalance, and 7.8% for hostile work environment (being bullied or harassed). The highest prevalence rate of job insecurity was found for construction and extraction occupations. Workers in legal occupations had the highest prevalence rate of work-family imbalance. Workers in protective service occupations had the highest prevalence rate of hostile work environment. CONCLUSIONS We identified demographic characteristics along with industries and occupations with the highest prevalence rates for three adverse workplace psychosocial factors. These data can be used for benchmarking and identification of targets for investigation and intervention activities.

Risk of Cancer Among Firefighters in California, 1988–2007

BACKGROUND Most studies of firefighter cancer risks were conducted prior to 1990 and do not reflect risk from advances in building materials. METHODS A case-control study using California Cancer Registry data (1988-2007) was conducted to evaluate the risk of cancer among firefighters, stratified by race. RESULTS This study identified 3,996 male firefighters with cancer. Firefighters were found to have a significantly elevated risk for melanoma (odds ratio [OR] = 1.8; 95% confidence interval [CI] 1.4-2.1), multiple myeloma (OR 1.4; 95%CI 1.0-1.8), acute myeloid leukemia (OR 1.4; 95%CI 1.0-2.0), and cancers of the esophagus (OR 1.6; 95%CI 1.2-2.1), prostate (OR 1.5; 95%CI 1.3-1.7), brain (OR 1.5; 95%CI 1.2-2.0), and kidney (OR 1.3; 95%CI 1.0-1.6). CONCLUSIONS In addition to observing cancer findings consistent with previous research, this study generated novel findings for firefighters with race/ethnicity other than white. It provides additional evidence to support the association between firefighting and several specific cancers.

The prevalence of selected potentially hazardous workplace exposures in the US: Findings from the 2010 National Health Interview Survey

OBJECTIVE Assess the national prevalence of current workplace exposure to potential skin hazards, secondhand smoke (SHS), and outdoor work among various industry and occupation groups. Also, assess the national prevalence of chronic workplace exposure to vapors, gas, dust, and fumes (VGDF) among these groups. METHODS Data were obtained from the 2010 National Health Interview Survey (NHIS). NHIS is a multistage probability sample survey of the civilian non-institutionalized population of the US. Prevalence rates and their variances were calculated using SUDAAN to account for the complex NHIS sample design. RESULTS The data for 2010 were available for 17,524 adults who worked in the 12 months that preceded interview. The highest prevalence rates of hazardous workplace exposures were typically in agriculture, mining, and construction. The prevalence rate of frequent handling of or skin contact with chemicals, and of non-smokers frequently exposed to SHS at work was highest in mining and construction. Outdoor work was most common in agriculture (85%), construction (73%), and mining (65%). Finally, frequent occupational exposure to VGDF was most common among mining (67%), agriculture (53%), and construction workers (51%). CONCLUSION We identified industries and occupations with the highest prevalence of potentially hazardous workplace exposures, and provided targets for investigation and intervention activities.

Quit interest, quit attempt and recent cigarette smoking cessation in the US working population, 2010

Objectives To determine the prevalence of cigarette smoking cessation and examine the association between cessation and various factors among workers in a nationally representative sample of US adults. Methods Data were derived from the 2010 National Health Interview Survey. Prevalence rates were calculated for interest in quitting smoking, making an attempt to quit smoking, and successful smoking cessation (defined as smokers who had quit for 6–12 months). Logistic regression analyses were used to identify factors associated with cessation after adjustment for demographic characteristics (age group, race/ethnicity, educational level and marital status). Results Data were available for 17 524 adults who were employed in the 12 months prior to interview. The prevalence of quit interest, quit attempt and recent cessation was 65.2%, 53.8% and 6.8%, respectively. Quit interest was less likely among workers with long work hours, but more likely among workers with job insecurity, or frequent workplace skin and/or respiratory exposures. Quit attempt was more likely among workers with a hostile work environment but less likely among workers living in a home that permitted smoking or who smoked ≥11 cigarettes/day. Recent smoking cessation was less likely among workers with frequent exposure to others smoking at work or living in a home that permitted smoking, but more likely among workers with health insurance. Conclusions Factors associated with cessation interest or attempt differed from those associated with successful cessation. Cessation success might be improved by reducing exposure to others smoking at work and home, and by improving access to health insurance.

Lung cancer risk among construction workers in California, 1988–2007†‡

BACKGROUND Although lung cancer risks can vary by race/ethnicity and by construction occupation, these risks have not been examined extensively. METHODS This study analyzed 110,937 lung cancer cases identified from the California Cancer Registry between 1988 and 2007. Mean age at diagnosis, proportion diagnosed at an advanced stage, and proportion with 3-year survival were calculated for lung cancer cases employed in the construction industry. Case-control methodology was also used to assess the risk of lung cancer. Morbidity odds ratios (MORs) were estimated by conditional logistic regression. RESULTS Construction workers were found to have a significantly elevated risk for all lung cancer combined (MOR = 1.57) and for each lung cancer histologic subtype examined. All construction occupations, except managers/engineers and supervisors, had a significantly elevated risk for all lung cancer combined. Roofers and welders had the highest risks for total lung cancer and for each of the histologic subtypes. Construction workers in each of the four race/ethnicity groups also had significantly increased lung cancer risks. Compared to non-construction workers, construction workers were diagnosed at an earlier age, at a more advanced stage, and had significantly lower 3-year survival, though differences were modest. CONCLUSION These findings justify additional reductions in carcinogenic exposures in construction, and increased support for smoking cessation programs at construction sites.

Hearing difficulty and tinnitus among U.S. workers and non‐workers in 2007

BACKGROUND Hearing loss and tinnitus are two potentially debilitating physical conditions affecting many people in the United States. The purpose of this study was to estimate the prevalence of hearing difficulty, tinnitus, and their co-occurrence within U.S. METHODS Data from the 2007 National Health Interview Survey (NHIS) were examined. Weighted prevalence and adjusted prevalence ratios for self-reported hearing difficulty, tinnitus, and their co-occurrence were estimated and compared by demographic, among workers with and without occupational noise exposure, and across industries and occupations. RESULTS Seven percent of U.S. workers never exposed to occupational noise had hearing difficulty, 5% had tinnitus and 2% had both conditions. However, among workers who had ever been exposed to occupational noise, the prevalence was 23%, 15%, and 9%, respectively (P < 0.0001). CONCLUSIONS Hearing difficulty and tinnitus are prevalent in the U.S.; especially among noise-exposed workers. Improved strategies for hearing conservation or better implementation are needed.

Acute myeloid leukemia risk by industry and occupation

Abstract Acute myeloid leukemia (AML) is the most common type of leukemia found in adults. Identifying jobs that pose a risk for AML may be useful for identifying new risk factors. A matched case–control analysis was conducted using California Cancer Registry data from 1988 to 2007. This study included 8999 cases of AML and 24 822 controls. Industries with a statistically significant increased AML risk were construction (matched odds ratio [mOR] = 1.13); crop production (mOR = 1.41); support activities for agriculture and forestry (mOR = 2.05); and animal slaughtering and processing (mOR = 2.09). Among occupations with a statistically significant increased AML risk were miscellaneous agricultural workers (mOR = 1.76); fishers and related fishing workers (mOR = 2.02); nursing, psychiatric and home health aides (mOR = 1.65); and janitors and building cleaners (mOR = 1.54). Further investigation is needed to confirm study findings and to identify specific exposures responsible for the increased risks.