Skip to main content
SpringerLink
Log in

Physical workload and obesity have a synergistic effect on work ability among construction workers

  • Original Article
  • Published:
International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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).

Results

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).

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Airila A, Hakanen JJ, Schaufeli WB, Luukkonen R, Punakallio A, Lusa S (2014) Are job and personal resources associated with work ability 10 years later? The mediating role of work engagement. Work Stress 28(1):87–105

    Article  Google Scholar 

  • Alavinia SM, van Duivenbooden C, Burdorf A (2007) Influence of work-related factors and individual characteristics on work ability among Dutch construction workers. Scand J Work Environ Health 33(5):351–357

    Article  Google Scholar 

  • Allesøe K, Søgaard K, Aadahl M, Boyle E, Holtermann A (2016) Are hypertensive women at additional risk of ischaemic heart disease from physically demanding work? Euro J Prev Cardiol 23(10):1054–1061

    Article  Google Scholar 

  • Andersen LL, Fallentin N, Thorsen SV, Holtermann A (2016) Physical workload and risk of long-term sickness absence in the general working population and among blue-collar workers: prospective cohort study with register follow-up. Occup Environ Med 73(4):246–253

    Article  Google Scholar 

  • Arem H, Moore SC, Patel A, Hartge P, Berrington de Gonzalez A, Visvanathan K., Campbell PT, Freedman M, Weiderpass E, Adami HO, Linet MS, Lee IM, Matthews CE (2015) Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. JAMA Intern Med 175:959–967

    Article  Google Scholar 

  • Balogh I, Ørbæk P, Ohlsson K, Nordander C,. Unge J, Winkel J, Hansson G-Å (2004) Self-assessed and directly measured occupational physical activities—influence of musculoskeletal complaints, age and gender. Appl Ergon 35(1):49–56

    Article  CAS  Google Scholar 

  • Claessen H, Arndt V, Drath C, Brenner H (2009) Overweight, obesity and risk of work disability: a cohort study of construction workers in Germany. Occup Environ Med 66(6):402–409

    Article  CAS  Google Scholar 

  • Clays E, De Bacquer D, Van Herck K, De Backer G, Kittel F, Holtermann A (2012) Occupational and leisure time physical activity in contrasting relation to ambulatory blood pressure. BMC Public Health 12:1002

    Article  Google Scholar 

  • Curtis GL, Chughtai M, Khlopas A, Newman JM, Khan R, Shaffiy S, Nadhim A, Bhave A, Mont MA (2017) Impact of physical activity in cardiovascular and musculoskeletal health: Can motion be medicine? J Clin Med Res 9(5):375–381

    Article  Google Scholar 

  • Fimland MS, Vie G, Johnsen R, Nilsen TI, Krokstad S, Bjørngaard JH (2015) Leisure-time physical activity and disability pension: 9 years follow-up of the HUNT study, Norway. Scand J Med Sci Sports 25(6):e558–e565

    Article  CAS  Google Scholar 

  • Fimland MS, Vie G, Holtermann A, Krokstad S, Nilsen TIL (2018) Occupational and leisure-time physical activity and risk of disability pension: prospective data from the HUNT study, Norway. Occup Environ Med 75(1):23–28

    Article  Google Scholar 

  • Hall JE, Crook ED, Jones DW, Wofford MR, Dubbert PM (2002) Mechanisms of obesity-associated cardiovascular and renal disease. Am J Med Sci 324(3):127–137

    Article  Google Scholar 

  • Holtermann A, Hansen JV, Burr H, Søgaard K, Sjøgaard G (2012) The health paradox of occupational and leisure-time physical activity. Br J Sports Med 46(4):291–295

    Article  CAS  Google Scholar 

  • Holtermann A, Krause N, van der Beek AJ, Straker L (2018) The physical activity paradox: six reasons why occupational physical activity (OPA) does not confer the cardiovascular health benefits that leisure time physical activity does. Br J Sports Med 52(3):149–150

    Article  Google Scholar 

  • Ilmarinen J (2005) Towards a longer worklife. FIOH Bookstore, Helsinki

    Google Scholar 

  • Jarvholm B, Stattin M, Robroek SJ, Janlert U, Karlsson B, Burdorf A (2014) Heavy work and disability pension - a long term follow-up of Swedish construction workers. Scand J Work Environ Health 40(4):335–342

    Article  Google Scholar 

  • Jaul E, Barron J (2017) Age-related diseases and clinical and public health implications for the 85 years old and over population. Front Public Health 5:335

    Article  Google Scholar 

  • Johnson JV, Hall EM (1988) Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population. Am J Public Health 78(10):1336–1342

    Article  CAS  Google Scholar 

  • Karlqvist L, Leijon O, Harenstam A (2003) Physical demands in working life and individual physical capacity. Eur J Appl Physiol 89(6):536–547

    Article  CAS  Google Scholar 

  • Knol MJ, VanderWeele TJ (2012) Recommendations for presenting analyses of effect modification and interaction. Int J Epidemiol 41(2):514–520

    Article  Google Scholar 

  • Korshøj M, Lidegaard M, Skotte JH, Krustrup P, Krause N, Søgaard K, Holtermann A (2015) Does aerobic exercise improve or impair cardiorespiratory fitness and health among cleaners? A cluster randomized controlled trial. Scand J Work Environ Health 41(2):140–152

    Article  Google Scholar 

  • Korshøj M, Lidegaard M, Krustrup P, Jørgensen MB, Søgaard K, Holtermann A (2016) Long term effects on risk factors for cardiovascular disease after 12-months of aerobic exercise intervention—a worksite RCT among cleaners. PLoS One, 11(8), e0158547

  • Krause N, Lynch JW, Kaplan GA, Cohen RD, Salonen R, Salonen JT (2000) Scand J Work Environ Health 26(3):227–236

    Article  CAS  Google Scholar 

  • Krause N, Brand RJ, Arah OA, Kauhanen J (2015) Occupational physical activity and 20-year incidence of acute myocardial infarction: results from the Kuopio Ischemic heart disease risk factor study. Scand J Work Environ Health 41(2):124–139

    Article  Google Scholar 

  • Labrunée M, Antoine D, Vergès B, Robin I, Casillas J-M, Gremeaux V (2012) Effects of a home-based rehabilitation program in obese type 2 diabetics. Ann Phys Rehabilitation Med 55(6):415–429

    Article  Google Scholar 

  • Laitinen J, Nayha S, Kujala V (2005) Body mass index and weight change from adolescence into adulthood, waist-to-hip ratio and perceived work ability among young adults. Int J Obes (Lond) 29(6):697–702

    Article  CAS  Google Scholar 

  • Lidegaard M, Søgaard K, Krustrup P, Holtermann A, Korshøj M (2018) Effects of 12 months aerobic exercise intervention on work ability, need for recovery, productivity and rating of exertion among cleaners: a worksite RCT. Int Arch Occup Environ Health 91(2):225–235

    Article  Google Scholar 

  • Ma CC, Gu JK, Charles LE, Andrew ME, Dong RG, Burchfiel CM (2018) Work-related upper extremity musculoskeletal disorders in the United States: 2006, 2009, and 2014 national health interview survey. Work 60(4):623–634

    Article  Google Scholar 

  • Nevanpera N, Ala-Mursula L, Seitsamo J, Remes J, Auvinen J, Hopsu L,.. . Laitinen J (2015) Long-lasting obesity predicts poor work ability at midlife: A 15-year follow-up of the northern Finland 1966 birth cohort study. J Occup Environ Med 57(12):1262–1268

    Article  Google Scholar 

  • Nurminen E, Malmivaara A, Ilmarinen J, Ylöstalo P, Mutanen P, Ahonen G, Aro T (2002) Effectiveness of a worksite exercise program with respect to perceived work ability and sick leaves among women with physical work. Scand J Work Environ Health 28:85–93

    Article  Google Scholar 

  • Pensola T, Haukka E, Kaila-Kangas L, Neupane S, Leino-Arjas P (2016) Good work ability despite multisite musculoskeletal pain? A study among occupationally active Finns. Scand J Public Health 44(3):300–310

    Article  Google Scholar 

  • Petersen CB, Eriksen L, Tolstrup JS, Søgaard K, Grønbæk M, Holtermann A (2012) Occupational heavy lifting and risk of ischemic heart disease and all-cause mortality. BMC Public Health 12:1070

    Article  Google Scholar 

  • Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX,.. . Metabolism (2006) Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American heart association scientific statement on obesity and heart disease from the obesity committee of the council on nutrition, physical activity, and metabolism. Circulation 113(6):898–918

    Article  Google Scholar 

  • Proper KI, Staal BJ, Hildebrandt VH, van der Beek AJ, van Mechelen W (2002) Effectiveness of physical activity programs at worksites with respect to work-related outcomes. Scand J Work Environ Health 28:75–84

    Article  Google Scholar 

  • Reeuwijk KG, Robroek SJ, Niessen MA, Kraaijenhagen RA, Vergouwe Y, Burdorf A (2015) The prognostic value of the work ability index for sickness absence among office workers. PLoS One, 10(5), e0126969

    Article  CAS  Google Scholar 

  • Robroek SJ, Jarvholm B, van der Beek AJ, Proper KI, Wahlstrom J, Burdorf A (2017) Influence of obesity and physical workload on disability benefits among construction workers followed up for 37 years. Occup Environ Med 74(9):621–627

    Article  Google Scholar 

  • Scafoglieri A, Clarys JP, Cattrysse E, Bautmans I (2014) Use of anthropometry for the prediction of regional body tissue distribution in adults: benefits and limitations in clinical practice. Aging Dis 5(6):373–393

    Google Scholar 

  • Schneider HJ, Friedrich N, Klotsche J, Pieper L, Nauck M, John U, Wittchen HU (2010) The predictive value of different measures of obesity for incident cardiovascular events and mortality. J Clin Endocrinol Metab 95(4):1777–1785

    Article  CAS  Google Scholar 

  • Siegrist J (1996) Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol 1(1):27–41

    Article  CAS  Google Scholar 

  • Singh JP, Larson MG, Manolio TA et al. Blood pressure response during treadmill testing as a risk factor for newonset hypertension. The Framingham heart study. Circulation, 99:1831–1836

  • Stock SR, Fernandes R, Delisle A, Vézina N (2005) Reproducibility and validity of workers’ self-reports of physical work demands. Scand J Work Environ Health 31(6):409–437

    Article  Google Scholar 

  • Tang K, Boonen A, Verstappen SM, Escorpizo R, Luime JJ, Lacaille D, Fautrel B, Bosworth A, Cifaldi M, Gignac MA, Hofstetter C, Leong A, Montie P, Petersson IF, Purcaru O, Bombardier C, Tugwell PS, Beaton DE (2014) Worker productivity outcome measures: OMERACT filter evidence and agenda for future research. J Rheumatol 41(1):165–176

    Article  Google Scholar 

  • Taris TW, Kompier MAJ (2014) Cause and effect: Optimizing the designs of longitudinal studies in occupational health psychology. Work Stress 28(1):1–8

    Article  Google Scholar 

  • Thijssen E, van Caam A, van der Kraan PM (2015) Obesity and osteoarthritis, more than just wear and tear: pivotal roles for inflamed adipose tissue and dyslipidaemia in obesity-induced osteoarthritis. Rheumatology 54(4):588–600

    Article  CAS  Google Scholar 

  • Tuomi K, Luostarinen T, Ilmarinen J, Klockars M (1991) Work load and individual factors affecting work disability among aging municipal employees. Scand J Work Environ Health 17(Suppl 1):94–98

    Google Scholar 

  • Tuomi K, Ilmarinen J, Martikainen R, Aalto L, Klockars M (1997) Aging, work, life-style and work ability among Finnish municipal workers in 1981–1992. Scand J Work Environ Health 23(Suppl 1):58–65

    Google Scholar 

  • Tuomi K, Huuhtanen P, Nykyri E, Ilmarinen J (2001) Promotion of work ability, the quality of work and retirement. Occup Med (Lond) 51(5):318–324

    Article  CAS  Google Scholar 

  • Umer W, Antwi-Afari MF, Li H, Szeto GP, Wong AY (2018) The prevalence of musculoskeletal symptoms in the construction industry: a systematic review and meta-analysis. Int Arch Occup Environ Health 91(2):125–144

    Article  Google Scholar 

  • van den Berg TI, Alavinia SM, Bredt FJ, Lindeboom D, Elders LA, Burdorf A (2008) The influence of psychosocial factors at work and life style on health and work ability among professional workers. Int Arch Occup Environ Health 81(8):1029–1036

    Article  Google Scholar 

  • van den Berg TI, Elders LA, de Zwart BC, Burdorf A (2009) The effects of work-related and individual factors on the Work Ability Index: a systematic review. Occup Environ Med 66(4):211–220

    Article  Google Scholar 

  • Vanni K, Virtanen P, Luukkaala T, Nygård CH (2012) Relationship between perceived work ability and productivity loss. Int J Occup Saf Ergon 18(3):299–309

    Article  Google Scholar 

  • Viester L, Verhagen EA, Hengel KM, Koppes LL, van der Beek AJ, Bongers PM (2013) The relation between body mass index and musculoskeletal symptoms in the working population. BMC Musculoskelet Disord 14:238

    Article  Google Scholar 

  • von Bonsdorff MB, Seitsamo J, Ilmarinen J, Nygård CH, von Bonsdorff ME, Rantanen T (2011a) Work ability in midlife as a predictor of mortality and disability in later life: a 28-year prospective follow-up study. Can Med Assoc J 183(4):E235–E242

    Article  Google Scholar 

  • von Bonsdorff ME, Kokko K, Seitsamo J, von Bonsdorff MB, Nygård CH, Ilmarinen J, Rantanen T (2011b) Work strain in midlife and 28-year work ability trajectories. Scand J Work Environ Health 37(6):455–463

    Article  Google Scholar 

  • Wang X, Dong XS, Choi SD, Dement J (2017) Work-related musculoskeletal disorders among construction workers in the United States from 1992 to 2014. Occup Environ Med 74:374–380

    Article  Google Scholar 

  • WHO (2000) Obesity: preventing and managing the global epidemic: report of a WHO consultation. WHO, Geneva

    Google Scholar 

  • Wiktorin C, Karlqvist L, Winkel J (1993) Validity of self-reported exposures to work postures and manual materials handling. Scand J Work Environ Health 19(3):208–214

    Article  CAS  Google Scholar 

  • Williamson W, Boardman H, Lewandowski AJ, Leeson P (2016) Time to rethink physical activity advice and blood pressure: A role for occupation-based interventions? Euro J Preven Cardiol 23(10):1051–1053

    Article  Google Scholar 

  • Yashin AI, Arbeev KG, Kulminski A, Akushevich I, Akushevich L, Ukraintseva SV (2007) Health decline, aging and mortality: how are they related? Biogerontology, 8(3):291–302

    Article  Google Scholar 

Download references

Acknowledgements

We thank the construction workers for their contribution and Arbouw/Volandis for the collaboration.

Funding

The Netherlands Organization for Health Research and Development (ZonMw) partly funded this study (Project number: 531005004). The funder was not involved in determining the study design, the collection, analysis or interpretation of the data, in the writing of the report, or in the decision to submit the paper for publication.

Author information

Authors and Affiliations

  1. Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands

    Susanne C. Tonnon, Allard J. van der Beek, Hidde P. van der Ploeg & Karin I. Proper

  2. Department of Public Health, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands

    Suzan R. J. Robroek & Alex Burdorf

  3. Volandis, Postbus 85, 3840 AB, Harderwijk, The Netherlands

    Margo Caspers

  4. National Institute for Public Health and the Environment, Centre for Nutrition, Prevention and Health Services, Postbus 1, 3720 BA, Bilthoven, The Netherlands

    Karin I. Proper

Authors
  1. Susanne C. Tonnon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Suzan R. J. Robroek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Allard J. van der Beek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alex Burdorf
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hidde P. van der Ploeg
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Margo Caspers
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Karin I. Proper
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Allard J. van der Beek.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Respondents gave consent to use their data for scientific purposes upon completion of the periodic medical examination questionnaire.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tonnon, S.C., Robroek, S.R.J., van der Beek, A.J. et al. Physical workload and obesity have a synergistic effect on work ability among construction workers. Int Arch Occup Environ Health 92, 855–864 (2019). https://doi.org/10.1007/s00420-019-01422-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00420-019-01422-7

Keywords

Search

Navigation