Smoking habits and occupational disability: a cohort study of 14 483 construction workers

• Published in: Occupational and environmental medicine (London, England) England), 2010-02, Vol.67 (2), p.84-90
• Main Authors: Claessen, Heiner, Arndt, Volker, Drath, Christoph, Brenner, Hermann
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Body mass index; Cardiovascular diseases; Cigar smoking; Cigarette smoking; Cohort Studies; Confounding Factors (Epidemiology); Construction workers; Disabilities; Disability; Disability Evaluation; dorsopathy; Epidemiologic Methods; Facility Design and Construction; Germany - epidemiology; Humans; Male; Medical sciences; mental disease; Mental illness; Middle Aged; Occupational Diseases - epidemiology; Occupational Diseases - etiology; respiratory disease; Respiratory diseases; smoking; Smoking - adverse effects; Smoking - epidemiology; Smoking cessation; Tobacco smoking; Tobacco, tobacco smoking; Toxicology; Workplace
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oem.2009.046318

ObjectivesAlthough smoking causes a variety of diseases and both, a high smoking prevalence and permanent occupational disability are a great burden on the population level, data about the impact of smoking habits on occupational disability are sparse. The objective of this study was to examine the influence of smoking habits on occupational disability among construction workers, an occupational group with particularly high smoking prevalence.MethodsThe association between smoking and occupational disability was examined during a mean follow-up of 10.8 years in a cohort of 14 483 male construction workers in Württemberg, Germany. The cohort was linked to the regional pension register of the German pension fund to identify workers who were granted a disability pension during the follow-up. HRs (Hazard Ratios) were calculated with non-smokers as reference by the Cox proportional hazards model adjusting for potential confounding factors such as age, nationality, type of occupation, alcohol consumption and body mass index.ResultsOverall, 2643 cases of occupational disability were observed, with dorsopathy (21%) being the most common cause. Clear dose-response relationships were seen between smoking and occupational disability due to all causes, as well as occupational disability due to respiratory, cardiovascular and mental diseases, cancer and dorsopathy. Particularly strong associations were seen between heavy smoking (≥20 cigarettes/day) and occupational disability due to mental and respiratory diseases (HR 3.25, 95% CI 1.93 to 5.46 and HR 3.26, 95% CI 1.69 to 6.27, respectively).ConclusionSmoking is associated with increased risk of occupational disability among construction workers, in particular occupational disability due to respiratory, cardiovascular and mental diseases, cancer and dorsopathy.