The impact of surveillance on weight change and predictors of change in a population-based firefighter cohort.

OBJECTIVE: To document weight changes in a population-based cohort of male career firefighters and evaluate the impact of health surveillance on subsequent participant behavior and body composition. METHODS: Body mass index, waist circumference, and body fat percentage were assessed longitudinally in 311 male firefighters. RESULTS: Firefighters who reported making no changes after the baseline assessment (42.1%) experienced a 0.64 ± 3.1 kg average weight gain, whereas firefighters who reported making one or more health behavior change (ie, changing their diet, increasing their physical activity, or both; 52.1%) lost an average of -1.3 kg. CONCLUSIONS: Regular health surveillance may motivate some firefighters to make health behavior changes. Although it is not currently the norm, fire departments should provide firefighters with annual health assessments including body composition and fitness measures, consistent with those recommended by the fire service's Wellness and Fitness Initiative.

Obesity and injury-related absenteeism in a population-based firefighter cohort.

A consistent relationship has been demonstrated between obesity and absenteeism in the workplace. However, most studies have focused on primarily sedentary occupational groups. Firefighting is a physically demanding profession that involves significant potential for exposure to dangerous situations and strenuous work. No studies to date have evaluated the impact of obesity on risk for absenteeism among firefighters. We examined the cross-sectional association between BMI and obesity and injury-related absenteeism. BMI, body fat percentage (BF%), waist circumference (WC), injury, and injury-related absenteeism were assessed in 478 career male firefighters. One hundred and fifteen firefighters reported an injury in the previous year and the number of days absent from work due to their injury. BMI was an independent predictor of absenteeism due to injury even after adjustment for confounding variables. Firefighters meeting the definition of class II and III obesity had nearly five times (odds ratio (OR) = 4.89; 95% confidence interval (CI) = 3.63-6.58) the number missed work days due to injury when compared to their normal weight counterparts and their elevated risk was greater than firefighters with class I obesity (OR = 2.71; 95% CI = 2.01-3.65) or those who were overweight (OR = 2.55; 95% CI = 1.90-3.41). The attributable per capita costs of class II and III obesity-related absenteeism over the last year were $1,682.90 per firefighter, $254.00 per firefighter for class I obesity, and $74.41 per firefighter for overweight. Our findings suggest that class II and III obesity were associated with substantial attributable costs to employers and our cost estimates probably underestimate the actual financial burden.

The prevalence of overweight, obesity, and substandard fitness in a population-based firefighter cohort.

OBJECTIVE: To examine the prevalence of overweight and obesity in firefighters. METHODS: Body mass index (BMI), waist circumference, and body fat percentage (BF%) were assessed in 478 career and 199 volunteer male firefighters from randomly selected departments. RESULTS: High prevalence rates of overweight + obesity (BMI ≥ 25 kg/m) and obesity (BMI ≥ 30 kg/m) were found in career (79.5%; 33.5%) and volunteer firefighters (78.4%; 43.2%). False-positive obesity misclassification based on BMI, compared to waist circumference and BF%, was low (9.8% and 2.9%, respectively). False negatives were much higher: 32.9% and 13.0%. Obese firefighters demonstrated unfavorable cardiovascular disease (CVD) profiles. CONCLUSIONS: The prevalence of overweight and obesity exceeded that of the US general population. Contrary to common wisdom, obesity was even more prevalent when assessed by BF% than by BMI, and misclassifying muscular firefighters as obese by using BMI occurred infrequently.