The health behaviors of the older US worker.

BACKGROUND: As the US workforce ages, lifestyle factors will increasingly affect their health, yet little information is available on their prevalence in older working populations. METHODS: Using the nationally representative 1997-2003 National Health Interview Survey (NHIS), reported current smoking, risky drinking and leisure-time physical activity behaviors of older workers (> or =65 years) were compared with older non-workers. These behaviors were evaluated by age, gender, race, ethnicity, and occupation, as well as prototype "healthy" and "risky" persons. RESULTS: The study population of 4,946 older US workers and 38,313 older non-workers represented an estimated 3.9 million older workers and 28.9 million older non-workers annually. Relative to older non-workers, older workers reported more current smoking and risky drinking, but higher levels of leisure-time physical activity with variations by subpopulations. CONCLUSIONS: Less than 4% of the older US worker population reported overall healthy behaviors. Certain occupations and other subpopulations can be targeted for age-appropriate behavioral interventions.

Leisure-time physical activity levels of the US workforce.

BACKGROUND: Few studies in the US have assessed physical activity levels across worker groups, despite the increasingly sedentary milieu of contemporary US occupations and increasing obesity rates among US workers. The present study determined the proportion of US workers meeting the Healthy People 2010 Guidelines for leisure-time physical activity levels in major US occupational groups. METHODS: Self-reported leisure-time physical activity was defined as: a) light-moderate activity > or =30 min five or more times per week; and/or b) vigorous activity > or =20 min three or more times per week. Findings collected on over 150,000 US workers, who participated in the 1997-2004 National Health Interview Surveys, were stratified by occupational group. RESULTS: On average, the proportions of US workers meeting recommended leisure-time physical activity levels were 31% in female and 36% in male US workers. There was substantial variation in the gender-specific rates of leisure-time physical activity levels by occupation (range: 16-55%) with the lowest rates noted in blue collar groups. CONCLUSIONS: Leisure-time physical activity levels were sub-optimal among all major US worker groups, with substantial variability across occupations. As part of disease prevention, health professionals should promote increased physical activity levels among those occupations identified with very low rates of leisure-time physical activity.

Dental care access and unmet dental care needs among U.S. workers: the National Health Interview Survey, 1997 to 2003.

BACKGROUND: Healthy People 2010 oral health objectives call for an increase in the proportion of adults who use the oral health care system annually. To assess progress toward this goal, the authors evaluated dental care utilization and the extent of unmet dental care needs of U.S. workers and their families. METHODS: The authors conducted sex-specific analyses by occupation of 135,004 U.S. worker participants in the nationally representative National Health Interview Surveys (NHIS) conducted from 1997 to 2003. RESULTS: The reported lack of oral health care within the preceding year ranged from 18.9 to 57.8 percent among male workers and from 17.6 to 50.0 percent among female workers. Sex-specific occupational groups with the highest rates of reported unmet dental care needs included male health service occupations (17.1 percent) and female construction and extractive trade workers (26.8 percent). CONCLUSION: There are significant oral health care underutilization and high rates of unmet dental care needs among many U.S. worker groups. Strategies to increase regular dental visits for U.S. worker groups reporting low dental care access and high dental need are paramount. CLINICAL IMPLICATIONS: Targeting strategic dental care access programs to identified U.S. worker groups reporting dental care access deficits can improve oral health.

Smoking rate trends in U.S. occupational groups: the 1987 to 2004 National Health Interview Survey.

OBJECTIVE: It is unknown if the gap in smoking rates observed between United States blue- and white-collar workers over the past four decades has continued into the new millennium. METHODS: The National Health Interview Survey is a nationally representative survey of the US civilian population. Smoking and current occupational status were assessed over survey periods 1987 to 1994 and 1997 to 2004 (n= 298,042). RESULTS: There were significant annual reductions in smoking rates for all adult US workers in both survey periods. Several blue-collar groups had greater annual smoking rate reductions in the most recent survey period relative to the earlier survey period. However, the majority of blue-collar worker groups had pooled 1997 to 2004 smoking rates in excess of the 24.5% smoking prevalence noted for all workers. CONCLUSION: Development of effective smoking prevention strategies specifically targeting blue-collar groups is warranted.

Occupation and lung cancer mortality in a nationally representative U.S. Cohort: The National Health Interview Survey (NHIS).

OBJECTIVE: The objective of this study was to assess the risk of lung cancer mortality in a nationally representative sample of U.S. workers by occupation. METHODS: National Death Index linkage identified 1812 lung cancer deaths among 143,863 workers who participated in the 1987, 1988, and 1990-1994 National Health Interview Surveys. RESULTS: Current and former smoking status was predictive of lung cancer mortality (hazard ratio [HR] = 15.1 and 3.8, respectively). Occupations with significantly higher risk for age- and smoking-adjusted lung cancer mortality included heating/air/refrigeration mechanics (HR = 3.0); not specified mechanics and repairers (HR = 2.8); financial records processing occupations (HR = 1.8); freight, stock, and materials handlers (HR = 1.5); and precision production occupations (HR = 1.4). CONCLUSION: Although tobacco use continues to be the single most important risk factor for lung cancer mortality, occupational exposure to lung carcinogens should be targeted as well to further reduce the burden of lung cancer.

Morbidity ranking of U.S. workers employed in 206 occupations: the National Health Interview Survey (NHIS) 1986-1994.

OBJECTIVE: The objective of this study was to rank U.S. occupations by worker morbidity. METHODS: From 1986 through 1994, morbidity information was collected on over 410,000 U.S. workers who participated in the National Health Interview Survey, an annual household survey representative of the U.S. civilian noninstitutionalized population. A multivariate adjusted logistic regression morbidity summary score was created for each worker group based on seven indicators: days of restricted activity, bedrest, and missed work in the previous 2 weeks; doctor visits and hospitalizations in the previous 12 months; reported health conditions; and health status. RESULTS: Worker groups reporting the greatest morbidity included social workers, inspectors, postal clerks, psychologists, and grinding machine operators; worker groups reporting the least morbidity included dentists, pilots, physicians, pharmacists, and dietitians. CONCLUSIONS: These findings aid in the identification of worker groups that require increased attention for morbidity research and prevention.

Obesity in US workers: The National Health Interview Survey, 1986 to 2002.

OBJECTIVES: Obesity has emerged as one of the most important public health issues in the United States. We assessed obesity prevalence rates and their trends among major US occupational groups. METHODS: Self-reported weight and height were collected annually on US workers, aged 18 years or older, from the 1986 to 1995 and the 1997 to 2002 National Health Interview Surveys. Overall, occupation-, race-, and gender-specific rates of obesity (defined as a body mass index>30.0 kg/m2) were calculated with data pooled from both study periods (n>600,000). Annual occupation-specific prevalence rates were also calculated, and their time trends were assessed. RESULTS: Obesity rates increased significantly over time among employed workers, irrespective of race and gender. The average yearly change increased from 0.61% (+/-.04) during the period from 1986 to 1995 to 0.95% (+/-.11) during the period from 1997 to 2002. Average obesity prevalence rates and corresponding trends varied considerably across occupational groups; pooled obesity prevalence rates were highest in motor vehicle operators (31.7% in men; 31.0% in women). CONCLUSIONS: Weight loss intervention programs targeting workers employed in occupational groups with high or increasing rates of obesity are urgently needed.

Longest held job in U.S. occupational groups: the National Health Interview Survey.

OBJECTIVE: We sought to assess the validity of using current or most recent occupation as surrogate for longest-held job (and its exposures). METHODS: The National Health Interview Survey (NHIS) is an annual, probability, cross-sectional U.S. population survey. The 1986 and 1988 NHIS occupational supplements provided information for more than 49,000 workers. Using Cohen's Kappa, concordance was assessed by occupational group and several subgroups. RESULTS: Statistically significant results were observed for all occupational groups. More than 70% of 13 broad occupations had a Kappa of 50.0 or greater, with variable concordance by subpopulation. Among 206 occupational groups, there was more variability: Kappa ranged from 92.7 (dentists) to 9.2 (farm managers). CONCLUSIONS: Moderate-to-high levels of agreement was observed in this large, representative sample of US workers. Therefore, current occupation can be used as a surrogate for longest-held job for many occupational subgroups.

Trends in US smoking rates in occupational groups: the National Health Interview Survey 1987-1994.

It is unknown if reductions in U.S. adult smoking rates are uniform across occupational groups. The National Health Interview Survey (NHIS) is a multistage area probability cross-sectional survey of the U.S. civilian population. Data on occupational and smoking status were collected on 141122 adult participants from the 1987, 1988, and 1990 -1994 NHIS annual surveys. Overall smoking rates ranged from 58% in roofers to 4% in physicians, with higher rates found among blue collar professions. There were reductions in smoking from 1987-1994 within 72% of occupational groups; 19 of these downward trends were significant and occurred exclusively within white collar professions. Blue collar workers continue to smoke in large numbers, whereas white collar workers report lower rates along with corresponding significant downward trends in rates among selected occupational groups. The development of effective smoking prevention strategies targeting blue collar groups is needed.