Obesity Increases Workers' Compensation Costs
DURHAM, N.C. -- Gaining too much weight can be as bad for an
employer's bottom line as it is for a person's waistline.
A Duke University Medical Center analysis found that obese
workers filed twice the number of workers' compensation claims,
had seven times higher medical costs from those claims and lost
13 times more days of work from work injury or work illness
than did nonobese workers.
Workers with higher risk jobs were found to be more likely
to file workers' compensation claims, and obese workers in
high-risk jobs incurred the highest costs, both economically
Although workers' compensation plans vary from state to
state, they all require that employers carry insurance policies
to cover their employees should they be injured on the job. The
plans can pay for employee medical costs, compensation for loss
of current or future wages, or compensation for pain and
"We all know obesity is bad for the individual, but it isn't
solely a personal medical problem -- it spills over into the
workplace and has concrete economic costs," said Truls Ostbye,
MD, PhD., professor of community and family medicine.
The results of the study were published April 23, 2007, in
the Archives of Internal Medicine. The study was supported by a
grant from the National Institute for Occupational Safety and
"Given the strong link between obesity and workers'
compensation costs, maintaining healthy weight is not only
important to workers but should also be a high priority for
employers," Ostbye said. "Work-based programs designed to
target healthful eating and physical activity should be
developed and then evaluated as part of a strategy to make all
workplaces healthier and safer."
The researchers looked at the records of 11,728 employees of
Duke University who received health risk appraisals between
1997 and 2004. Duke collects this information anonymously in
order to identify areas of potential occupational risk and to
develop plans to reduce that risk. The analysis covered a
diverse group of workers, such as administrative assistants,
groundskeepers, nurses and professors.
The researchers looked at the relationship between body mass
index (BMI) and the rate of workers' compensation claims.
Because the BMI takes into account both a person's height and
weight, it is considered the most accurate measure of obesity.
For Americans, a BMI of 18.5 to 24.9 is considered normal; 25
to 29.9 is considered overweight, and 30 and above is
considered obese. (See BMI
The researchers found that workers with a BMI greater than
40 had 11.65 claims per 100 workers, compared with 5.8 claims
per 100 in workers within the recommended range. In terms of
average lost days of work, the obese averaged 183.63 per 100
employees, compared with 14.19 per 100 for those in the
recommended range. The average medical claims costs per 100
employees were $51,019 for the obese and $7,503 for the
The body parts most prone to injury among obese workers were
the lower extremity, wrist or hand, and back. The most common
causes of these injuries were falls or slips, and lifting.
"We think these findings can be generalized to the community
as a whole, since the demographics of Duke closely reflect the
local area," said study co-author John Dement, Ph.D., professor
of occupational and environmental medicine, who is the
principal investigator for development of the workplace safety
surveillance program at Duke." We can use the Duke population
to think about the community, so the solutions we come up can
benefit the community as well.
"The primary message is that we need to reduce the burden on
workers' compensation by intervening not only on individual
risk factors such as obesity but also within the workplace to
reduce the risk of injury," Dement said. "By targeting obesity
and workplace risks simultaneously, we can reduce absenteeism,
increase the overall health of our workers, and decrease the
cost of health care for all employees."
Duke has a number of programs available to encourage
employees to adopt more healthful lifestyles and occupational
safety and health programs to reduce the risk of injuries.
Future research is aimed at testing different strategies to see
if they are effective in creating healthier and safer
workplaces, and then determining whether or not they are cost