www.safetyandhealthmagazine.com/articles/weighing-down-safety
Weighing down safety

Weighing down safety

Small workplace changes can make a big difference in combating worker obesity

April 1, 2013

KEY POINTS

  • At its current rate, obesity among employees will cost U.S. workplaces up to $580 billion in lost productivity and nearly $210 billion in medical costs every year by 2030.
  • Some experts say the workplace presents employees with a "toxic environment" in which it is too easy to consume calories and too difficult to burn them.
  • Simple, inexpensive workplace changes such as encouraging walking and introducing healthier food options can reduce workers' body weight and help prevent future weight gain.
  • Wayne Robinson used to feel nervous entering a confined space at the construction site where he worked. At 245 pounds, he was concerned he was too heavy to be rescued in the event of an emergency. He also worried about his crew, some of whom were too big to fit into the confined space.

    Now 190 pounds, Robinson, building supervisor for Conway, AR-based Nabholz Construction Services, said he feels much safer at work. His safety equipment fits better and he is more flexible, making performing physical tasks more fluid. Mentally, he feels much more aware of his surroundings – and his safety – than when he was 55 pounds heavier.

    “Part of having a good, sound mind and being safe is being healthy,” said Chris Goldsby, executive vice president of operations for Nabholz’s Oklahoma City office. Goldsby also has noticed the link between weight and safety among workers. “That is eating properly, getting the nutrients we need, getting the rest we need, and I think exercise is a part of that as well. The more out of shape you are, the more likely you are to get hurt because you are not going to be doing things correctly.”

    Currently, more than 35 percent of U.S. adults are obese – defined by the Centers for Disease Control and Prevention as having a body mass index of 30 or greater. A September 2012 report from Trust for America’s Health and the Robert Wood Johnson Foundation stated that, at its current rate, obesity among employees will cost U.S. workplaces up to $580 billion in lost productivity and nearly $210 billion in medical costs every year by 2030. Depending on the state, this would result in a 1.9 to 34.5 percent increase in health care costs for obesity-related health problems.

    Who’s responsible?

    Beyond the increased costs associated with providing health care to obese workers, recent studies have linked obesity and severe obesity – defined as having a BMI of 40 or greater – with more frequent and costly injuries. A study published in the Archives of Internal Medicine (Vol. 167, No. 8) determined that the cost of injuries suffered by obese and severely obese workers is nearly double that of normal-weight workers, and severely obese workers have nearly twice as many workers’ compensation claims as normal-weight workers. A literature review published in Injury Prevention (Vol. 13, No. 1) listed multiple studies linking increased risk of injury to obese workers. An excess of body fat can potentially increase an employee’s risk of injury by reducing the availability of properly fitting personal protective equipment, increasing the risk of musculoskeletal injury and limiting workers’ cognitive decision-making and judgment abilities. (See diagram for more information about the potential impact of obesity and severe obesity on workers.)

    “Obesity in the workplace has a big impact on the workers themselves and their health,” said Susan Yanovski, co-director of the National Institutes of Health’s Office of Obesity Research. “It also has an impact on the company, as people who have obesity have more health problems and health care costs. You are also going to see more absenteeism and presenteeism. So, it is in everyone’s best interest to help employees achieve and maintain a healthier body weight.”

    Yanovski served as a producer and expert for “The Weight of the Nation,” an HBO documentary on the factors contributing most to the rising rates of obesity in the United States. The documentary asserts that U.S. employees live and work in a “toxic environment” where it is too easy to ingest calories and too difficult to burn them off. Among the factors discussed were longer commutes and increasingly longer and more stressful workdays, which increase the body’s release of hormones that turn calories into fat more quickly.

    “[Personal responsibility] has to be part of the equation,” said Lisa Walvoord, vice president of policy for Denver-based LiveWell Colorado, an organization that advocates for healthier and fitter citizens and communities. “But if you are being told that you need to eat healthier and get more physical activity in your day, and you are working in a worksite that does not support that, and you are spending the largest portion of your waking hours at work? It is going to be really hard for you to achieve your goals and change your personal behavior.”

    Workplace interventions

    Employers can take simple actions to address obesity among workers at its root causes, Yanovski said. Organizations with high rates of overweight or obese workers can adopt individual interventions such as purchasing commercial weight-loss programs for workers, establishing onsite support groups, and offering gym membership fee waivers or prizes for losing weight. Workplace environment changes include adjusting the physical space of a workplace to encourage physical activity and healthier food options.

    “Not everything needs to be something expensive or difficult to implement,” she said.

    LiveWell Colorado provides the following tips to help increase healthy behaviors among workers:

    • Encourage workers to drink water instead of sugary beverages.
    • Promote physical activity and moving around during the day.
    • Make healthy food options available to employees and encourage them to make healthy choices.
    • Incorporate stretch breaks into meeting agendas.
    • Replace candy bowls with fresh fruit bowls at the front desk.
    • Institute walking meetings when applicable.


    Encourage individual change

    Jayme Mayo, certified physician assistant and wellness director for Nabholz Construction Services, said the United States’ obesity epidemic has impacted employees’ perceptions of weight at the company.

    “People have reset what normal looks like,” she said. “When they see someone overweight they think that is normal, and when they see someone obese they think that is overweight. It is only when they see someone who is morbidly obese do they think that person should do something.”

    Still, despite encouragement from the company, individual motivation is key to success, Mayo said. When speaking with employees or spouses, she focuses on helping them realize the importance of preventive care with annual exams and being a “smart consumer” with medications.

    “I don’t think they realize the impact that [being obese] has or is going to have on their life,” she said. “I do not like the thought of someone being injured or sick or debilitated for something that did not have to happen.”

    For Robinson, his desire to know his grandchildren motivated him to lose weight and keep it off. “I want to be a grandpa,” he said. “My grandfather died from a heart attack when I was 8 months old, and my dad died when my daughter was a year old. I used to be tired when I got home, and did not play with the kids. Now, I [live healthier] for the kids.”

    Nabholz Construction Services: One company’s journey to a healthier and safer weight among its workforce

    In 2007, Nabholz Construction Services – a Conway, AR-based commercial construction contracting company with more than 1,000 employees – launched a voluntary wellness program that focused on obesity and obesity-related conditions in an effort to stabilize increasing health care costs. About three-fourths of the workforce participated in the first companywide health screening. The results: 42 percent of workers had untreated high blood pressure, 46 percent had untreated high cholesterol and 42 workers had cases of undiagnosed or untreated diabetes.

    These health conditions contributed to the high rates of obesity among workers at the time, said Jayme Mayo, certified physician assistant and wellness director for Nabholz. More than half the workers weighed more than 200 pounds, with 29 percent weighing more than 225 pounds and 16 percent more than 250 pounds.

    “We realized the depth and breadth of the health issues that existed in our company,” Greg Williams, chief financial officer for Nabholz, said in “The Weight of the Nation,” a 2012 HBO documentary on obesity in the United States. “Are [workers] headed for a stroke or a heart attack? We are worried about them personally, but we are also worried about the impact the lack of wellness would have on our ability to function as a company.”

    Obesity also was affecting employees’ ability to work safely and workers’ compensation costs. Mayo said that when looking at workers’ comp claims for back injuries, many of those workers tended to be obese.

    The company also needed to purchase safety construction equipment that can accommodate workers who weigh up to 350 pounds, including hard hats that fit the severely obese.

    Developing a new solution

    Nabholz began its voluntary wellness program based on points and credits, but changed it in 2009 and 2010 to a results-based program that addresses five areas: tobacco use, obesity, blood pressure, blood glucose (sugar) and cholesterol. The company provides incentives for improvement in one or more of these areas.

    The company also began taking other actions to encourage healthier behaviors. Lindsey Dixon, a full-time registered dietitian, was hired. Employees and spouses can use an onsite medical clinic or workout rooms. Each office and large jobsite has a blood pressure machine, tape measure and body fat monitor. Also, either Mayo or Dixon regularly visits offices and jobsites for wellness testing and to interact with workers about their health.“I think – what I realized – is that one of the best things I have ever given the employees and spouses is my time and attention,” Mayo said. She spends up to 60 minutes with an employee or spouse explaining various aspects of nutrition, such as questions to ask your doctor, how to read a food label and setting up a safe fitness routine.“Once you have a relationship, they are more comfortable asking and talking to me about more private and personal issues than cholesterol and blood pressure,” she said. “This is what has made the difference for us. It is not ‘because I said so’ or ‘because I told you so.’ You educate someone and it empowers them to be more proactive with their health and ultimately with their life.”

    Chris Goldsby, executive vice president of operations for Nabholz’s Oklahoma City office, was inspired by Mayo’s approach, so he decided to sit down with his workers as well to discuss their health.

    “We do not invade our employees’ privacy; we are seeking to help them understand where their health issues may be,” he said. “I talk about the intangible pieces they may not see.”

    Goldsby recognizes his employees for losing weight and other wellness achievements by awarding a vacation day at the annual Christmas party, giving out plaques called “wellies” that represent their success or awarding an employee a spot on the wall of achievements.

    Success as a company

    Nabholz’s wellness efforts save the company more than $600,000 annually, according to the documentary. But the biggest cost savings are the prevention of heart attacks, cancer, strokes and other costly medical events, Mayo said.

    Between 2007 and 2011, the rate of high blood pressure among employees participating in screenings decreased to 22 percent in 2011 from 40 percent in 2007. At the same time, employees have been shedding the pounds:

    • The number of workers weighing more than 200 pounds decreased about 11 percent.
    • The number of workers weighing more than 225 pounds decreased about 10 percent.
    • The number of workers weighing 250 pounds or more decreased about 6 percent.

    – TJB