Obesity Increases Workers' Compensation Costs

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 and medically.

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 suffering.

"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 Health.

"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 calculator at

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 non-obese.

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."