Occupations with High Obesity Prevalence in Washington State

Posted on by Wendy Lu, MPH; David Bonauto, MD, MPH; Joyce Fan, PhD;Casey Chosewood, MD; Sara E. Luckhaupt,MD, MPH


If work and the workplace contribute to poor health behaviors, should employers attempt to improve those behaviors?  It likely is in the employer’s best interest to do so.

Poor health behaviors can lead to chronic disease.  Workers with chronic disease may be at higher risk for workplace injury, have more absenteeism, and diminished productivity at work. Once injured, workers with chronic diseases take a longer time to return to work.  So the best strategy would be for employers to promote healthy behaviors to prevent the occurrence of these chronic diseases.

Many state health departments offer chronic disease prevention programs. Surprisingly, there is a dearth of state-level information about the health behaviors of workers across occupations.  We recently presented findings from a research study;[1] where the main objective was to estimate the level of obesity and other worker health behaviors by occupation in Washington State. We used the Behavioral Risk Factor Surveillance System (BRFSS) survey for this research.  BRFSS is the world’s largest telephone health survey and a nationwide surveillance system, collecting on-going behavioral information in the U.S. and providing valuable public health data.

The prevalence of obesity among all Washington workers was 24.6%. However, the prevalence of obesity across occupations ranged from 11.6% to 38.6%.  The three occupational groups with the highest obesity prevalence were:

  1.  Truck drivers, 38.6%.
  2.  Transportation and material moving (bus drivers, crane operators, etc), 37.9%.
  3. Protective services (for example, firefighters, police officers and correctional officers), 33.3%.

When compared to health diagnosing occupations (physicians and dentists, for example) and after adjusting for other covariates,[2] most occupations had significantly increased odds of obesity.

Inclusion of occupation on the BRFSS allows estimation of the prevalence of current smoking, adequate fruit and vegetable intake, and leisure time physical activity levels. Based on these measures, specific occupational groups can be evaluated against national and state efforts at promoting workplace wellness.  For example, of the 28 occupational groups, 10 had already met the Healthy People 2020 goal for smoking prevalence at less than 12%.-

Using occupation as a means to target workplace wellness and health promotion activities makes sense when you look at correlations between good and poor health behaviors.  In this research, occupations with a high prevalence of obesity had a lower prevalence of vigorous leisure time physical activity, a lower prevalence of adequate fruit and vegetable consumption and a higher prevalence of smoking.

Only 2003, 2005, 2007 and 2009 BRFSS data were used because respondent’s information on fruit and vegetable intake was only collected those years.  Since there are very few systematic measures of the health of workers by occupation at the state level, we want to emphasize the value of capturing health information by occupation across all states in BRFSS.  The findings of this research study identify high risk occupational groups of obesity in Washington State for better allocation of financial and public health resources, and similar research could be done for other health concerns of the workforce in other states.

Also worthy of further exploration is the connection between the conditions and nature of the work within an industry sector and health behaviors.  The work demands, risks, schedules, remuneration, and other requirements that many jobs in certain industries and occupations entail have the potential to strongly influence the overall health of workers in those occupations.  How do these parameters affect health behaviors and ultimately health outcomes?  How can workplace policies, environments and conditions be made safer and more conducive to positive health opportunities and more informed decision-making?  How can we better understand the interaction between healthier, safer work and a healthier citizenry? Current research funded by NIOSH is beginning to examine these issues in a more comprehensive way.

The Washington findings from the BRFSS that the prevalence of obesity varies by occupation are consistent with another recent study out of NIOSH that examined the prevalence of obesity among workers by industry and occupation and by work organization factors using data from the 2010 National Health Interview Survey Occupational Health Supplement (NHIS-OHS).[3]  Like the BRFSS data, the NHIS data showed a relatively high prevalence of obesity among workers in protective service and transportation and material moving occupations.  After adjustment for covariates, employment in health care and social assistance and public administration industries, as well as architecture and engineering, community and social service, protective service, and office and administrative support occupations was also associated with increased obesity prevalence.  Among all workers, working for more than 40 hours per week and exposure to a hostile work environment were also significantly associated with obesity.

The NIOSH Total Worker HealthTM program takes a comprehensive approach to promoting worker health by advancing the integration of health protection and health promotion in the workplace.  The effort focuses on both improving the quality and safety of work and empowering workers for better health-related decision making.  Visit the NIOSH Total Worker HealthTM website to  find out more about the current research, interventions and promising practices.

For more information about the SHARP (Safety & Health Assessment & Research for Prevention) program at the Washington State Department of Labor and Industries visit the webpage.

Wendy Lu, MPH; David Bonauto, MD, MPH; Joyce Fan, PhD;  L. Casey Chosewood, MD;  Sara E. Luckhaupt, MD, MPH


Miss. Lu is an epidemiologist in SHARP research program at the Washington State Department of Labor and Industries.

Dr. Bonauto is the medical director of SHARP research program at the Washington State Department of Labor and Industries.

Dr. Fan is an epidemiologist in SHARP research program at the Washington State Department of Labor and Industries.

Dr. Chosewood is the Senior Medical Officer for Total Worker HealthTM at NIOSH.

Dr. Luckhaupt is a medical epidemiologist in the NIOSH Division of Surveillance, Health Evaluations and Field Studies.

[1] Bonauto DK, Lu D, Fan ZJ. Obesity Prevalence by Occupation in Washington State, Behavioral Risk Factor Surveillance System. Prev Chronic Dis 2014; 11:130219. www.cdc.gov/pcd/issues/2014/13_0219.htm?s_cid=pcd9e04_x. Accessed February 18, 2014.

[2] Other covariates include age, gender, race/ethnicity, annual household income, educational attainment, current smoking, leisure time and occupational physical activity levels and fruit and vegetable intake.

[3] Luckhaupt SE, Cohen M, Li J, Calvert GM. Prevalence of obesity among U.S. workers and associations with occupational factors. Am J Prev Med 2014;46(3):237–248. http://www.sciencedirect.com/science/article/pii/S074937971300617X

Posted on by Wendy Lu, MPH; David Bonauto, MD, MPH; Joyce Fan, PhD;Casey Chosewood, MD; Sara E. Luckhaupt,MD, MPH

12 comments on “Occupations with High Obesity Prevalence in Washington State”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    Many top jobs around the world seems to having such problems! Interesting facts! Good time to pay attention on these critical factors related with human resource.

    This is very good article. Indeed, a painful weight problem won’t solve itself. Stress makes people eat a lot of fast food which of course creates a weight problem. Stress can be easily reduced with self-hypnosis. Everybody can learn self-hypnosis and use it to reduce his or her stress. No drugs, cigarettes or alcohol needed.

    Your weight problem can be solved with self-hypnosis by changing eating habits. Instead eating junk you can enjoy healthy food which are mostly fruits and vegetables. As a result your health will be improved, you will have more vital energy!

    I think one of the biggest issues is work, a body in movement stays that way. Most places just are not that active.

    As a hypnotherapy practitioner in West Lothian, Scotland, I have the priviledge of working with a lot of people with weight problems.

    It does not seem to matter what job they do, but more the level of stress they allow into their lives. Eating releases powerful hormones that calm the body from stress responses, but is not a long term solution. The previous poster is also correct, an increasingly sedentary lifestyle without any reduction in calorie intake is also contributing.

    People can change their situations through self- or assisted hypnosis.


    Poor health behaviors can lead to chronic disease.!!!
    Very valuable post.
    Obesity is upcoming problem all of us. We need to think about it.
    Visit us. Get to know about what is caused for obesity.

    The Holistic Method (The whole body approach ) is the key to wellness. Researchers discovered chronic stress can cause the body to produce/release extra cortisol, Cortisol is a contributing factor in increase appetite.
    Stress at work place may contribute in weight gain.
    Thank you for your hard work and education in prevention.

    I’m a 65 y/o bus driver dealing with BPH for past 9yrs. ONLY complications to date are 3 occasions off work suffering from bladder infection. On 2 of these occasions I was hospitalised for 1-2 days and put on antibiotic drip and medication for 1 week after discharge. I then spent 2-4 days off work and returned to normal work duties without complications. nb ONLY BPH symptoms I have ever suffered being lower back pain and accute appendicitis -like pain on occasions. NB I have NEVER had symptoms other than ment’d previously.

    Q. SPECIFIC; IN ALL RESEARCH I HAVE DONE TO DATE I have NOT found ANY link/info./ research papers etc. relating to urine retention and earlier onset of BPH symptoms related to my work as a busdriver. nb Due to tight schedules and non-provision of readily available bathroom/toilet facilities for the past 20+ years I have driven inummearable times for periods between 2-5 hours and have been unable to go to the toilet when ‘naturecalls’ !!. I believe my current severe BPH symptoms incl. massive prostrate /massive bladder/damage to bladder muscle/ uropathy/diverticulitis are ALL related my worplace environment which has exascerbated what was previously a ‘manageable ‘BPH condition.

    I am sorry to hear about your condition. While we are not aware of any completed research in this area, the National Academies of Science, Engineering, and Medicine: Transportation Research Board is in the process of funding research in this area. A summary of the research, which is expected to be completed early next year, can be found at http://apps.trb.org/cmsfeed/TRBNetProjectDisplay.asp?ProjectID=4119

    thanks for sharing this article, nowdays everyone has a busy lifestyle and nobody is focusing on their health.

    it is of great importance that the CDC Covid policies are observed, every were,.for our safety ,our families,and our communities,.

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