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Both obesity and underweight increase the risk of long-term sickness absence (LTSA) in working men. This U-shaped association highlights that underweight also poses an excess risk for LTSA.

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Area of Science:

  • Occupational Health
  • Epidemiology
  • Public Health

Background:

  • The relationship between excess weight and sickness absence (SA) is established, but the impact of underweight on SA remains under-researched.
  • Understanding the full spectrum of BMI-related risks for SA is crucial for occupational health.
  • This study addresses the knowledge gap regarding underweight and SA.

Purpose of the Study:

  • To investigate the association between Body Mass Index (BMI) extremes and long-term sickness absence (LTSA).
  • To examine the effects of both underweight and obesity on LTSA in a working population.
  • To explore potential sex-specific differences in BMI-related LTSA risks.

Main Methods:

  • Utilized data from the Japan Epidemiology Collaboration on Occupational Health study.
  • Included 77,760 workers (aged 20-59 years) with information on medically certified LTSA (≥30 consecutive days) from April 2012 to March 2017.
  • Employed sex-specific Cox proportional hazards models to analyze associations between BMI categories and LTSA.

Main Results:

  • In males, both obesity (HR=1.81) and underweight (HR=1.56) were significantly associated with increased LTSA compared to normal weight.
  • A U-shaped association between BMI categories and LTSA was observed in males for both mental and physical disorders.
  • Females with overweight showed an elevated risk of LTSA (HR=1.54).

Conclusions:

  • Both obesity and underweight are linked to a higher risk of LTSA in the Japanese working-age male population.
  • The findings underscore the importance of considering underweight as a significant risk factor for LTSA.
  • Future research and occupational health strategies should address the excess risk of LTSA associated with underweight.