Currently in Australia, 63.4% of adults (11.2 million people) aged 18 years and over are considered to be overweight (35.5% or 6.3 million people) or obese (27.9% or 4.9 million people) (ABS 2015). Given these statistics, employers must carefully consider the potential risks associated with overweight or obese employees including secondary health issues (such as cardiovascular disease, high blood pressure and Type 2 diabetes), lower productivity, work limitations, increased risk of injury and illness and extended recovery time after an injury.
What is obesity?
Determining whether a person is overweight or obese is measured at the population level using the Body Mass Index (BMI).
BMI is a simple weight to height index which is calculated by dividing a person’s weight in kilograms by their height in metres squared. As an example, a male who is 1.80 metres in height and weighs 78 kg would have a BMI of 24.1.
For adults, the World Health Organisation (WHO) defines ‘overweight’ and ‘obese’ as:
- Overweight – having a BMI greater than or equal to 25; and
- Obese – having a BMI greater than or equal to 30.
According to the WHO, a high BMI is considered a major risk factor for non-communicable (that is, non-infectious or non-transmissible) diseases such as:
- Cardiovascular diseases (for example, heart disease and stroke);
- Type 2 diabetes;
- Musculoskeletal disorders (for example, osteoarthritis); and
- Some cancers (for example, endometrial, breast, ovarian, prostate, liver, gallbladder, kidney, and colon).
Without further action, it is projected that the financial cost associated with obesity in the general population will be a total of $87.7 billion in additional direct and indirect costs for the period from 2015 to 2025 (Price Waterhouse Cooper 2015).
Given the prevalence of overweight and obese people in the general population, what are the implications for employers?
1. Primary duty of care
The primary duty of care imposed on employers to ensure, so far as is reasonably practicable, the health and safety of workers, is broad and includes considering the health risks associated with obesity as illustrated by the following examples.
(a) Sedentary work and obesity
- Sedentary behaviour, including prolonged durations of unbroken seated work is associated with a range of poor health outcomes including musculoskeletal problems, cardiovascular disease, diabetes, obesity, some cancers and premature death. Prolonged sitting is also a causal factor in the onset or aggravation or pre-existing musculoskeletal disorders such as lower back pain due to the adoption of a ‘static’ posture over an extended period of time.
Considering these risks, employers should implement control measures which focus on:
- Reducing prolonged sitting such as through the use of ‘sit-stand’ desks and frequent short breaks involving standing, walking or a combination of both (Safe Work Australia 2016); and
- Encouraging moderate-intensity aerobic exercise such as promoting lunchtime sporting initiatives and having bicycle lockers and shower facilities for employees who cycle to work. The WHO recommends that adults aged between 18 to 64 should perform at least 150 minutes of moderate-intensity aerobic physical activity, or at least 75 minutes of vigorous-intensity aerobic physical activity, throughout the week, or an equivalent combination of moderate and vigorous-intensity activity (WHO 2011).
(b) Shift work and obesity
Shift work is typically described as any shift that falls outside the normal daylight hours of 7:00 am to 6:00 pm. Shift work has been linked with a number of adverse health effects, one of which is obesity. It is not clear what the exact causal link is between shift work and obesity but it most likely relates to a combination of circadian and metabolic factors. 12% to 16% fewer calories are burnt when sleeping during the day as compared to sleeping at night. Lower energy levels may also contribute to the poor diet and low exercise levels often observed in shift workers (Zhao and Turner 2008).
Employers who engage shift workers should therefore consider:
- promoting healthy eating habits such as by encouraging workers to eat small, frequent meals and moderate their caffeine consumption;
- promoting moderate-intensity aerobic exercise before, during and after shifts in line with the WHO’s recommendations outlined above; and
- promoting good sleeping habits including maintaining a regular sleep schedule, having curtains with backing or blinds to reduce light and reducing noise with sound insulation on doors and windows.
2. Pre-employment and fitness for work examinations
The assessment of an employee’s fitness for work, either before or during employment, is an important consideration for employers. Pre-employment medical assessments assist employers to identify health-related issues (including obesity and any associated co-morbidities) which may affect a person’s ability to safely perform the job for which they are being considered. Fitness for work assessments during employment are also valuable as they can be tailored to the specific physical demands of the job that the employee is currently performing.
The vital ingredients for the effective performance of these assessments are:
- determining the physical demands for each manual task/operation required to be performed; and
- referencing these physical demands as part of the inherent requirements of each position description.
Obesity is a challenging, multifaceted condition. Employers must take this challenge into account when assessing health and safety risks in the workplace and must implement appropriate controls to eliminate or minimise these risks.
- Australian Bureau of Statistics (2015): National Health Survey: First Results 2014-15;
- Price Waterhouse Cooper (2015): Weighing the cost of obesity – A case for action;
- Safe Work Australia (2016): Sedentary Work – Evidence on an emergent work health and safety issue;
- Van der Ploeg, H, Chey, T, Korda, R.J, Banks, E and Bauman, A (2012): Sitting Time and All-Cause Mortality Risk in 222 497 Australian Adults. Archives of Internal Medicine, 172(6), pp.494-500.
- World Health Organisation (2011): Information sheet – Global recommendations on physical activity for health 18 – 64 years old;
- World Health Organisation (2016): Factsheet – Obesity and overweight;
- Zhao, I and Turner, C (2008): The impact of shift work on people’s daily health habits and adverse health outcomes. Australian Journal of Advanced Nursing, Volume 25 (3).