Weight gain in public hospital workers: a retrospective cohort study

Montzel, Denise Renani von Brixen; Costa, Bruna Vieira de Lima; Silva, Flávia Moraes

doi:10.1590/1413-81232018247.17272017

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Brasil

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ARTICLE • Ciênc. saúde colet. 24 (7) • July 2019 • https://doi.org/10.1590/1413-81232018247.17272017 copy

Weight gain in public hospital workers: a retrospective cohort study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study assessed changes in the nutrition profile of public hospital workers over a period of three decades and the association between nutritional status and occupational factors. A retrospective cohort study was conducted with staff taken on in 1980, 1990, and 2000 still working in the hospital in 2013. The following data was obtained from staff records: sociodemographic characteristics; and body weight and height, recorded during pre-employment and periodic medical examinations. The latter was used to calculate body mass index (BMI).The final sample consisted of 386 workers (76.4% women and 88.1% white) with a mean age of 29.3 ± 7.3 years. Mean body weight and BMI at admission were highest in the 2000 cohort (W = 66.3 ± 12.5kg; BMI = 21.3 ± 2.5 kg/m²), compared to 1980 (W = 56.7 ± 10.2 kg; BMI = 21.3 ± 2.5 kg/m²)and 1990 (W = 62.2 ± 11.5 kg; BMI = 22.9 ± 3.3 kg/m²) cohorts. Variation in weight and BMI between the pre-employment examination and final periodic examination was highest in the 2000 cohort. When stratified by sex, this difference in variation was observed only in men. No association was found between variation in body weight and BMI and work shift and occupation. The increase in weight and BMI reflects the nutritional transition in Brazil, underscoring the need for nutritional surveillance and the implementation of health education programs directed at staff.

Cohort study; Weight gain; Nutritional status; Occupational health

	1980 (n = 68)	1990 (n = 175)	2000 (n = 143)	Valor de P
Age (years)	24.76±4.36a	28.26±6.21b	32.81±8.07c	<0.001¹
Gender (Female)	58 (85.3%)	125 (71.5%)	109 (76.2%)	0.166²
Skin color (White)	61 (89.7%)	153 (87.42%)	126 (87.5%)	0.167²
Shift (Day)	37 (54.4%)	123 (70.3%)	105 (73.4%)	0.017¹
Occupation
Care staff	51 (75%)	106 (60.6%)	92 (64.3%)	0.187²
Administrative staff	17 (25%)	69 (39.4%)	51 (35.7%)	0.187²
Weight (Kg)	56.68±10.25^a	62.22±11.48^b	66.31±12.55^c	<0.001¹
BMI (Kg/m²)	21.30±2.52^a	22.86±3.28^b	24.19±3.64^c	<0.001¹

	1980 n = 68	1990 n = 173	2000 n = 139	Valor de p¹
∆ weight(kg)
Total	4.17 (2.08 – 6.17)^a	3.50 (-2.95 – 9.50)^a,b	7.00 (2.50 – 12.00)^c	< 0.001
Women	3.83 (2.00 – 5.83)	4.23 (-1.00 – 11.13)	5.00 (2.00 – 10.00)	0.199
Men	5.50 (2.25 – 6.33)^a	-0.25 (-6.00 – 7.25)^a,b	9.00 (5.00 – 14.00)^a,c	0.012
∆ BMI (kg/m²)
Total	1.54 (0.82 – 2.30)^a	1.21 (.0.94 – 4.15)^a,b	2.60 (0.92 – 4.44)^a,c	< 0.001
Women	1.47 (0.80– 2.34)^a	1.01 (-0.74 – 4.12)^a	2.08 (0.77 – 4.05)^a	0.112
Men	1.64 (0.79 – 2.10)^a	1.41 (-1.69 – 4.45)^a,b	3.09 (1.68 – 5.00)^a,c	0.019

	Day shift (n = 265)	Night shift (n = 121)	P-value
Age (years)	29.43 ± 7.57	29.04 ± 6.73	0,620¹
Gender (Female)	76.2%	73.6%	0,356²
Skin color (White)	72.1%	66.9%	0,183²
Weight(kg)
Pre-employment examination	63.11 ± 12.07	61.96 ± 12.27	0,388¹
Final periodic examination	71.76 ± 14.99	71.41 ± 14.95	0,835¹
BMI (kg/m²)
Pre-employment examination	23.17 ± 3.55	22.86 ± 3.2	0,411¹
Final periodic examination	26.5 ± 5.46	26.49 ± 5.56	0,985¹
Classification of BMI
Pre-employment examination			0,488²
Underweight	5.3%	4.1%
Healthy weight	66.4%	69.4%
Overweight	22.6%	24%
Obese	5.7%	2.5%
Final periodic examination			0,926²
Underweight	3.8%	4.1%
Healthy weight	37.4%	39.7%
Overweight	31.7%	33.1%
Obese	24.5%	21.5%

	Care staff n = 248	Administrative staff n = 137	P-value
Age (years)	29.6 ± 6.44	28.8 ± 8.7	0.349¹
Gender (Female)	17.7%	35%	<0.001²
Skin color (White)	73.8%	65%	0.075²
WEIGHT(kg)
Pre-employment examination	61.79 ± 11.98	64.44 ± 12.28	0.042¹
Final periodic examination	71.15 ± 15.22	72.44 ± 14.52	0.423¹
BMI (kg/m²)
Pre-employment examination	22.94 ± 3.48	23.31 ± 3.39	0.303¹
Final periodic examination	26.37 ± 5.63	26.71 ± 5.25	0.567¹
Classification ofBMI
Pre-employment examination
Underweight	5.2%	4.4%	0.734²
Healthy weight	69.8%	62.8%
Overweight	20.6%	27.7%
Obese	4.4%	5.1%
Final periodic examination
Underweight	4%	3.6%	0.828²
Healthy weight	39.9%	35%
Overweight	30.6%	34.3%
Obese	22.6%	25.5%

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

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[TFN1001] BMI = body mass index. ¹ ANOVA (post hoc analysis carried out using Tukey’s test with significant differences represented by superscript letters) ² Chi-squared test (residual analysis with significant differences represented by superscript letters). Data presented as mean ± standard deviation or number and percentage of workers with the characteristic.