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Objectives: To quantify risk factors for nonoccupational absence from musculoskeletal disorders (MSD) among petroleum-manufacturing employees., Methods: We conducted a 4-year follow-up study including 860 employees with an MSD illness absence of 4 days or longer and 5691 employees with no MSD absence. Odds ratios were calculated using logistic regression., Results: Risk of MSD absence from low back and non-low back disorders was significantly associated with physically demanding job, overweight/obesity, prior absence from MSD, and absence from cardiovascular, respiratory, or mental illness, or accidents during the study period. Smoking also increased risk of low back disorders., Conclusions: Results suggest it is possible to reduce the impact of MSD through integrated safety prevention and health promotion programs including traditional elements of job factor evaluation, training, and ergonomics, but also health counseling and support for weight reduction, smoking cessation, and personal fitness programs.

Objective: To assess the combined impact of health risk factors on mortality., Methods: A 21-year mortality follow-up of 12,896 Shell Oil Company employees was conducted. Relative risks of mortality, expressed as hazard ratios, in relation to the six risk factors, including cigarette smoking, obesity, high blood pressure, total cholesterol, serum glucose, and triglycerides, were calculated using a Cox proportional hazards model., Results: Employees with health risk factors had higher mortality rates for all-causes combined and for cardiovascular diseases compared to employees without such risk factors. Smoking, obesity, hypercholesterolemia, and hyperglycemia independently and significantly predicted cardiovascular disease mortality. Mortality risks from all causes and from cardiovascular disease increased with the number of risk factors present., Conclusions: This study found a positive association between several health risk factors and mortality. A greater number of risk factors corresponded to a higher rate of death. Reductions of employee health risk factors may be an effective means of improving employees' long-term health.

Objective: To further investigate the mortality risk of employees who worked in the petroleum refinery industry, we updated an earlier investigation by extending the mortality follow-up by an additional 14 years through 2003., Methods: The cohort consisted of 10,621 employees with an average follow-up of 34 years. We used the standardized mortality ratio (SMR) adjusted for age, race, and calendar years as a measure of risk., Results: Overall mortality (SMR=0.77, 95% confidence interval [CI], 0.74-0.79), all cancer mortality (SMR=0.87, 95% CI=0.82-0.93), and most cause-specific mortalities for the total study population were lower than or similar to that of the population of Harris County, Texas. This study did not show a significant increase in leukemia in the total population or in any of the subgroups. The only statistically significant excess of mortality found in this study was an increase in mesothelioma among maintenance employees; the SMR was 4.78 (95% CI=2.54-8.17) among employees who worked for a minimum of one year and was 7.51 (95% CI=3.75-13.45) among those with 10 or more years of employment and 20 or more years of latency., Conclusions: After more than half a century of follow-up, employees at this facility continue to show more favorable mortality outcomes than the general local population. Overall, no statistically significant increase of leukemia or of any of the specific cell types was found. The increased mesothelioma is likely related to past exposure to asbestos.

Purpose: The purpose of this study is to determine the incidence of cancer among employees at two petrochemical facilities in south Louisiana, and to compare their cancer rates to those of the general population of south Louisiana., Methods: Records on 4639 active and former employees and retirees from the two plants were linked to the Louisiana Tumor Registry (LTR) database by LTR staff to ascertain incident cases of cancer. Standardized incidence ratios (SIRs) were then calculated using the south Louisiana population as the comparison and adjusted for age, race, and time period., Results: There was a significant 16% deficit of overall cancer cases for males in this cohort (SIR=0.84; 95% CI, 0.74-0.95). The only significantly elevated SIR in males was for cancer of the bone and joint (SIR=6.89; 95% CI, 1.42-20.1). This result was based on three non-fatal cases of bone cancer with different histologies, occurring in different parts of the body. These cases worked in different units of one plant. Significant deficits were seen for lung cancer, non-Hodgkin's lymphoma, and cancer of the oral cavity and pharynx. Cancer incidence among 719 female employees was non-significantly increased (SIR=1.24; 95% CI, 0.81-1.82). Breast cancer accounts for the excess (SIR=1.46; 95% CI, 0.73-2.61). Seventy percent of the breast cancer cases worked in an office setting., Conclusions: This study found little evidence of any association between cancer incidence and employment at these two petrochemical facilities. The increased incidence of bone cancer is unlikely to be due to occupational exposures. The non-significant excess of breast cancer may be due to early detection or other important unmeasured confounders, such as certain reproductive factors.

Purpose: Examine employee illness absence and the economic impact of overweight and obesity in a petrochemical industry workforce. Methods: A 10-year follow-up (1994–2003) of 4153 Shell Oil Company employees was conducted. Absence frequency rates and average number of workdays lost were calculated for normal weight, overweight, and obese employees with and without the presence of additional risk factors. The study also assessed the change in overweight and obesity prevalence in the study population and estimated the current and future economic impact of these conditions. Results: Overall, obese employees were 80% more likely to have absences (24.0 vs. 13.3 per 100 employees) and were absent 3.7 more days (7.7 vs. 4.0 days) per year compared with those employees with normal body weights. Among employees with no additional risk factors, overweight employees lost more than 1.5 times more days (4.2 vs. 2.6 days) per year, and obese employees more than 2.5 times more days (7.2 vs. 2.6 days) compared with their normal-weight colleagues. Similarly, absence frequency attributable to cardiovascular disease significantly increased among employees with one or two additional risk factors present, such as smoking, high blood pressure, or hypercholesterolemia. The direct cost of illness absence from overweight and obesity for this study population was $1,873,500. Furthermore, 31% of the total illness absence was attributable to overweight and obesity in 1994, and the percentage had risen to 36% by 2003. Conclusions: The economic impact to employers is great and will continue to rise unless measures are taken, particularly to reduce the number of employees moving from overweight to obesity with time. [Copyright &y& Elsevier]