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Cost-Effectiveness and Cost-Benefit of a Lifestyle Intervention for Workers in the Construction Industry at Risk for Cardiovascular Disease

Groeneveld, Iris F. PhD; van Wier, Marieke F. MSc; Proper, Karin I. PhD; Bosmans, Judith E. PhD; van Mechelen, Willem PhD, MD; van der Beek, Allard J. PhD

Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e31821b9c24
ORIGINAL ARTICLES: CME Available for This Article at

Objective: To investigate the cost-effectiveness and cost–benefit of a lifestyle intervention for construction workers with an elevated risk of cardiovascular disease.

Methods: In this randomized controlled trial, usual care was compared to a 6-month individual-based lifestyle intervention. At 6 and 12 months, weight, absenteeism, health care use, and lifestyle-related expenses were determined. Missing data were imputed. A cost-effectiveness analysis was performed from a societal perspective. Uncertainty around the incremental cost-effectiveness ratio (ICER) was estimated by bootstrapped cost–effect pairs. A cost–benefit analysis was performed from an employer's perspective, subtracting the incremental costs from the incremental benefits.

Results: The ICER was €145/kg weight loss. The difference between intervention and control group in net employer costs was €254 (95% CI: −1070 to 1536).

Conclusion: Implementation of this important and effective intervention depends on the societal and employer's willingness to pay.

Author Information

From the Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center (Dr Groeneveld, Dr Proper, Prof. dr. van Mechelen, and Prof. dr. van der Beek); Body@Work, Research Center Physical Activity, Work and Health (Dr Groeneveld, Dr Proper, Prof. dr. van Mechelen, and Prof. dr. van der Beek); and Department of Health Economics & Health Technology Assessment, Institute of Health Sciences, Faculty of Earth and Life Sciences, VU University (Drs van Wier and Bosmans), Amsterdam, the Netherlands.

Address correspondence to: Prof. dr. A.J. van der Beek, Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands. E-mail:

This project was funded by Stichting Arbouw, national organization involved in monitoring and improving working conditions and occupational health of workers in construction industry.

Authors Iris Groeneveld, Marieke van Wier, Karin Proper, Judith Bosmans, Willem van Mechelen, and Allard van der Beek have no commercial interest related to this research.

The JOEM Editorial Board and planners have no financial interest related to this research.

©2011The American College of Occupational and Environmental Medicine