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Body Mass Index and Premature Mortality in Physically Heavily Working Men—A Ten-Year Follow-Up of 20,000 Construction Workers

Arndt, Volker MD, MPH; Rothenbacher, Dietrich MD, MPH; Zschenderlein, Bernd MD; Schuberth, Stephan MD; Brenner, Hermann MD, MPH

Journal of Occupational and Environmental Medicine: August 2007 - Volume 49 - Issue 8 - p 913-921
doi: 10.1097/JOM.0b013e31814544fe
Original Articles

Objective: Although obesity is clearly associated with diabetes and cardiovascular disease, health consequences of being mildly or moderately overweight are less clear in physically heavily working men.

Methods: The association between body mass index (BMI) and mortality was assessed over a 10-year period in a cohort of 19,513 male construction workers, who underwent routine occupational health examination during 1986 to 1992.

Results: Among never smokers normal and overweight men experienced similar mortality. Among smokers, we observed a strong U-shaped association between BMI and all-cause mortality, which was lowest for BMI levels between 25 and 35 kg/m2 after control for potential covariates.

Conclusions: BMI levels commonly considered to reflect overweight may not necessarily be associated with increased mortality in physically heavily working men.

From the German Cancer Research Center (Drs Arndt, Rothenbacher, and Brenner), Division of Clinical Epidemiology and Aging Research, Heidelberg; and Workmen’s Compensation Board for Construction Workers (Drs Zschenderlein and Schuberth), Occupational Health Service, Böblingen, Germany.

Address correspondence to: Volker Arndt, MD, MPH, German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research (C070), Bergheimer Strasse 20, 69115 Heidelberg, Germany; E-mail:

©2007The American College of Occupational and Environmental Medicine