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Occupational risks associated with cigarette smoking: a prospective study.

J Ryan, C Zwerling and E J Orav

East Boston Neighborhood Health Center, MA.

BACKGROUND. Studies have indicated that cigarette smokers have more occupational accidents and injuries and use more sick time and health benefits than nonsmokers, thereby producing sizeable costs for employers. However, they usually have not controlled for other possible sources of these costs. We analyzed occupational costs associated with smoking while adjusting for a number of potential confounders. METHODS. We conducted a prospective, controlled study of the association between smoking and employment outcomes in 2537 postal employees, adjusting for age, gender, race, drug use, job category, and exercise habits. RESULTS. For smokers, the relative risk for turnover was 1.01 (95% confidence interval [CI], 0.83-1.21); for accidents 1.29 (CI, 1.07-1.55); for injuries 1.40 (CI, 1.11-1.77); for discipline 1.55 (CI, 1.19-2.02). Their mean absence rate was 5.43% compared with 4.06% for nonsmokers. CONCLUSIONS. Our study shows that cigarette smoking is associated with adverse employment outcomes after controlling for a number of possible confounders. This finding has implications for companies formulating smoking policies and considering the establishment of smoking cessation programs.

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