Obesity prevalence and accuracy of BMI-defined obesity in Russian firefighters.

BACKGROUND: No data exist on obesity or the accuracy of body mass index (BMI) in Russian Federation firefighters. AIMS: To determine the prevalence of obesity and rates of misclassification of BMI-based obesity status. METHODS: Career firefighters in the Moscow region completed anthropometric assessments including height, weight, BMI, body fat per cent (BF%) and waist circumference (WC). Using these three methods, we defined obesity as BMI ≥30, BF% >25 and WC >102, respectively. RESULTS: The study group consisted of 167 male firefighters. Obesity prevalence was 22% for BMI [95% confidence interval (CI) 16.9-28.5], 60% for BF% (95% CI 52.5-67.3) and 28% for WC (95% CI 21.3-34.9). False positive rates for BMI-based obesity status were low, with 3% (95% CI -1.1 to 7.1) and 6% (95% CI 1.6-9.9) of non-obese participants defined by BF% and WC standards misidentified as obese using BMI. However, 65% (95% CI 55.7-77.4) of BF%-defined obese participants and 36% (95% CI 22.5-49.9) of WC-defined obese participants were misclassified as non-obese using BMI (i.e. false negatives). CONCLUSIONS: Rates of BMI-based obesity in Russian male firefighters were similar to that of males in the general Russian adult male population. Compared with BF% or WC standards, BMI-based obesity classi- fication produced low rates of false positives but demonstrated high rates of false negatives.

Accuracy of self-reported weight, height and BMI in US firefighters.

BACKGROUND: Obesity is of increasing concern especially among firefighters. Bias in self-reported body weight, height and body mass index (BMI) has received a great deal of attention given its importance in epidemiological field research on obesity. AIMS: To determine the validity of self-reported weight, height and BMI and identify potential sources of bias in a national sample of US firefighters. METHODS: Self-reported and measured weight and height (and BMI derived from them) were assessed in a national sample of 1001 career male firefighters in the USA and errors in self-reported data were determined. RESULTS: There were 1001 participants. Self-reported weight, height and BMI were significantly correlated with their respective measured counterparts, i.e. measured weight (r = 0.990; P < 0.001), height (r = 0.961; P < 0.001) and BMI (r = 0.976; P < 0.001). The overall mean difference and standard deviation between self-reported weight, height and BMI were 1.3±2.0kg, 0.94±1.9cm and 0.09±0.9kg/m(2), respectively, for male firefighters. BMI-based weight status (P < 0.001) was the most consistent factor associated with bias in self-reported BMI, weight and height, with heavier firefighters more likely to underestimate their weight and overestimate their height, resulting in underestimated BMIs. Therefore, using self-reported BMI would have resulted in overestimating the prevalence of obesity (BMI ≥ 30.0) by 1.8%, but underestimating the prevalence of more serious levels of obesity (Class II and III) by 1.2%. CONCLUSIONS: Self-reported weight and height (and the resulting BMI) were highly correlated with measured values. A primary and consistent source of error in self-reported weight, height and BMI based on those indices was BMI-based weight status.

Obesity and incident injury among career firefighters in the central United States.

OBJECTIVE: Firefighting is a dangerous profession with high injury rates, particularly musculoskeletal (MS), but limited longitudinal data is available to examine predictors of MS injuries in this population. DESIGN AND METHODS: The relationship between personal individual, nonoccupational factors (e.g., demographic characteristics, body composition, fitness, and health behaviors) and incident injury and incident MS injury in a prospective cohort of 347 firefighters from the central United States was examined. RESULTS: Baseline weight status was a significant predictor of incident MS injury, with obese (BMI ≥ 30 kg m(-2)) firefighters 5.2 times more likely (95% CI = 1.1-23.4) to experience a MS injury than their normal weight (BMI = 18.5-24.9 kg m(-2)) colleagues over the course of the study. Similarly, firefighters who were obese based on WC (>102.0 cm) were almost three times as likely (OR = 2.8, 95% CI = 1.2-6.4) to have a MS injury at follow-up. CONCLUSIONS: Findings highlight the importance of focusing on firefighters' body composition, nutrition and fitness as a means of decreasing risk for injury.

Accuracy of body mass index-defined overweight in fire fighters.

BACKGROUND: Overweight, obesity and weight gain are significant problems in the U.S. fire service. While classification of obesity using body mass index (BMI) has demonstrated accuracy and low rates of false positives when compared with body fat percentage (BF%)-based standards, no studies have examined the accuracy of BMI-based overweight and normal weight status with other comparable body composition indices. AIMS: To compare overweight and normal weight BMI categories with BF% standards from the American Council on Exercise and analogous waist circumference (WC) categories and to examine rates and types of misclassification in fire fighters. METHODS: Data were collected from 11 randomly selected career fire departments in the International Association of Fire Chief's Missouri Valley Region. Demographics, occupational history, and body composition indices (weight, BF% and WC) were obtained from male career fire fighters who were categorized as normal weight or overweight based on BMI. RESULTS: There were 293 participants of whom 92 had normal BMI. There were low rates of false positives (12%) and moderate rates of false negatives (22%) when comparing BMI categories to the compar able BF% categories. However, using WC as the standard resulted in very high rates of false positives (63%) and very low rates of false negatives (5%). CONCLUSIONS: BMI-based overweight status was associated with significant errors in classification depending on the standard to which it was compared.

Alcohol use among firefighters in the Central United States.

BACKGROUND: Although the US National Fire Service is concerned about alcohol use among firefighters, little research has been conducted on the topic. AIMS: To survey alcohol use patterns among career and volunteer firefighters. METHODS: Data were from a population-based cohort study of male firefighters conducted in randomly selected career and volunteer departments. Data were collected from 2008 to 2010. RESULTS: There were 656 participants from 11 career and volunteer 13 departments included in the study with a response rate of 97%. Career firefighters drank approximately 10 days per month (just about half of their off duty days) and drank relatively heavily on those days. Fifty-eight per cent of career and 40% of volunteer firefighters averaged three or more drinks and similar percentages reported binge drinking on the days they consumed alcohol. In general, firefighters who drank but did not binge drink tended to have the best health outcomes, while those who binge drank typically were at highest risk of negative health outcomes. Nine per cent of career and 10% of volunteer firefighters who drank self-reported driving while intoxicated in the previous 30 days. CONCLUSIONS: Given the high rates of heavy and binge drinking, local and nationally coordinated efforts to increase the surveillance of drinking behaviour among firefighters and the development of targeted prevention interventions are critically needed.

Prevalence of overweight and obesity in Thai population: results of the National Thai Food Consumption Survey.

Overweight and obesity are considered a serious health problem in Thailand. This study examined the prevalence of overweight and obesity in a nationally representative sample of Thai children and adults based on international standards. A cross-sectional population survey of 16,596 Thais aged 3 years and over was conducted. Heights and weights were obtained using standardized methods. Estimates of the overweight and obesity prevalence in children, adolescents, and adults were computed. The prevalence of overweight and obesity among children and adolescents aged 3 to 18 years was 7.6% and 9.0%, respectively, and was higher among boys than girls. Among adults, using the the Regional Office for the Western Pacific (WPRO) standard, 17.1% of adults were classified as overweight [body mass index (BMI) 23.0-24.9 kg/m²], 19.0% as class I obesity (BMI 25.0-29.9 kg/m²), and 4.8% as class II obesity (BMI ≥ 30.0 kg/m²). Using the World Health Organization (WHO) definition, 19.0% were overweight (BMI 25-29.9 kg/m²), 4.0% class I obesity (BMI 30.0-34.9 kg/m²), 0.8% class II obesity (BMI 35.0-39.9 kg/m²), and 0.1% class III obesity (BMI ≥ 40.0 kg/m²). There was a vast difference in obesity prevalence between the WHO and the WPRO criteria. Obesity prevalence when using the WPRO definition (23.8%) was almost five times greater than when defined with the WHO standard (4.9%). The present study found a high prevalence of overweight and obesity in nationally representative sample of the Thai population. Higher rates of overweight and obesity prevalence were computed using the WPRO standard when compared to the WHO standard.