Organized school age sporting activities influenced future LTPA in this cohort. Attempts to promote these activities may lead to increased levels of LTPA in adults.

Objectives-The accident rate might be influenced by intrinsic characteristics of the workers, by risks inherent in the work environment, or a combination of these factors. As increased weight may be associated with sleep disturbances and fatigue, a high body mass index (BMI) might be an independent risk factor for accidents in industrial workers. Methods-3801 men were examined and followed up for two years for the occurrence of accidents. The objective environmental conditions were recorded and translated into a single score of ergonomic stress level. Height and weight were recorded, as were possible confounding factors including measures of fatigue, type A personality, total night time sleep, job satisfaction, somatic complaints, smoking, and educational levels.Results-Both BMI and ergonomic stress levels independently predicted involvement in accidents (two or more) with those in the highest BMI quartile who worked in an environment with high ergonomic stress levels having a 4*6 times increased risk of accidents compared with those in the lowest BMI quartile who worked in an environment with low ergonomic stress levels (95% confidence interval (95% CI) 2-4-9-0, P < 0.001). Although increasing somatic complaints and a low educational level also were predictors of accidents, they did not mediate the effect of the BMI on the accident rate. Increasing age, less smoking, and decreased sleep hours were significantly associated with an increased BMI, but the association of BMI and involvement in accidents also could not be explained by those factors or the other confounders.Conclusions-BMI independently influences the accident rate. Further studies are warranted to confirm these findings and to explore mechanisms supporting biological plausibility. (Occup Environ Med 1996;53:832-835) Keywords: body mass index; industrial; accidents Individual variations in accident rates may be due to intrinsic characteristics of the workers, because some people are exposed to more risks, or because the occurrence of an accident increases the probability of having subsequent accidents. Accidents at work have been found to be related to personal characteristics' including type A personality,2 3 dysfunctional personal backgrounds, work dissatisfaction, strain at work,4 smoking,5 fatigue, negative feelings occurring when defences against hostility conflict with authority fail,7 and age, with both younger workers and older workers having more accidents than those in the middle age range.' The effect of the "riskiness" of the work environment on the accident rate, however, was taken into account in only one of the studies' and may have biased the results.Body mass index (BMI = weight (kg) divided by height (M2)) is an intrinsic characteristic which is easy to measure, and assesses degrees of obesity. An extremely high or low body mass index was reported to be a risk factor for injuries related to training in infantry soldiers,9 and Stoohs et al reported that commercial long haul lorry drivers with a BMI of > 30 kg/M2 had a twof...

Coronary and cerebrovascular diseases are more frequent among smokers than nonsmokers,'3 while obesity is a risk indicator for overall and cardiovascular mortality.45Both smoking and obesity are modifiable targets for health promotion. However, smoking cessation is associated with weight gain. To estimate the bias induced by this selection, mortality data were obtained from the Ministry of the Interior for 3795 of the participants in CORDIS I and for 1507 of those who did not participate. The remaining 245 eligible workers were excluded from the analysis because of discrepancies with their identification registrations. The age-adjusted 8-year mortality rate among the 3795 employees who entered CORDIS I was 67.6% of the agespecific rate for the general Israeli population; among the 1507 who did not enter the study, the figure was 91.2% of the expected rate. The 4-year mortality (1991)(1992)(1993)(1994) of 1332 of the 1338 employees who were seen in follow-up from 1988 through 1990 (CORDIS II) was 39.5% of the expected rate, while the 4-year mortality of 2399 of the 2478 who were lost to follow-up was 73.2% of the expected rate. There were no significant differences in age, BMI, blood pressure, total cholesterol, history of myocardial infarction, alcohol consumption, sports activity, or education between employees who were seen and those who were lost to follow-up (data not shown).

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