Serum uric acid and risk of occupational disability: findings from a cohort study of male construction workers in Germany.

Objective: The role of serum uric acid (UA) as an independent risk factor for several health outcomes remains controversial. However, given the accumulating evidence that UA is related to predictors of occupational disability such as obesity, excessive alcohol consumption, hypertension, and diabetes mellitus, UA may represent a relevant risk indicator for occupational disability, which has emerged as an important public health problem.

Methods: The association between UA and occupational disability was examined in a cohort of 16,532 male construction workers in Germany who underwent occupational health examinations from 1986 to 1992 and were followed until 2005. Cox regression analysis was employed with adjustment for established risk factors.

Results: A total of 3,002 cases of disability pension occurred during the followup. Risk of all-cause occupational disability was significantly increased for UA concentration in the top quartile (hazard ratio [HR] 1.25, 95% confidence interval [95% CI] 1.12-1.40) after adjustment for potential confounders when compared with UA levels in the lowest quartile (≤ 5.23 mg/dl). Cause-specific analysis revealed a significant association between increased UA and occupational disability due to cardiovascular diseases (HR 1.62, 95% CI 1.20-2.17). In addition, positive but statistically nonsignificant associations were observed for occupational disabilities due to respiratory diseases (HR 1.78, 95% CI 0.99-3.23), musculoskeletal disorders (HR 1.16, 95% CI 0.98-1.37), diseases of the digestive system (HR 1.59, 95% CI 0.69-3.67), and mental disorders (HR 1.40, 95% CI 0.95-2.06).

Conclusion: Our study is the first to our knowledge to indicate that increased UA might also serve as a potential independent risk indicator for occupational disability, in particular due to cardiovascular diseases.