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BMI category, recorded diagnosis composition, and occupational medicine certificate validity: the POLOCARIA study, 2016–2025

Year: 2026

Type: article

Abstract: Background: Occupational medicine examinations offer an opportunity to identify cardiometabolic risk among professionally active adults. This study examined associations between BMI, recorded diagnosis composition, circulatory parameters, and occupational medicine certificate validity. Methods: This retrospective observational study analyzed 988,822 patient-year records from 620,882 patients attending a large private healthcare network in Poland during 2016-2025. Associations were examined using chi-square tests, analysis of variance, Spearman correlations, and linear regression with standard errors clustered by patient. Results: Mean systolic blood pressure increased from 121.65 mmHg at normal weight to 141.01 mmHg in Class III obesity, while mean certificate validity decreased from 34.81 to 27.80 months. Diabetes/hyperglycaemia diagnoses represented 8.2% of selected diagnoses at normal weight and 20.8% in Class III obesity. BMI was negatively correlated with certificate validity (ρ = -0.172) and positively correlated with systolic blood pressure (ρ = 0.401). In the adjusted model, age category (β = -0.209), systolic blood pressure (β = -0.148), and BMI (β = -0.053) were associated with shorter certificate validity. Conclusions: Higher BMI was associated with higher blood pressure, greater representation of selected cardiometabolic diagnoses, and shorter certificate validity. Occupational examinations may support cardiometabolic risk recognition, but diagnosis percentages are not prevalence estimates and certificate validity is not a measure of work ability or a causal consequence of BMI.

Source: Frontiers in Public Health

DOI: 10.3389/fpubh.2026.1920503