Relationship between anemia and occupational fall injuries in female part-time employees: an observational study of large supermarket stores in Japan

Objectives: Occupational fall injuries have recently increased markedly in Japan, together with an increase in later-middle-aged females in the labor market. However, the association between anemia, which is prevalent among Japanese females, and falls is unclear. Here, we investigated the association between anemia and occupational fall injuries.

Methods: Participants were 6780 part-time female employees aged 35-64 working in Japanese supermarket stores of a retail company and who had at least 1 health checkup each year between 2017 and 2022. Anemia was defined as hemoglobin (Hb) <12.0 g/dL (mild: Hb = 11.0-11.9 g/dL, moderate-severe: Hb < 11.0 g/dL). Fall injuries were defined as slips, trips, and falls on the same level, requiring medical attention based on the occupational injury data by the company. Incidence rate ratios (IRRs) for falls were estimated using multilevel Poisson regression, adjusting for age and body mass index.

Results: The annual rate of occupational fall injuries was 0.7%. The adjusted IRR for occupational fall injuries among participants with anemia was 1.71 (95% CI, 1.12-2.60). When dividing anemia into 2 groups, IRR was 1.46 (95% CI, 0.84-2.53) for mild anemia and 2.13 (95% CI, 1.18-3.84) for moderate-severe anemia (P for trend = .007).

Conclusions: In this observational study of employees of large Japanese supermarket stores, anemia was significantly associated with a higher incidence of occupational falls. Our findings suggest the importance of anemia in the prevention of occupational falls.