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J Occup Environ Med. 2011 Jun;53(6):610-7. doi: 10.1097/JOM.0b013e31821b9c24.

Cost-effectiveness and cost-benefit of a lifestyle intervention for workers in the construction industry at risk for cardiovascular disease.

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  • 1Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, the Netherlands.



To investigate the cost-effectiveness and cost-benefit of a lifestyle intervention for construction workers with an elevated risk of cardiovascular disease.


In this randomized controlled trial, usual care was compared to a 6-month individual-based lifestyle intervention. At 6 and 12 months, weight, absenteeism, health care use, and lifestyle-related expenses were determined. Missing data were imputed. A cost-effectiveness analysis was performed from a societal perspective. Uncertainty around the incremental cost-effectiveness ratio (ICER) was estimated by bootstrapped cost-effect pairs. A cost-benefit analysis was performed from an employer's perspective, subtracting the incremental costs from the incremental benefits.


The ICER was € 145/kg weight loss. The difference between intervention and control group in net employer costs was € 254 (95% CI: -1070 to 1536).


Implementation of this important and effective intervention depends on the societal and employer's willingness to pay.

[PubMed - indexed for MEDLINE]
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