Can the Probiotic Lactobacillus Reuteri Improve Work-Place Healthiness?

According to the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO), probiotics are defined as “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.”

Lactobacillus reuteri is a type of probiotic bacteria that is found in the gut flora and has been effectively used in treating acute diarrhea, infantile colic, rotavirus, and female urogenital tract infections, amongst other conditions. Probiotics, i.e., naturally occurring bacteria are known to help maintain a healthy immune system by providing strong protection against infections.

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The general health and well-being of an employee is important to boost the productivity and success of a company. Working in a steel industry could be quite challenging in terms of alternating shifts, stress factors (heat, noise, dust, etc.) all of which put together could take a toll on the employee’s health. To make the matters worse, increased numbers of respiratory and gastrointestinal problems have been reported in these employees leading to high rates of sick leave.

Many studies conducted in the past have demonstrated that regular intake of a probiotic could reduce the duration of respiratory and gastrointestinal diseases and even prevent their occurrence. The safety and efficacy of the probiotic L. reuteri have also been demonstrated in many trials.

A double-blind randomized placebo-controlled parallel group design trial was conducted from June 2012 to June 2013 at the ArcelorMittal steel company in Bremen to investigate the high rates of employee sick leave in this company. 242 male employees aged between 18 and 65 years participated in the study, to see if regular intake of the probiotic Lactobacillus reuteri (DSM 17938) could have any effect on the rate of sick leaves, mainly due to respiratory and gastrointestinal diseases suffered by them.

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Participants of the study were randomly assigned to two groups; intervention group and control group. The 121 participants in the intervention group were assigned to take one chewable tablet containing at least 5 × 10⁸ colony-forming units of L. reuteri per day over a total duration of 90 days, whereas the 121 participants in the control group were assigned to take one placebo tablet per day.

During the study period, the participants were asked to maintain a diary to report any symptoms mainly related to respiratory and gastrointestinal tract such as cough, cold, sore throat, headache, stomach ache, fever, vomiting, diarrhea as well as sick leave and the duration of sick leave. The actual sick days where the participant could not attend work was analyzed as the primary outcome and the symptoms were considered as secondary outcomes.

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Data of only 159 participants were available for intention-to-treat analysis, since 83 participants did not return their diaries and therefore were not considered in the final analysis.

After the total study duration of 90 days, it was seen that an average number of sick days (due to respiratory and gastrointestinal symptoms) in the intervention group was reported to be 2.24 whereas in the control group, it was reported to be 2.02 (p = 0.53), demonstrating no statistically significant difference between the treatment and control groups.

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The longest cumulative sick leave for a single participant was reported to be 30 days in the intervention group and 24 days in the control group. It was also seen that about 65% of the participants in the intervention group and about 70% in the control group did not report any sick leave due to respiratory and gastrointestinal symptoms during the study period.

The only beneficial effect reported for the probiotic was prevention of diarrhea (diarrhea was reported on 0.60 days for intervention group versus 1.33 days in the control group; p = 0.01).

This results of the study demonstrated that the probiotic L. reuteri did not reduce the number of days of sick leave due to respiratory and gastrointestinal diseases among male employees in the steel industry and the only statistically significant effect seen was the prevention of diarrhea. Thus further research is warranted to adequately investigate the results of the study.