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Ogasawara A, Nagata T, Odagami K, Nagata M, Adi NP, Mori K. Relationship between diabetes treatment status and occupational accidents. J Diabetes Investig 2024. [PMID: 38517117 DOI: 10.1111/jdi.14187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 12/17/2023] [Accepted: 03/04/2024] [Indexed: 03/23/2024] Open
Abstract
AIMS To evaluate the relationship between diabetes treatment status and occupational accidents. METHODS A cross-sectional study was conducted using an online questionnaire survey completed in March 2022 among workers aged 20 years or older. The questionnaire included questions about diabetes treatment status and occupational accidents. The association between the treatment status of diabetes and occupational accidents was examined using a logistic regression analysis. RESULTS The study included 25,756 participants with no diabetes, 1,364 participants receiving diabetes treatment, 177 participants who had interrupted diabetes treatment, and 396 participants who needed diabetes treatment but had not seen a doctor. Compared with those with diabetes treatment, the odds ratio of occupational accidents among participants without diabetes was 0.40 (95% CI: 0.32-0.49), the odds ratio among participants with interrupted diabetes treatment was 4.15 (95% CI: 2.86-6.01), and the odds ratio among participants who needed diabetes treatment but had not seen a doctor was 1.25 (95% CI: 0.89-1.77). CONCLUSIONS This study showed that diabetes treatment status was related to occupational accidents, and it may be important for workers with diabetes to be supported to balance their diabetes management and their work commitments.
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Affiliation(s)
- Ayana Ogasawara
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Tomohisa Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kiminori Odagami
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Masako Nagata
- Department of Occupational Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Nuri Purwito Adi
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Strollo F, Furia A, Verde P, Bellia A, Grussu M, Mambro A, Petrelli MD, Gentile S. Technological innovation of Continuous Glucose Monitoring (CGM) as a tool for commercial aviation pilots with insulin-treated diabetes and stakeholders/regulators: A new chance to improve the directives? Diabetes Res Clin Pract 2021; 172:108638. [PMID: 33358969 DOI: 10.1016/j.diabres.2020.108638] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022]
Abstract
Civil aviation pilots who develop insulin-treated diabetes and want to renew a Commercial Pilot License (CPL) represent a medical, social and regulatory problem. This depends on justified concerns about hypoglycemia, the most threatening event for people who carry out jobs requiring a high level of concentration and reliability. This negatively affects social and working aspects of pilots' lives, who have a high profile and a high-cost professional qualification. It could be possible now to revise this attitude thanks to the availability of Continuous Glucose Monitoring (CGM) devices. CGM clearly showed to prevent hypoglycemic events in insulin-treated diabetic patients by allowing strict monitoring and trend prediction of glucose levels. By systematizing available data on such devices and present regulations in CPL issuance worldwide, our review can be used as handy tool for a fruitful discussion among the scientific community, national and international civil aviation regulators, stakeholders and pilots, aimed at evaluating the evidence-based opportunity to revise CPL issuance criteria for insulin-treated diabetic pilots. For the above-mentioned reasons, there are, among the regulatory administrations of Civil Aviation around the globe, several different approaches and limitations set for the subjects with insulin-treated diabetes who want to obtain, or renew, a CPL.
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Affiliation(s)
- F Strollo
- AMD (Associazione Medici Diabetologi), ESAM (European Society of Aerospace Medicine) and IRCCS San Raffaele Pisana, Rome, Italy.
| | - A Furia
- ENAC (Italian National Civil Aviation Authority), Aeromedical Section, Rome, Italy
| | - P Verde
- AIMAS (Italian Association of AeroSpace Medicine) and IAF (Italian Air Force), Experimental Flight Center, Aerospace Medicine Department, Pratica di Mare, Rome, Italy
| | - A Bellia
- SID (Società Italiana di Diabetologia), Department of Systems Medicine, Rome University, "Tor Vergata", Italy
| | - M Grussu
- ANIAD (Italian National Association of Athletes with Diabetes), Oristano, Italy
| | - A Mambro
- AIMAS (Italian Association of AeroSpace Medicine), Anesthesiology and Resuscitation Unit, Alesini CTO Hospital, Rome, Italy
| | - M D Petrelli
- SID (Società Italiana di Diabetologia), Clinic of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy
| | - S Gentile
- Associazione Medici Diabetologi), Campania University "Luigi Vanvitelli", Naples, Italy, and Nefrocenter Research & Nyx Start-UP, Naples, Italy
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Nishida T, Terada K, Ikeda H, Inoue Y. Seizures, accidental injuries at work, and reasons for resignation in people with epilepsy. Epilepsy Behav 2020; 111:107237. [PMID: 32575014 DOI: 10.1016/j.yebeh.2020.107237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/12/2020] [Accepted: 06/03/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Few studies have examined seizures, accidental injuries at work, and reasons for resignation in people with epilepsy (PWE). We performed a questionnaire survey of PWE to identify the risk of injury at work, its relationship to different seizure characteristics, and reasons for resignation. METHODS We distributed a questionnaire survey in the outpatient clinic of a single epilepsy center. Medical information was obtained retrospectively from medical records. RESULTS Of 200 patients who received the questionnaire, 172 responded. Two-fifths of PWE had experienced seizures at work, but the risk of accidental injuries due to epileptic seizures was only 0.01 person/year (1.0%) and 0.018 injuries/year, whereas the risk of accidental injuries not related to seizures was 0.039 person/year (3.9%) and 0.083 injuries/year. All accidental injuries due to seizures at work were caused by seizures characterized by a fall and inappropriate behavior with impaired awareness. Most accidental injuries due to seizures at work were caused by seizures that occurred at least once a year. The types of injuries reported were bruising, abrasion, laceration, fracture, burn, and submersion injuries. A quarter of PWE had left previous jobs because of epilepsy, of these, about four-fifths reported that seizures at the workplace had interfered with their own or others' tasks. SIGNIFICANCE The risk of seizure-related injury is not high compared to the risk of injury not related to seizures, and most injuries due to seizures are not severe. The features of seizures with a fall, impaired awareness, and inappropriate behavior, as well as seizure frequency, should be considered when evaluating the risks associated with seizures in the workplace. Most PWE who had left their previous job because of epilepsy had experienced seizures at the workplace interfering with their own or others' tasks.
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Affiliation(s)
- Takuji Nishida
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Kiyohito Terada
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ku, Shizuoka 420-8688, Japan
| | - Hitoshi Ikeda
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ku, Shizuoka 420-8688, Japan
| | - Yushi Inoue
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ku, Shizuoka 420-8688, Japan
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Abstract
PURPOSE OF REVIEW The effects of hypoglycemia can result in injury, including at work. Our goal was to review the recent medical literature regarding hypoglycemia and occupational injuries and provide guidance to clinicians asked to render opinions regarding fitness for work duties in individuals with diabetes. RECENT FINDINGS Recent studies contain conflicting conclusions regarding the occupational risks posed by workers with diabetes. However, the US Federal Motor Carrier Safety Administration concluded there was sufficient evidence to change the rule that previously disqualified commercial drivers with insulin-treated diabetes. Blanket employment policies that disqualify workers with diabetes are unnecessary in many occupational fields. In assessing occupational risks and fitness for duty in workers with diabetes, it is important to perform an individualized assessment of the worker and consider the risk factors for hypoglycemia, information from the treating clinician, essential functions of the job, and, if needed, availability of reasonable accommodations.
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Affiliation(s)
- Robert M Gerbo
- Department of Occupational and Environmental Sciences, Section of Occupational Medicine, West Virginia University School of Public Health, 3860 Health Sciences Center, Morgantown, WV, 26506-9145, USA.
| | - Chuan Fang Jin
- Department of Occupational and Environmental Sciences, Section of Occupational Medicine, West Virginia University School of Public Health, 3860 Health Sciences Center, Morgantown, WV, 26506-9145, USA
| | - Karen Clark
- Department of Medicine, Section of General Internal Medicine, West Virginia University School of Medicine, Morgantown, WV, USA
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Gorton HC, Webb RT, Carr MJ, DelPozo-Banos M, John A, Ashcroft DM. Risk of Unnatural Mortality in People With Epilepsy. JAMA Neurol 2019; 75:929-938. [PMID: 29630689 DOI: 10.1001/jamaneurol.2018.0333] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Importance People with epilepsy are at increased risk of mortality, but, to date, the cause-specific risks of all unnatural causes have not been reported. Objective To estimate cause-specific unnatural mortality risks in people with epilepsy and to identify the medication types involved in poisoning deaths. Design, Setting, and Participants This population-based cohort study used 2 electronic primary care data sets linked to hospitalization and mortality records, the Clinical Practice Research Datalink (CPRD) in England (from January 1, 1998, to March 31, 2014) and the Secure Anonymised Information Linkage (SAIL) Databank in Wales (from January 1, 2001, to December 31, 2014). Each person with epilepsy was matched on age (within 2 years), sex, and general practice with up to 20 individuals without epilepsy. Unnatural mortality was determined using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes V01 through Y98 in the Office for National Statistics mortality records. Hazard ratios (HRs) were estimated in each data set using a stratified Cox proportional hazards model, and meta-analyses were conducted using DerSimonian and Laird random-effects models. The analysis was performed from January 5, 2016, to November 16, 2017. Exposures People with epilepsy were identified using primary care epilepsy diagnoses and associated antiepileptic drug prescriptions. Main Outcomes and Measures Hazard ratios (HRs) for unnatural mortality and the frequency of each involved medication type estimated as a percentage of all medication poisoning deaths. Results In total, 44 678 individuals in the CPRD and 14 051 individuals in the SAIL Databank were identified in the prevalent epilepsy cohorts, and 891 429 (CPRD) and 279 365 (SAIL) individuals were identified in the comparison cohorts. In both data sets, 51% of the epilepsy and comparison cohorts were male, and the median age at entry was 40 years (interquartile range, 25-60 years) in the CPRD cohorts and 43 years (interquartile range, 24-64 years) in the SAIL cohorts. People with epilepsy were significantly more likely to die of any unnatural cause (HR, 2.77; 95% CI, 2.43-3.16), unintentional injury or poisoning (HR, 2.97; 95% CI, 2.54-3.48) or suicide (HR, 2.15; 95% CI, 1.51-3.07) than people in the comparison cohort. Particularly large risk increases were observed in the epilepsy cohorts for unintentional medication poisoning (HR, 4.99; 95% CI, 3.22-7.74) and intentional self-poisoning with medication (HR, 3.55; 95% CI, 1.01-12.53). Opioids (56.5% [95% CI, 43.3%-69.0%]) and psychotropic medication (32.3% [95% CI, 20.9%-45.3%)] were more commonly involved than antiepileptic drugs (9.7% [95% CI, 3.6%-19.9%]) in poisoning deaths in people with epilepsy. Conclusions and Relevance Compared with people without epilepsy, people with epilepsy are at increased risk of unnatural death and thus should be adequately advised about unintentional injury prevention and monitored for suicidal ideation, thoughts, and behaviors. The suitability and toxicity of concomitant medication should be considered when prescribing for comorbid conditions.
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Affiliation(s)
- Hayley C Gorton
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, MAHSC (Manchester Academic Health Sciences Centre), Manchester, United Kingdom.,National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, MAHSC, Manchester, United Kingdom
| | - Roger T Webb
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, MAHSC, Manchester, United Kingdom.,Centre for Mental Health and Safety, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester, United Kingdom
| | - Matthew J Carr
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, MAHSC, Manchester, United Kingdom.,Centre for Mental Health and Safety, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester, United Kingdom
| | | | - Ann John
- Farr Institute, Swansea University Medical School, Swansea, United Kingdom
| | - Darren M Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, MAHSC (Manchester Academic Health Sciences Centre), Manchester, United Kingdom.,National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, MAHSC, Manchester, United Kingdom
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Jovanović J, Šarac I, Đinđić N, Jovanović S. THE INFLUENCE OF WORKING CONDITIONS, HEALTH STATUS AND CHARACTERISTICS OF WORKERS ON THE OCCURRENCE OF WORKPLACE INJURIES. ACTA MEDICA MEDIANAE 2017. [DOI: 10.5633/amm.2017.0403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Kouvonen A, Kivimäki M, Pentti J, Aalto V, Oksanen T, Virtanen M, Vahtera J. Diabetes and risk of occupational injury: a cohort study. Diabet Med 2017; 34:1629-1636. [PMID: 28703867 DOI: 10.1111/dme.13423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2017] [Indexed: 12/18/2022]
Abstract
AIMS To investigate if diabetes is associated with a higher risk of occupational (workplace or commuting) injury. METHODS Medication data from the Finnish Prescription Register were used to identify diabetes cases in 2004 in a large employee cohort (the Finnish Public Sector study). These data were linked to injury records obtained from the Federation of Accident Insurance Institutions. A total of 1020 diabetes cases (median age 52 years, range 20 to 65 years; 66% women) and their 5234 age- and sex-matched controls were followed up until 2011. Sex-stratified Cox proportional hazards models, adjusting for age, occupational status, obesity and health behaviours, were applied. Because of the small number of men in the cohort, injury types and locations were only examined among women. RESULTS During the median follow-up of 6.7 years, 25% of the participants with diabetes (n=252) and 20% of those without (n=1051) experienced an occupational injury. The association between diabetes and injury was stronger in women than men (P=0.048). Diabetes was associated with a higher risk of workplace (hazard ratio 1.37, 95% CI 1.11 to 1.69) and commuting (hazard ratio 1.36, 95% CI 1.03 to 1.79) injury in women. With regard to different injury types and locations, diabetes was associated with bone fractures, dislocations, sprains and strains, and injuries to upper and lower extremities. In men, there was an association between insulin-treated diabetes and commuting injury (hazard ratio 3.14, 95% CI 1.52 to 6.49). CONCLUSIONS Diabetes was associated with workplace and commuting injuries in women. Men with insulin-treated diabetes had a higher risk of commuting injuries.
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Affiliation(s)
- A Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Administrative Data Research Centre - Northern Ireland, Centre for Public Health, Queen's University Belfast, Belfast, UK
- SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland
| | - M Kivimäki
- Finnish Institute of Occupational Health, Turku and Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - V Aalto
- Finnish Institute of Occupational Health, Turku and Helsinki, Finland
| | - T Oksanen
- Finnish Institute of Occupational Health, Turku and Helsinki, Finland
| | - M Virtanen
- Finnish Institute of Occupational Health, Turku and Helsinki, Finland
| | - J Vahtera
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland
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Li AK, Nowrouzi-Kia B. Impact of Diabetes Mellitus on Occupational Health Outcomes in Canada. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 8:96-108. [PMID: 28432371 PMCID: PMC6679613 DOI: 10.15171/ijoem.2017.992] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/13/2017] [Indexed: 11/23/2022]
Abstract
Background: Research suggests that diabetes mellitus (DM) has a negative impact on employment and workplace injury, but there is little data within the Canadian context. Objective: To determine if DM has an impact on various occupational health outcomes using the Canadian Community Health Survey (CCHS). Methods: CCHS data between 2001 and 2014 were used to assess the relationships between DM and various occupational health outcomes. The final sample size for the 14-year study period was 505 606, which represented 159 432 239 employed Canadians aged 15–75 years during this period. Results: We found significant associations between people with diabetes and their type of occupation (business, finance, administration: 2009, p=0.002; 2010, p=0.002; trades, transportation, equipment: 2008, p=0.025; 2011, p=0.002; primary industry, processing, manufacturing, utility: 2013, p=0.018), reasons for missing work (looking for work: 2001, p=0.024; school or education: 2003, p=0.04; family responsibilities: 2014, p=0.015; other reasons: 2001, p<0.001; 2003, p<0.001; 2010, p=0.015), the number of work days missed (2010, 3 days, p=0.033; 4 days, p=0.038; 11 days, p<0.001; 24 days, p<0.001), and workrelated injuries (traveling to and from work: 2014, p=0.003; working at a job or business: 2009, p=0.021; 2014, p=0.001). Conclusion: DM is associated with various occupational health outcomes, including workrelated injury, work loss productivity, and occupation type. This allows stakeholders to assess the impact of DM on health outcomes in workplace.
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Affiliation(s)
- Anson Kc Li
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M6, Canada
| | - Behdin Nowrouzi-Kia
- School of Rural and Northern Health, Centre for Research in Occupational Safety and Health, Laurentian University, 935 Ramsey Lake Rd, Sudbury, Ontario, P3E 2C6, Canada.
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Krumholz A, Hopp JL, Sanchez AM. Counseling Epilepsy Patients on Driving and Employment. Neurol Clin 2016; 34:427-42, ix. [DOI: 10.1016/j.ncl.2015.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Palmer KT, Walker-Bone K, Harris EC, Linaker C, D'Angelo S, Sayer AA, Gale CR, Evandrou M, van Staa T, Cooper C, Coggon D. Health and Employment after Fifty (HEAF): a new prospective cohort study. BMC Public Health 2015; 15:1071. [PMID: 26482655 PMCID: PMC4615332 DOI: 10.1186/s12889-015-2396-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 09/29/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Demographic trends in developed countries have prompted governmental policies aimed at extending working lives. However, working beyond the traditional retirement age may not be feasible for those with major health problems of ageing, and depending on occupational and personal circumstances, might be either good or bad for health. To address these uncertainties, we have initiated a new longitudinal study. METHODS/DESIGN We recruited some 8000 adults aged 50-64 years from 24 British general practices contributing to the Clinical Practice Research Datalink (CPRD). Participants have completed questionnaires about their work and home circumstances at baseline, and will do so regularly over follow-up, initially for a 5-year period. With their permission, we will access their primary care health records via the CPRD. The inter-relation of changes in employment (with reasons) and changes in health (e.g., major new illnesses, new treatments, mortality) will be examined. DISCUSSION CPRD linkage allows cost-effective frequent capture of detailed objective health data with which to examine the impact of health on work at older ages and of work on health. Findings will inform government policy and also the design of work for older people and the measures needed to support employment in later life, especially for those with health limitations.
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Affiliation(s)
- Keith T Palmer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. .,ARUK-MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
| | - Karen Walker-Bone
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. .,ARUK-MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
| | - E Clare Harris
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. .,ARUK-MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
| | - Cathy Linaker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. .,ARUK-MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. .,ARUK-MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
| | - Avan Aihie Sayer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. .,Centre for Research on Ageing, University of Southampton, Southampton, UK. .,Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK. .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. .,NIHR Collaboration for Leadership in Applied Health Research and Care: Wessex, Southampton, UK. .,Newcastle University Institute for Ageing and Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.
| | - Catharine R Gale
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
| | - Maria Evandrou
- Centre for Research on Ageing, University of Southampton, Southampton, UK.
| | | | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. .,ARUK-MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
| | - David Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. .,ARUK-MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
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Virtanen M, Ervasti J, Mittendorfer-Rutz E, Tinghög P, Lallukka T, Kjeldgård L, Pentti J, Alexanderson K. Trends of diagnosis-specific work disability after newly diagnosed diabetes: a 4-year nationwide prospective cohort study. Diabetes Care 2015; 38:1883-90. [PMID: 26251407 DOI: 10.2337/dc15-0247] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 07/13/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We examined trends of diagnosis-specific work disability after newly diagnosed diabetes, comparing individuals with diabetes with those without diabetes, and identified the subgroups with the highest levels of work disability. RESEARCH DESIGN AND METHODS The register data of diabetes medication and in- and outpatient hospital visits were used to identify all recorded new diabetes cases among the population aged 25-59 years in Sweden in 2006 (n = 14,098). Data for a 4-year follow-up of ICD-10 physician-certified sickness absence and disability pension days (2007‒2010) were obtained from the Swedish Social Insurance Agency. Comparisons were made using a random sample of the population without recorded diabetes (n = 39,056). RESULTS The most common causes of work disability were mental and musculoskeletal disorders; diabetes as a reason for disability was rare. Most of the excess work disability among people with diabetes compared with those without diabetes was owing to mental disorders (mean difference adjusted for confounding factors 18.8‒19.8 compensated days/year), musculoskeletal diseases (12.1‒12.8 days/year), circulatory diseases (5.9‒6.5 days/year), diseases of the nervous system (1.8‒2.0 days/year), and injuries (1.0‒1.2 days/year). The disparity in mental disorders first widened and then narrowed, while the difference in other major diagnostic categories was stable over 4 years. The highest rate (45.3 days/year) was found among people who had diabetes, lived alone, and were disabled from work owing to mental disorders. CONCLUSIONS The increased risk of work disability among those with diabetes is largely attributed to comorbid mental, musculoskeletal, and circulatory diseases. It is important to monitor comorbid conditions and take account of socioeconomic disadvantage.
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Affiliation(s)
- Marianna Virtanen
- Finnish Institute of Occupational Health, Helsinki and Turku, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki and Turku, Finland
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Petter Tinghög
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tea Lallukka
- Finnish Institute of Occupational Health, Helsinki and Turku, Finland Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Linnea Kjeldgård
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jaana Pentti
- Finnish Institute of Occupational Health, Helsinki and Turku, Finland
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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12
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Palmer KT, D'Angelo S, Harris EC, Linaker C, Coggon D. Sensory impairments, problems of balance and accidental injury at work: a case-control study. Occup Environ Med 2014; 72:195-9. [PMID: 25523936 DOI: 10.1136/oemed-2014-102422] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Sensory impairments are becoming increasingly common in the workforces of Western countries. To assess their role in occupational injury, and that of disorders of balance, we undertook a case-control study. METHODS Using the Clinical Practice Research Datalink, which documents all medical consultations, referrals and diagnoses in primary care for 6% of the British population, we identified 1348 working-aged patients who had consulted medical services over a 22-year period for workplace injury (cases) and 6652 age-matched, sex-matched and practice-matched controls. Risks were assessed by conditional logistic regression, for earlier recorded diagnoses of visual impairment, common eye diseases, hearing loss, perforated ear drum, non-acute otitis media and disorders of balance. RESULTS In all, 173 (2.2%) participants had an earlier eye problem, 792 (9.9%) an ear problem (including 336 with impaired hearing and 482 with non-acute otitis media) and 266 (3.3%) a disorder of balance. No associations were found with glaucoma, cataract, retinal disorders or perforation of the ear drum specifically, but adjusted ORs were moderately elevated for eye and ear problems more generally, and higher where there was a record of blindness or partial sight (OR 1.90, 95% CI 1.05 to 3.44) or non-acute otitis media (OR 2.04, 95% CI 1.64 to 2.54). Risks for non-acute otitis media and for disorders of balance were particularly elevated for consultations in the 12 months preceding injury consultation (OR 2.70, 95% CI 1.58 to 4.62 and 1.77, 95% CI 1.01 to 3.11, respectively). CONCLUSIONS Problems of vision, impairments of hearing and disorders of balance all may carry moderately increased risks of occupational injury.
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Affiliation(s)
- Keith T Palmer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - E Clare Harris
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Cathy Linaker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - David Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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