1
|
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.
Collapse
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
| |
Collapse
|
2
|
Alhainen M, Härmä M, Pentti J, Ervasti JM, Kivimäki M, Vahtera J, Stenholm S. Sleep duration and sleep difficulties as predictors of occupational injuries: a cohort study. Occup Environ Med 2021; 79:224-232. [PMID: 34650000 DOI: 10.1136/oemed-2021-107516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/06/2021] [Indexed: 11/03/2022]
Abstract
STUDY OBJECTIVES To examine the association between sleep duration and sleep difficulties with different types and causes of workplace and commuting injuries. METHODS The data were derived from the Finnish Public Sector study including 89.543 participants (178.309 person-observations). Participants reported their sleep duration and sleep difficulties between 2000 and 2012. These were linked to occupational injury records from the national register maintained by the Federation of Accident Insurance Institutions. Risk of injuries was followed up 1 year after each study wave. Logistic regression analysis with generalised estimating equations (GEEs) was used to examine the association between sleep duration/difficulties and risk of injuries, and multinomial logistic regression with GEE was used to examine the association with injury types and causes. RESULTS Both sleep duration and difficulties were associated with injuries. Employees with short sleep (≤6.5 hours) had 1.07-fold odds of workplace injuries (95% CI 1.00 to 1.14) and 1.14 times higher odds of commuting injuries (95% CI 1.04 to 1.26) compared with employees with normal sleep duration. For employees with disturbed sleep, the corresponding ORs were 1.09-fold (95% CI 1.02 to 1.17) and 1.14-fold (95% CI 1.04 to 1.26) compared with those without sleep difficulties, respectively. The risk of commuting injuries was higher among those who had difficulty in falling asleep (OR 1.29, 95% CI 1.07 to 1.55), woke up too early (OR 1.11, 95% CI 1.00 to 1.23) or had non-restorative sleep (OR 1.18, 95% CI 1.05 to 1.33). CONCLUSIONS Short sleep duration and sleep difficulties are associated with slightly increased risk of workplace and commuting injuries.
Collapse
Affiliation(s)
- Maria Alhainen
- Department of Public Health, University of Turku, Turku, Finland .,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Mikko Härmä
- Development of Work and Organizations, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jenni M Ervasti
- Work Organizations, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Finnish Institute of Occupational Health, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Varanka-Ruuska T, Tolvanen M, Vaaramo E, Keinänen-Kiukaanniemi S, Sebert S, Rautio N, Ala-Mursula L. Glucose metabolism in midlife predicts participation in working life: a Northern Finland Birth Cohort 1966 study. Occup Environ Med 2020; 77:324-332. [DOI: 10.1136/oemed-2019-106170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/19/2019] [Accepted: 01/01/2020] [Indexed: 12/25/2022]
Abstract
ObjectiveTo evaluate how clinically measured glucose metabolism categories predict registered participation in working life.MethodsIn the 46-year follow-up of Northern Finland Birth Cohort 1966 (n=5328, 2342 men and 2986 women), we used oral glucose tolerance tests, surveys and glycated haemoglobin to determine glucose metabolism categorised as normal, pre-diabetes, screen-detected and previous type 2 diabetes (T2D). Consequent participation in working life during the 2-year follow-up period was measured as registered disability, unemployment and employment days, for which incidence rate ratios (IRRs) with 95% CIs were calculated using Poisson regression, adjusted for baseline employment and socioeconomic, health-related and behavioural factors.ResultsIn comparison to normal glucose, all categories of impaired glucose metabolism were associated with poorer participation in working life in the unadjusted models. After adjustments, the risks (IRR (95% CI)) of disability days remained heightened by both screen-detected and previous T2D among men (1.3 (1.3 to 1.4) and 1.5 (1.4 to 1.5), respectively), whereas among women the risks were lowered (0.9 (0.8 to 0.9) and 0.9 (0.9 to 1.0), respectively). The risks of unemployment were consistently higher in all categories of impaired glucose metabolism, and were the highest among women with previous T2D (1.6 (1.5 to 1.6)). Correspondingly, the rates of total employment days were lower in relation to screen-detected T2D among men and women (5% and 6%, respectively), and previous T2D (6% and 3%).ConclusionsOverall, impaired glucose metabolism associated with deteriorated working life participation already in middle age. The high prevalence of impaired glucose metabolism emphasises the need for actions to support sustainable working careers.
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|