Comorbidity and work disability among employees with diabetes: Associations with risk factors in a pooled analysis of three cohort studies
Comorbidity and work disability among employees with diabetes: Associations with risk factors in a pooled analysis of three cohort studies
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DOI：
10.1177/1403494815605245
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发表时间：
2016-02-01
影响因子：
3.4
通讯作者：
Virtanen, Mariana
中科院分区：
文献类型：
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作者：
Ervasti, Jenni;Kivimaki, Mika;Virtanen, Mariana
目的：在患有糖尿病的员工中，合并症可能会大大降低工作能力。我们研究了患有或不患有合并症的糖尿病患者的社会经济状况、生活方式因素和工作压力与工作障碍的关系。方法：在对来自芬兰（芬兰公共部门研究 FPS）、英国（Whitehall II）和法国（GAZEL）职业队列的个体参与者数据进行汇总分析时，对 1925 名患有糖尿病的员工进行了平均 4 年的随访。根据基线合并症状况和随后的工作残疾情况，参与者被分为四组：无合并症糖尿病，无/低度工作残疾；合并糖尿病，无/低度工作残疾；具有中度/高度工作障碍的非共病糖尿病；以及伴有中度/高度工作障碍的合并糖尿病。使用第 1 组（上面列出的第一个）作为参考组，通过多项回归评估工作残疾风险。结果：无论是否有合并症，社会经济地位较低的参与者出现较高工作残疾的几率较高（无合并症的参与者中 OR = 3.12；95% CI 2.25-4.33；有合并症的参与者中 OR = 2.61；95% CI 1.93-3.51）。肥胖与合并症存在横截面相关性（OR = 1.95；对于无残疾的合并症，95% CI 1.35-2.83），这种关联在那些丧失工作能力的人中尤为明显（OR = 2.61；对于残疾合并症，95% CI 1.89-3.60）。工作紧张与高度/中度工作障碍相关，仅在患有合并症的参与者中存在（OR = 1.63；95% CI 1.14-2.34）。结论：三项队列研究的汇总数据表明，社会经济地位低下、肥胖和工作压力与糖尿病员工的合并症和工作残疾增加有关。
Aims: Among employees with diabetes, comorbidity may considerably deteriorate working capacity. We examined how socioeconomic status, lifestyle factors and job strain were related to work disability in individuals with diabetes with and without comorbidity. Methods: In this pooled analysis of individual-participant data from occupational cohorts from Finland (Finnish Public Sector Study FPS), UK (Whitehall II) and France (GAZEL), 1925 employees with diabetes were followed on average for 4 years. Participants were categorized into four groups, according to their baseline comorbidity status and subsequent work disability, as: non-comorbid diabetes with no/low work disability; comorbid diabetes with no/low work disability; non-comorbid diabetes with moderate/high work disability; and comorbid diabetes with moderate/high work disability. The risk of work disability was assessed with multinomial regression, using Group 1 (the first listed above) as the reference group. Results: Participants with low socioeconomic status had increased odds for higher work disability, irrespective of comorbidity (OR = 3.12; 95% CI 2.25-4.33, among participants with no comorbidity, and OR = 2.61; 95% CI 1.93-3.51 among those with comorbidity). Obesity was cross-sectionally associated with comorbidity (OR = 1.95; 95% CI 1.35-2.83 for comorbidity without disability), and this association was particularly pronounced among those whom became work disabled (OR = 2.61; 95% CI 1.89-3.60 for comorbidity with disability). Job strain was associated with high/moderate work disability, only among participants with comorbidity (OR = 1.63; 95% CI 1.14-2.34). Conclusions: Pooled data from three cohort studies showed that low socioeconomic status, obesity, and job strain are linked to both comorbidity and increased work disability in employees with diabetes.