Socioeconomic gradient in work disability in diabetes: evidence from three occupational cohorts
Socioeconomic gradient in work disability in diabetes: evidence from three occupational cohorts
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DOI：
10.1136/jech-2015-205943
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发表时间：
2016-02-01
影响因子：
6.3
通讯作者：
Virtanen, Marianna
中科院分区：
文献类型：
--
作者：
Ervasti, Jenni;Kivimaeki, Mika;Virtanen, Marianna
背景 社会经济地位在糖尿病员工工作残疾中的作用尚不清楚。我们研究了患有和未患有糖尿病的员工的社会经济地位与工作残疾之间的关联，同时考虑到合并症。方法我们使用了来自芬兰、法国和英国的三个职业队列的个体参与者数据（患有糖尿病的员工，n = 2170，年龄匹配和性别匹配的无糖尿病对照，n = 4340）。在所有队列中，调查数据均与登记数据相关联，并且员工平均随访时间为 4.4 年。社会经济地位基于职业头衔。工作伤残（因病缺勤和伤残抚恤金）被索引为伤残天数和伤残次数。使用荟萃分析汇总特定研究的估计值，并通过荟萃回归研究效应修正。结果 糖尿病患者每年平均残疾天数和发作次数比非糖尿病患者高 1.5-3.5 倍。在糖尿病患者中，最低职业岗位的工作残疾风险几乎是最高职业岗位的四倍（第 3.82 天的相对不平等指数 (RII)；95% CI 2.77 至 5.56；第 3.80 次的 RII；95% CI 3.13 至 4.61）。无论合并症如何，这种关联在两性中都是一致的。相对而言，在没有糖尿病的人中，社会经济地位和工作残疾的关联是相似的。结论在患有和没有糖尿病的人中观察到工作残疾存在很强的社会经济梯度。
Background The role of socioeconomic status in work disability among employees with diabetes is not well known. We examined the association between socioeconomic status and work disability among employees with and without diabetes taking into account comorbid conditions.Methods We used individual participant data from three occupational cohorts from Finland, France and the UK (employees with diabetes, n=2170, age-matched and sex-matched controls without diabetes, n=4340). In all cohorts, survey data were linked with register data and the employees were followed up on average for 4.4 years. Socioeconomic status was based on occupational titles. Work disability (sickness absence and disability pension) was indexed as the numbers of disability days and episodes. The study-specific estimates were pooled using meta-analysis and effect modifications were studied with meta-regression.Results The average numbers of disability days and episodes per year were 1.5-3.5 times higher for persons with diabetes compared to those without. Among persons with diabetes, the risk of work disability was almost four times higher in the lowest compared to the highest occupational position (relative index of inequality (RII) for days 3.82; 95% CI 2.77 to 5.56; RII for episodes 3.80; 95% CI 3.13 to 4.61). This association was consistent in both sexes and regardless of comorbid conditions. In relative terms, the association of socioeconomic status and work disability was similar among those free of diabetes.Conclusions A strong socioeconomic gradient in work disability was observed among people with and without diabetes.