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Workers in manufacturing, driving, cleaning jobs at highest type 2 diabetes risk

Swedish adults working in manufacturing, driving and cleaning jobs are three times more likely to develop type 2 diabetes when compared with university teachers and physiotherapists, according to study data presented at the European Association for the Study of Diabetes annual meeting.

Sofia Carlsson

“The risk for type 2 diabetes differs dramatically across occupational groups and so does the prevalence of risk factors for type 2 diabetes, among men even at the time they enter the labor market,” Sofia Carlsson, PhD, an associate professor and senior lecturer in the unit of epidemiology at the Karolinska Institutet in Stockholm, told Endocrine Today. “If we could reduce overweight and increase physical activity in occupational groups with high risk, such as professional drivers, cleaners and manufacturing workers, major health benefits may be made.”

Carlsson and colleagues analyzed data from national registers for all Swedish citizens born between 1937 and 1979 who were gainfully employed between 2001 and 2013 (n = 4,550,892) and followed for a diagnosis of diabetes from 2006 to 2015 (n = 201,717). Diabetes prevalence in 2013 (mean age, 51 years) and age-standardized diabetes incidence (per 1,000 person-years) were analyzed across the 30 most common occupations among men and women. Information on BMI, physical fitness and smoking status was obtained through registry data.

Within the cohort, prevalence of type 2 diabetes was 5.2% among men and 3.2% among women (overall prevalence, 4.2%). Type 2 diabetes prevalence was highest among drivers for men (8.8%) and among manufacturing workers for women (6.4%); however, diabetes incidence varied dramatically across occupational groups.

Type 2 diabetes diagnosis 2019 adobe 
Swedish adults working in manufacturing, driving and cleaning jobs are three times more likely to develop type 2 diabetes when compared with university teachers and physiotherapists.
Source: Adobe Stock

Among men, type 2 diabetes incidence was highest for manufacturing workers (9.41 per 1,000 person-years) and professional drivers (9.32 per 1,000 person-years) and lowest among university teachers (3.44 per 1,000 person-years). Among women, diabetes incidence was highest among manufacturing workers (7.2 per 1,000 person-years) and cleaners (6.18 per 1,000 person-years) and lowest among physiotherapists (2.2 per 1,000 person-years).

In analyses stratified by age, researchers observed that, among men aged at least 55 years, diabetes prevalence was highest for manufacturing workers (14.9%), followed by drivers (14.2%) and office clerks (13.1%). Among women aged at least 55 years, diabetes prevalence was highest for manufacturing workers (10.7%), followed by kitchen assistants (8.7%) and cleaners (8.3%).

The researchers suggested the differences in diabetes prevalence and incidence are associated with the prevalence of lifestyle risk factors.

“We found major differences in the prevalence of being overweight and smoking and in the level of physical fitness across these occupational groups, even at young ages,” the researchers wrote.

The researchers noted that occupations with the highest diabetes incidence also fall into the low socioeconomic status group; however, they wrote that job title is a “much more specific indicator” of type 2 diabetes risk vs. socioeconomic status alone, as diabetes incidence varies substantially across occupations within the low socioeconomic strata.

“To reduce the future diabetes burden it is crucial to curb the inflow of new patients,” the researchers said in a press release. “Intervention studies have consistently shown it is possible to reduce diabetes incidence in high-risk groups by lifestyle modification. If job title can be used as a risk indicator of type 2 diabetes, it can be used to identify groups for targeted interventions, and hopefully inspire employers to implement diabetes prevention programs tailored to their workforces.” – by Regina Schaffer

Reference:

Carlsson S, et al. Diabetologia. 2019;doi:10.1007/s00125-019-04997-5.

Carlsson S, et al. OP 378. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 16-20, 2019; Barcelona, Spain.

Disclosure: Carlsson reports no relevant financial disclosures.

Swedish adults working in manufacturing, driving and cleaning jobs are three times more likely to develop type 2 diabetes when compared with university teachers and physiotherapists, according to study data presented at the European Association for the Study of Diabetes annual meeting.

Sofia Carlsson

“The risk for type 2 diabetes differs dramatically across occupational groups and so does the prevalence of risk factors for type 2 diabetes, among men even at the time they enter the labor market,” Sofia Carlsson, PhD, an associate professor and senior lecturer in the unit of epidemiology at the Karolinska Institutet in Stockholm, told Endocrine Today. “If we could reduce overweight and increase physical activity in occupational groups with high risk, such as professional drivers, cleaners and manufacturing workers, major health benefits may be made.”

Carlsson and colleagues analyzed data from national registers for all Swedish citizens born between 1937 and 1979 who were gainfully employed between 2001 and 2013 (n = 4,550,892) and followed for a diagnosis of diabetes from 2006 to 2015 (n = 201,717). Diabetes prevalence in 2013 (mean age, 51 years) and age-standardized diabetes incidence (per 1,000 person-years) were analyzed across the 30 most common occupations among men and women. Information on BMI, physical fitness and smoking status was obtained through registry data.

Within the cohort, prevalence of type 2 diabetes was 5.2% among men and 3.2% among women (overall prevalence, 4.2%). Type 2 diabetes prevalence was highest among drivers for men (8.8%) and among manufacturing workers for women (6.4%); however, diabetes incidence varied dramatically across occupational groups.

Type 2 diabetes diagnosis 2019 adobe 
Swedish adults working in manufacturing, driving and cleaning jobs are three times more likely to develop type 2 diabetes when compared with university teachers and physiotherapists.
Source: Adobe Stock

Among men, type 2 diabetes incidence was highest for manufacturing workers (9.41 per 1,000 person-years) and professional drivers (9.32 per 1,000 person-years) and lowest among university teachers (3.44 per 1,000 person-years). Among women, diabetes incidence was highest among manufacturing workers (7.2 per 1,000 person-years) and cleaners (6.18 per 1,000 person-years) and lowest among physiotherapists (2.2 per 1,000 person-years).

In analyses stratified by age, researchers observed that, among men aged at least 55 years, diabetes prevalence was highest for manufacturing workers (14.9%), followed by drivers (14.2%) and office clerks (13.1%). Among women aged at least 55 years, diabetes prevalence was highest for manufacturing workers (10.7%), followed by kitchen assistants (8.7%) and cleaners (8.3%).

The researchers suggested the differences in diabetes prevalence and incidence are associated with the prevalence of lifestyle risk factors.

“We found major differences in the prevalence of being overweight and smoking and in the level of physical fitness across these occupational groups, even at young ages,” the researchers wrote.

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The researchers noted that occupations with the highest diabetes incidence also fall into the low socioeconomic status group; however, they wrote that job title is a “much more specific indicator” of type 2 diabetes risk vs. socioeconomic status alone, as diabetes incidence varies substantially across occupations within the low socioeconomic strata.

“To reduce the future diabetes burden it is crucial to curb the inflow of new patients,” the researchers said in a press release. “Intervention studies have consistently shown it is possible to reduce diabetes incidence in high-risk groups by lifestyle modification. If job title can be used as a risk indicator of type 2 diabetes, it can be used to identify groups for targeted interventions, and hopefully inspire employers to implement diabetes prevention programs tailored to their workforces.” – by Regina Schaffer

Reference:

Carlsson S, et al. Diabetologia. 2019;doi:10.1007/s00125-019-04997-5.

Carlsson S, et al. OP 378. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 16-20, 2019; Barcelona, Spain.

Disclosure: Carlsson reports no relevant financial disclosures.

    Perspective
    Guy Fagherazzi

    Guy Fagherazzi

    The study is the first of its kind to exhibit, at the level of an entire country, major differences in type 2 diabetes incidence by occupation. The analysis is based on all Swedish employees, thanks to the national registries available in this country. They found that, among men, manufacturing workers and professional drivers had the highest incidence of type 2 diabetes, whereas among women, manufacturing workers and cleaners had the higher risk. These results can certainly be explained by a combination of factors, such as differences in lifestyle factors — overweight and obesity, diet, physical activity, sleep — that all have an impact on type 2 diabetes incidence, as well as chronic exposure to pollutants or stress, job strain or a low socioeconomic background. We have growing evidence that these exposures are independent risk factors for type 2 diabetes. Demonstrating this association was not feasible in this work, but ideally, future studies with large population-based cohorts should control for all these factors when estimating the association between occupation and type 2 diabetes risk.

    Still, this is a landmark study that gives an overview of the occupations with the highest risk for developing type 2 diabetes, which will help to prioritize the implementation of specific prevention programs adapted to the workplace. It will also encourage other countries to replicate this study.

    • Guy Fagherazzi, MSc, PhD, HDR
    • Research Leader of the Digital Epidemiology Hub
      Department of Population Health
      Luxembourg Institute of Health

    Disclosures: Fagherazzi reports no relevant financial disclosure.

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