Abstract
To investigate if diabetes is associated with a higher risk of occupational (workplace or commuting) injury. 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. 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). Diabetes was associated with workplace and commuting injuries in women. Men with insulin-treated diabetes had a higher risk of commuting injuries.
Highlights
The prevalence of diabetes is rapidly increasing
Diabetes was associated with a higher risk of workplace and commuting injury in women
There was an association between insulin-treated diabetes and commuting injury
Summary
The prevalence of diabetes is rapidly increasing. The International Diabetes Federation has predicted that the number of people with diabetes globally will increase from 387 million in 2014 to 592 million by 2035 [1]. A systematic review conducted in 2008 identified only two case–control studies and one large cross-sectional study on diabetes and occupational injury, and found a moderate positive association [4]. Another systematic review from the same year but on risk factors for work-related road traffic crashes resulting in injury, found two reasonable-quality studies that both reported an association between diabetes and increased risk of injury [5]. In a case–control study from the UK, diabetes medication was not associated with a higher risk of injury [8]. Many of these studies have been limited by self-reported data, cross-sectional design, or their focus on just one industry or occupation. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK
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