Diabetes and work: The need of a close collaboration between diabetologist and occupational physician

Prognostic factors for return to work in patients affected by chronic low back pain: a systematic review

Chronic low back pain (LBP) represents a leading cause of absenteeism from work. An accurate knowledge of complex interactions is essential in understanding the difficulties of return to work (RTW) experienced by workers affected by chronic LBP. This study aims to identify factors related to chronic LBP, the worker, and the psycho-social environment that could predict and influence the duration of an episode of sick leave due to chronic LBP.Studies reporting the relation between prognostic factors and absenteeism from work in patients with LBP were included. The selected studies were grouped by prognostic factors. The results were measured in absolute terms, relative terms, survival curve, or duration of sick leave. The level of evidence was defined by examining the quality and the appropriateness of findings across studies in terms of significance and direction of relationship for each prognostic factor.A total of 20 studies were included. Prognostic factors were classified in clinical, psycho-social, and social workplace, reaching a total of 31 constructs. Global conditions with less favorable repercussions on worker's lives resulted in a delay in time to RTW. Older age, female, higher pain or disability, depression, higher physical work demands, and abuse of smoke and alcohol have shown strong level of evidence for negative outcomes.High global health well-being, great socioeconomic status, and good mental health conditions are decisive in RTW outcomes. Interventions that aim at RTW of employee's sick-listed with LBP should focus on psycho-social aspects, health behaviors, and workplace characteristics.

Association of oral health with various work problems: a cross-sectional study of Japanese workers

BACKGROUND

Oral diseases affect quality of life and known to decrease productivity. We examined the impact of oral health status on various types of work problems.

METHODS

This cross-sectional study used data from an internet-based self-report questionnaire survey administered to workers in Japan. Responses to the questionnaire regarding seven types of oral health-related work problems (1. Stress; 2. Lack of focus; 3. Lack of sleep; 4. Lack of energy; 5. Lack of communication due to halitosis; 6. Lack of communication due to appearance; 7. Lack of ability due to dental-related pain) were investigated and statistically analyzed. Explanatory variables were self-reported oral health status, number of teeth, and gum bleeding. To examine the association of oral health with the presence of work problems, logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI). Age, sex, educational attainment, income, the presence of diabetes, and industrial classifications were used as the covariates.

RESULTS

A total of 3,930 workers (mean age: 43.3 (SD = 11.7), 2,057 males and 1,873 females) were included. Overall, a total of 6.2% of workers reported having at least one oral health-related work problem in the past year, whereas 21.8% of those with poor self-reported oral health reported work problems. Workers with poor self-reported oral health were 3.58 (95% CI (1.70-7.56) times higher odds of reporting work problems than those with excellent self-reported oral health.

CONCLUSIONS

Oral health was found to be associated with various work problems. Oral health promotion policies are needed in the workplace.

Determinants of early working impairments in multiple sclerosis

Introduction

Unemployment can directly affect social status and identity. Assessing and adjusting determinants of early working impairments in a chronic disease can thus reduce its long-term burden. Hereby, we aim to evaluate differences in occupational history and early working impairments between people with multiple sclerosis (MS) and healthy workers.

Methods

This is a cross-sectional study comparing 71 workers with MS [age 41.7 ± 9.4 years; females 59.1%; EDSS 2.0 (1.0-6.0)] and 71 controls (age 42.6 ± 11.9 years; females 33.8%). All participants filled in Work Ability Index (WAI), Work Productivity and Activity Impairment (WPAI), European Questionnaire for Quality of Life (EuroQoL), Beck Depression Inventory II (BDI-II), and Pittsburgh Sleep Quality Index (PSQI). In MS, we further collected expanded disability status scale (EDSS), MS Questionnaire for Job difficulties (MSQ-Job), Fatigue severity scale (FSS), and the Brief International Cognitive Assessment for MS (BICAMS).

Results

Workers with MS were more working disabled (p < 0.01), less exposed to workplace risks (p < 0.01), and more limited in fitness to work (p = 0.01), compared with controls. On linear regression models adjusted by age, sex, education, and type of contract, people with MS had worse WAI (Coeff=-5.47; 95% CI = -7.41, -3.53; p < 0.01), EuroQoL (Coeff = -4.24; 95% CI = -17.85, -6.50; p < 0.01), BDI-II (Coeff = 3.99; 95% CI = 2.37, 7.01; p < 0.01), and PSQI (Coeff = 4.74; 95% CI = 3.13, 7.61; p < 0.01), compared with controls, but no differences in WPAI (p = 0.60). EuroQoL, BDI-II, and PSQI were equally associated with both WAI and WPAI in MS and controls (all p< 0.01). In MS, worse MSQJob was associated with higher EDSS (Coeff = 5.22; 95% CI = 2.24, 7.95; p < 0.01), progressive disease (Coeff = 14.62; 95% CI = 5.56, 23.69; p < 0.01), EuroQoL (Coeff = 4.63; 95% CI = 2.92, 6.35; p < 0.01), FSS (Coeff = 0.55; 95% CI = 0.38, 0.72; p < 0.01), and cognitive impairment (Coeff = 4.42; 95% CI = 0.67, 8.22; p = 0.02).

Discussion

Early factors associated with working difficulties in MS include disability, fatigue, depression, and cognitive dysfunction. Early identification of clinical features potentially causing working difficulties should be considered to enhance job retention, along with targeted prevention and protection measures.

Factors associated with work ability in adults with diabetes

AIMS

The aims of this study were to explore associations between clinical and diabetes-related factors with work ability in a sample of working adults with diabetes.

BACKGROUND

Adults with diabetes may face challenges in the workplace, including managing their diabetes and overall physical and mental health.

METHODS

This was a cross-sectional design with a sample of 101 working adults. Subjects completed valid and reliable surveys assessing depressive symptoms, diabetes self-care, fear of hypoglycemia, diabetes distress, cardiovascular health using American Heart Association's Life's Simple 7 (range 0-7) and work ability. Factors significantly associated with work ability at bivariate level were included in linear and logistic regression.

RESULTS

The majority of the sample was female (65%) (mean age 54.1 ± 10.5), White (74%), non-Hispanic (93%), worked full-time (65%) and had type 2 diabetes (87%) (mean duration 12.4 ± 9.5 years). The majority (55%) had low diabetes distress, but 24% had high distress and 28% had depressive symptoms. The sample achieved 2.5 ± 1.4 ideal AHA heart health indices and 33% rated their work ability as excellent. In linear regression higher depressive scores were associated with lower work ability scores (b = -0.45, p = .002). In logistic regression, scores on heart health (OR = 1.4; 95%CI:1.0-1.9, p = .03) and diabetes distress (OR = 0.6, 95%CI:0.4-0.9, p = .048) were significantly associated with work ability at its best.

CONCLUSION

Both cardiovascular and psychological health may impact work ability in adults with diabetes. Routinely screening for diabetes distress and depression while also promoting ideal cardiovascular health may improve overall health and work ability in this population.