OBJECTIVETo measure the impact of diabetes on work cessation, i.e., on the risks of work disability, early retirement, and death while in the labor force.RESEARCH DESIGN AND METHODSWe used data from the GAZEL prospective cohort of 20,625 employees of the French national gas and electricity company “EDF-GDF.” We identified 506 employees with diabetes and randomly selected 2,530 nondiabetic employed control subjects matched for major sociodemographic and occupational characteristics. Using a multistate Cox model, we estimated hazard ratios (HRs) comparing the risks of transition from employment to disability, retirement, and death over time between participants with versus without diabetes.RESULTSEmployment rate decreased more rapidly in participants with diabetes (51.9 and 10.1% at 55 and 60 years, respectively) compared with nondiabetic participants (66.5 and 13.4%, respectively). Participants with diabetes had significantly increased risks of transition from employment to disability (HR 1.7 [95% CI 1.0–2.9]), retirement (HR 1.6 [1.5–1.8]), and death (HR 7.3 [3.6–14.6]) compared with participants without diabetes. Between 35 and 60 years, each participant with diabetes lost an estimated mean time of 1.1 year in the workforce (95% CI 0.99–1.14) compared with a nondiabetic participant.CONCLUSIONSOur results provide evidence for a profound negative impact of diabetes on workforce participation in France. Social and economic consequences are major for patients, employers, and society—a burden that is likely to increase as diabetes becomes more and more common in the working-aged population.

Introduction Although previous studies have related occupational exposure and epicondylitis, the evidence is moderate, and mostly based on cross-sectional studies. Suspected physical exposures were tested over a three year period in a large longitudinal cohort study of workers in the United States. Method In a population-based study including a variety of industries, 1107 newly employed workers were examined; only workers without elbow symptoms at baseline were included. Baseline questionnaires collected information on personal characteristics and self-reported physical work exposures and psychosocial measures for the current or most recent job at 6 months. Epicondylitis (lateral and medial) was the main outcome, assessed at 36 months based on symptoms and physical examination (palpation or provocation test). Logistic models included the most relevant associated variables. Results Of 699 workers tested after 36 months who did not have elbow symptoms at baseline, 48 suffered from medial or lateral epicondylitis (6.9%), with 34 cases of lateral epicondylitis (4.9%), 30 cases of medial epicondylitis (4.3%), and 16 workers who had both. After adjusting for age, lack of social support, and obesity, consistent associations were observed between self-reported wrist bending/twisting and forearm twisting/rotating/screwing motion and future cases of medial or lateral epicondylitis (odds ratios 2.8 [1.2;6.2] and 3.6 [1.2;11.0] respectively in men and women). Conclusion Self-reported physical exposures that implicate repetitive and extensive/prolonged wrist bend/twisting and forearm movements were associated with incident cases of lateral and medial epicondylitis in a large longitudinal study, although other studies are needed to better specify the exposures involved.

No abstract