Medical Sociology Unit, Hannover Medical School, Hannover, Germany.
PLoS One. 2024 Sep 27;19(9):e0309725. doi: 10.1371/journal.pone.0309725. eCollection 2024.
Individuals of working age spend a significant amount of time at the workplace making it an important context for disease prevention and management. The temporal development and prevalence of T2D have been shown to differ in the working population based on gender, age group and occupational sector regardless of socioeconomic status. Given potential differences in risk factors associated with different work environments, this study aims to define vulnerable occupational groups by examining T2D severity and its trends in working men and women with T2D of two age groups and among nine occupational sectors.
The study is based on claims data of the statutory health insurance provider AOKN. The study population consisted of all insured working individuals with T2D. T2D severity was measured using the adapted diabetes complications severity index-complication count (DCSI-CC). Mean DCSI-CC scores were calculated over four time periods between 2012 and 2019 for men and women of the age groups 18-45 and 46+ years and among nine occupational sectors. Trends of DCSI-CC were investigated using ordinal logistic regression analyses to examine the effect of time-period on the odds of having higher DCSI scores.
Overall, there was a significant rise in T2D severity over time in working men and women of the older age group. Moreover, the study displayed occupational sector differences in T2D severity and its trends. Over all, working men of all sectors had higher DCSI-CC scores compared to working women. Individuals working in the sector "Transport, logistics, protection and security" and "Construction, architecture, measuring and building technology" had higher T2D severity, while those working in the "Health sector, social work, teaching & education" had relatively lower T2D severity. There was a gender-specific significant increase over time in T2D severity in the above-mentioned occupational sectors.
The study displayed gender, age group and occupational sector differences in T2D severity and its trends. Working individuals could thus benefit from personalized prevention interventions that consider occupational contexts. As a next step, examining T2D trends and severity in specific occupations within the vulnerable occupational sectors is needed.
处于工作年龄段的个体在工作场所花费大量时间，这使其成为疾病预防和管理的重要场所。无论社会经济地位如何，基于性别、年龄组和职业部门，2 型糖尿病（T2D）的时间发展和流行情况在工作人群中有所不同。鉴于与不同工作环境相关的潜在风险因素差异，本研究旨在通过检查两个年龄组和九个职业部门中患有 T2D 的男性和女性的 T2D 严重程度及其趋势，来确定脆弱职业群体。
该研究基于法定健康保险公司 AOKN 的索赔数据。研究人群包括所有患有 T2D 的参保工作个体。使用改良的糖尿病并发症严重程度指数-并发症计数（DCSI-CC）来衡量 T2D 的严重程度。在 2012 年至 2019 年的四个时间段内，为年龄在 18-45 岁和 46+岁的男性和女性以及九个职业部门计算平均 DCSI-CC 评分。使用有序逻辑回归分析来研究 DCSI-CC 的趋势，以检查时间段对具有更高 DCSI 评分的可能性的影响。
总体而言，在年龄较大的工作男性和女性中，T2D 的严重程度随着时间的推移呈显著上升趋势。此外，该研究还显示了 T2D 严重程度及其趋势在职业部门之间存在差异。总的来说，所有部门的男性工作者的 DCSI-CC 评分均高于女性工作者。在“运输、物流、保护和安全”和“建筑、建筑、测量和建筑技术”部门工作的个体 T2D 严重程度较高，而在“卫生部门、社会工作、教学和教育”部门工作的个体 T2D 严重程度相对较低。在上述职业部门中，T2D 严重程度随时间推移呈显著性别特异性上升趋势。
该研究显示了 T2D 严重程度及其趋势在性别、年龄组和职业部门之间存在差异。工作个体可以因此受益于考虑职业背景的个性化预防干预措施。作为下一步，需要检查脆弱职业群体中特定职业的 T2D 趋势和严重程度。
