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2011

CIS 12-0142 Barruyer C.
Diabetes and work are compatible
Diabète et travail sont compatibles [en francés]
Diabetes affects a large number of persons who are employed, of employable age or on the labour market. This article addresses the issues of occupational hazards related to diabetes (wounds that heal slowly, hypoglycaemia causing attention deficit or somnolence), together with precautions to be taken by employers at the place of work (safety shoes suited to diabetic patients, regular working hours, appropriate work rhythm and workload).
Prévention BTP, Nov. 2011, No.147, p.48-50. Illus.
Diabète_et_travail_sont_compatibles_[BUY_THIS_ARTICLE] [en francés]

CIS 11-0336 Wang X.S., Armstrong M.E., Cairns B.J., Key T.J., Travis R.C.
Shift work and chronic disease: The epidemiological evidence
Shift work, including night work, has been hypothesized to increase the risk of chronic diseases, including cancer, cardiovascular disease (CVD), metabolic syndrome and diabetes. Recent reviews of evidence relating to these hypotheses have focussed on specific diseases or potential mechanisms, but no general summary of the current data on shift work and chronic disease has been published. Systematic and critical reviews and recent original studies were retrieved. The main conclusions are presented in text and tables. Published evidence is suggestive but not conclusive for an adverse association between night work and breast cancer but limited and inconsistent for cancers at other sites and all cancers combined. Findings on shift work, in relation to risks of CVD, metabolic syndrome and diabetes are also suggestive but not conclusive for an adverse relationship.
Occupational Medicine, 2011, Vol.61, p.78-89. 77 ref.
Shift_work.pdf [en inglés]

CIS 11-0200 Li Y., Sato Y., Yamaguchi N.
Shift work and the risk of metabolic syndrome - A nested case-control study
The objective of this study was to examine the association between shift work and the metabolic syndrome (MetS) using a large-scale longitudinal study design. Data were collected from a historical cohort of health checkups in the Japanese population. The baseline survey, which involved 16,952 inhabitants of the Minami Saku area of the Nagano Prefecture, was started in 1978. A nested case-control study was conducted between 1987 and 1990. This analysis was restricted to 6,712 men and women (age range 25-59 years). A conditional logistic regression model was used to estimate the risk of MetS associated with shift work. Compared with the day workers, shift workers had a significantly higher risk of MetS (odds ratio 1.87). It is suggested that the risk of MetS among shift workers be managed by educating this population to adopt suitable dietary habits.
International Journal of Occupational and Environmental Health, 2011, Vol.17, p.154-160. 35 ref.

2010

CIS 11-0507 Pietroiusti A., Neri A., Somma G., Coppeta L., Iavicoli I., Bergamaschi A., Magrini A.
Incidence of metabolic syndrome among night-shift healthcare workers
Night-shift work is associated with ischaemic cardiovascular disorders. It is not currently known whether it may be causally linked to metabolic syndrome (MS), a risk condition for ischaemic cardiovascular disorders. The syndrome presents with visceral obesity associated with mild alterations in glucidic and lipidic homeostasis and in blood pressure. The aim of this study was to assess whether a causal relationship exists between night-shift work and the development of MS. Male and female nurses performing night shifts, free from any component of MS at baseline, were evaluated annually for the development of the disorder during a four-year follow-up. Male and female nurses performing daytime work only, visited during the same time period, represented the control group. The cumulative incidence of MS was 9.0% (36/402) among night-shift workers, and 1.8% (6/336) among daytime workers (relative risk (RR) 5.0). The annual rate of incidence of MS was 2.9% in night-shift workers and 0.5% in daytime workers. Kaplan-Meier survival curves of the two groups were significantly different. Multiple Cox regression analyses showed that among selected variables (age, gender, smoking, alcohol intake, familiar history, physical activity and work schedule) the only predictors of occurrence of MS were sedentariness (hazard ratio (HR) 2.92) and night-shift work (HR 5.10).
Occupational and Environmental Medicine, Jan. 2010, vol.67, No.1, p.54-57. Illus. 29 ref.
Incidence.pdf [en inglés]

CIS 11-0583 Szosland D.
Shift work and metabolic syndrome, diabetes mellitus and ischaemic heart disease
This review article on health problems associated with shift work concludes that metabolic syndrome, diabetes mellitus and cardiovascular diseases are possibly due to an impairment of biological rhythm. The metabolic syndrome is a complex of interrelated risk factors for cardiovascular disease and diabetes. Higher prevalence of the metabolic syndrome has been demonstrated among shift workers. Rotating shift work has an impact on each component of metabolic syndrome. Shift work might also have an impact on metabolic variables, and be a risk factor for type 2 diabetes. Only a few studies report prevalence of impaired glucose metabolism and diabetes mellitus in relation to shift work. There is strong evidence of an association between shift work and coronary heart disease. Recent data increasingly reveal relations between shift work and plasma resistin, ghrelin, leptin and adiponectin.
International Journal of Occupational Medicine and Environmental Health, 2010, Vol.23, No.3, p.287-291. 37 ref.
Shift_work_and_metabolic_syndrome.pdf [en inglés]

CIS 11-0199 Marcinkiewicz A., Szosland D.
Selected risk factors of diabetes mellitus among road transport drivers
Road transport drivers are among the professional groups whose activities have a strong impact on public safety. In view of the nature of their professional activity, the drivers are at a higher risk of obesity and hypertension, and thus, indirectly, of carbohydrate metabolism disorders such as diabetes mellitus. This study on the prevalence of risk factors of diabetes mellitus among Polish road transport drivers used medical documentation accompanying the application for drivers' licence. Excessive body weight was recorded in 62.6% of the study population; 45.3% had overweight and 17.4% obesity. Hypertension was noted in 36.7% of the drivers, with increasing prevalence with age. Overweight was found to be a risk factor for hypertension. Hyperglycaemia was found in 47.5% of the drivers and was also increasing with age. Implications of these findings are discussed.
International Journal of Occupational Medicine and Environmental Health, 2010, Vol.23, No.2, p.175-180. 19 ref.
Selected_risk_factors.pdf [en inglés]

CIS 10-0436 Lowden A., Moreno C., Holmbäck U., Lennernäs M., Tucker P.
Eating and shift work - Effects on habits, metabolism and performance
Compared to day workers, shift workers are at higher risk of a range of metabolic disorders and diseases such as obesity, cardiovascular disease, peptic ulcers, gastrointestinal problems, failure to control blood sugar levels and metabolic syndrome. At least some of these complaints may be linked to the quality of the diet and irregular timing of eating; however other factors that affect metabolism are likely to play a part, including psychosocial stress, disrupted circadian rhythms, sleep debt, physical inactivity, and insufficient time for rest and revitalization. This literature survey examined studies on food and nutrition among shift workers. The discussion focuses on the quality of existing dietary assessment data, nutritional status parameters (particularly in obesity), the effect of circadian disruptions, and the possible implications for performance at work. Dietary guidelines as a basis for managing the nutrition of shift workers are proposed.
Scandinavian Journal of Work, Environment and Health, Mar. 2010, Vol.36, No.2, p.150-162. Illus. 96 ref.

CIS 10-0435 Suwazono Y., Uetani M., Oishi M., Tanaka K., Morimoto H., Nakada S., Sakata K.
Estimation of the benchmark duration of alternating shift work associated with increased total cholesterol levels among male Japanese workers
The aim of this study was to estimate the benchmark doses and their 95% lower confidence limits for the threshold number of years of alternating shift work associated with a relative increase in serum total cholesterol level (T-Cho), as an index of lipid metabolism. A 14-year prospective cohort study was conducted among 6886 male workers at a Japanese steel company who had received annual health check-ups between 1991 and 2005. The endpoints were either a 20, 25, 30, 35, 40 or 45% increase in T-Cho levels during the observation period, compared to T-Cho at baseline. The associations between the years of alternating shift work and the relative increases in T-Cho were investigated using pooled logistic regression, adjusted for other potential covariates. The threshold number of years of alternating shift work that caused a 5% increase in T-Cho among middle-aged workers was shown to be 21 years or more. Implications of these findings are discussed.
Scandinavian Journal of Work, Environment and Health, Mar. 2010, Vol.36, No.2, p.142-149. 28 ref.

CIS 10-0431 Puttonen S., Härmä M., Hublin C.
Shift work and cardiovascular disease - Pathways from circadian stress to morbidity
In order to establish a causal relation between shift work and cardiovascular disease (CVD), the pathways from the former to the latter need to be verified. This article reviews current knowledge of the mechanisms between shift work and CVD. Shift work can increase the risk of CVD by several interrelated psychosocial, behavioural, and physiological mechanisms. The psychosocial mechanisms relate to difficulties in controlling working hours, decreased work-life balance and poor recovery following work. The most probable behavioural changes are weight gain and smoking. The plausible physiological and biological mechanisms are related to the activation of the autonomic nervous system, inflammation, changed lipid and glucose metabolism, and related changes in the risk for atherosclerosis, metabolic syndrome and type II diabetes. The data provide evidence for possible disease mechanisms between shift work and CVD, but compelling evidence on any specific mechanism is missing.
Scandinavian Journal of Work, Environment and Health, Mar. 2010, Vol.36, No.2, p.96-108. Illus. 129 ref.
Shift_work_and_cardiovascular_disease.pdf [en inglés]

2009

CIS 09-1029 Di Milia L., Mummery K.
The association between job related factors, short sleep and obesity
A cross sectional survey of 346 shift and day workers (292 men and 59 women) was carried out to investigate possible associations between obesity, job related factors and sleep duration. Mean body mass index (BMI) was significantly higher in shift workers than in day workers. Mean BMI was also significantly higher in the group working long daily hours followed by medium working hours and short working hours. Obese individuals worked significantly longer hours and slept 18 min less per day compared to those with a normal BMI. The most significant predictor of obesity was long working hours (odds ratio OR 2.82), followed by being older (OR 2.05) and short sleep duration (OR 1.92).
Industrial Health, July 2009, Vol.47, No.4, p.363-368. Illus. 34 ref.

CIS 09-819 Martin B.C., Church T.S., Bonnell R., Ben-Joseph R., Borgstadt T.
The impact of overweight and obesity on the direct medical costs of truck drivers
The objective of this study was to quantify health care costs of truck drivers across categories of normal weight, overweight, and obese weight. Health care claims data from a transportation logistics company were obtained from 2004 to 2005 concerning 2849 truckers and were merged with their body mass index measures. A regression model was used to adjust for demographic and occupational variables. Unadjusted trimmed total cost for overweight subjects (USD 1613) and obese subjects (USD 1792) were significantly higher than for normal weight subjects (USD 1012). After multivariate adjustment, obese and overweight subjects had on average, USD 591 and USD 383 higher health care costs respectively than normal weight subjects. Both overweight and obese individuals had higher prevalences of hyperlipidemia, diabetes and hypertension than their normal weight counterparts.
Journal of Occupational and Environmental Medicine, Feb. 2009, Vol.51, No.2, p.180-184. Illus. 13 ref.

CIS 09-799 Goetzel R.Z., Baker K.M., Short M.E., Pei X., Ozminkowski R.J., Wang S., Bowen J.D., Roemer E.C., Craun B.A., Tully K.J., Baase C.M., DeJoy D.M., Wilson M.G.
First-year results of an obesity prevention program at the Dow Chemical Company
This article presents the first-year results from a workplace obesity prevention programme at a large chemical company in the United States. A study was conducted among 8013 employees at nine treatment worksites who received weight management interventions and 8013 controls based at three other worksites who did not receive the interventions. Data concerning changes in employees' weight, body mass index (BMI), and other health risks were subjected to statistical analyses. After one year, a modest treatment effect was observed for weight and BMI largely because the control group subjects gained weight; however, no effect was observed for overweight and obesity prevalence. With the exception of blood glucose, other risk factors (tobacco use, high blood pressure, and systolic and diastolic blood pressure values) decreased significantly.
Journal of Occupational and Environmental Medicine, Feb. 2009, Vol.51, No.2, p.125-138. Illus. 72 ref.

2008

CIS 09-1241 Szosland D., Marcinkiewicz A.
Carbohydrate metabolism disturbances among public transport drivers - The need for regulations in Poland
The aim of study was to draw attention to some problems that may emerge when attempting to certify medical fitness of drivers or driver candidate to drive public service vehicles. Data were obtained from routine medical examinations of public transport drivers of a provincial locality in Poland. Fasting blood was collected and analyzed with a blood glucose meter. Abnormal fasting glucose levels were noted in 23 drivers (21.7%). It is concluded that there is a need for regulations in Poland defining standard procedures for the diagnosis diabetes mellitus and specifying the frequency of periodic medical assessments in cases of diagnosed diabetes mellitus.
International Journal of Occupational Medicine and Environmental Health, 3rd quarter 2008, Vol.21, No.3, p.247-252. Illus. 23 ref.

CIS 09-1067 Baker K.M., Goetzel R.Z., Pei X., Weiss A.J., Bowen J., Tabrizi M.J., Nelson C.F., Metz R.D., Pelletier K.R., Thompson E.
Using a return-on-investment estimation model to evaluate outcomes from an obesity management worksite health promotion program
Certain modifiable risk factors lead to high health care costs and reduced worker productivity. A predictive return-on-investment (ROI) estimation model was applied to an obesity management intervention to demonstrate the use of econometric modelling in establishing financial justification for worksite health promotion. Self-reported risk factors of 890 employees with a body mass index ≥30 were analyzed using statistical evaluation methods. Changes in risk factors, demographics and financial measures comprised the model inputs that determined medical and productivity savings. Over one year, seven out of ten health risks decreased. Of total projected savings, 59% were attributed to reduced health care expenditures and 41% resulted from productivity improvements, a USD 1.17 return per dollar of investment.
Journal of Occupational and Environmental Medicine, Sep 2008, Vol.50, No.9, p.981-990. Illus. 50 ref.

CIS 09-1014 Sprince N.L., Pospisil S., Peek-Asa C., Whitten P.S., Zwerling C.
Occupational injuries among workers with diabetes: The national health interview survey, 1997-2005
The objective of this study was to assess associations between diabetes and occupational injury. Data from the 1997 to 2005 National Health Interview Survey comprised a sample of 195,284 adult workers. Multivariate logistic regression analysis assessed associations between diabetes and occupational injuries, adjusting for age, sex, race and education. There was no overall significant association between diabetes and occupational injury (adjusted odds ratio (OR) 1.18). However, there were increased risks among subgroups of diabetics who reported no current diabetes therapy (OR 1.87) or duration of diabetes longer than 12 years (OR 1.83). Implications of these findings are discussed.
Journal of Occupational and Environmental Medicine, July 2008, Vol.50, No.7, p.804-808. 11 ref.

CIS 09-537 Oberlinner C., Neumann S.M., Ott M.G., Zober A.
Screening for pre-diabetes and diabetes in the workplace
The objective of this study was to integrate diabetes screening and prevention into the existing occupational medical programme of a large German chemicals manufacturer. Screening to detect potential cases of pre-diabetes and diabetes was conducted using differing criteria to define risk groups over a 2-year period. Classification of new cases was based on fasting plasma glucose, random plasma glucose or oral glucose tolerance test (OGTT). Among 13,086 employees screened via fasting or random glucose, there were 96 diabetes and 650 pre-diabetes cases detected. Among high-risk employees, 20 new cases of pre-diabetes and eight cases of diabetes were detected in 84 employees assessed by OGTT. The percentage of employees with new findings increased with increasing age (2.3%, under age 40 compared to 11.4% for age 50 years and above) and body mass index (2.6, 6.1 and 11.4% among normal weight, overweight and obese employees, respectively). Implications of these findings are discussed.
Occupational Medicine, Jan. 2008, Vol.58, No.1, p.41-45. Illus. 19 ref.
http://occmed.oxfordjournals.org/cgi/reprint/58/1/41 [en inglés]

CIS 09-536 Cosgrove M.P., Sargeant L.A., Griffin S.J.
Does depression increase the risk of developing type 2 diabetes?
Workers may be tempted to allege that the onset of diabetes was precipitated or caused by depression induced by work in order to claim occupational disease compensation. The objective of this study was to quantify the association between work-related depression episodes and subsequent development of type 2 diabetes. It was carried in the form of a literature survey. Risk factors were calculated using the Levin formula. The pooled fully adjusted relative risk estimate from the three highest quality studies was 1.25. However, depression was no more frequent among those with and without type 2 diabetes. Only 20% of cases of diabetes can be attributed to depression in people with both conditions. Further research is needed to determine possible causal mechanisms for the association and to ascertain whether depression and diabetes may have a common aetiology.
Occupational Medicine, Jan. 2008, Vol.58, No.1, p.7-14. Illus. 32 ref.
http://occmed.oxfordjournals.org/cgi/reprint/58/1/7 [en inglés]

CIS 09-330 Burgos Díez P., Rescalvo Santiago F., Ruiz Albi T., Velez Castillo M.
Estudio de obesidad en el medio sanitario
This study analyses the prevalence of overweight and obesity among health care workers. It involved a sample of 806 health care workers of a region of Spain, for which medical histories and anthropometric data were available. Overweight and obesity were defined as body mass indices of >25 and >30 respectively. Overall, the prevalences were found to be comparable to those reported in literature concerning the general population. After correcting for age, the prevalence of obesity was slightly higher for men. Other findings are discussed.
Medicina y seguridad del trabajo, 4th quarter 2008, Vol.54, No.213, p.75-80. Illus. 9 ref.
http://scielo.isciii.es/pdf/mesetra/v54n213/original6.pdf [en español]

CIS 09-147 Brook R.D., Jerrett M., Brook J.R., Bard R.L., Finkelstein M.M.
The relationship between diabetes mellitus and traffic-related air pollution
Air pollution is associated with an increased risk for cardiovascular events. Several of the biological pathways involved could also promote diabetes mellitus (DM). This study investigated the association between DM prevalence and exposure to traffic-related air pollution (nitrogen dioxide, NO₂). Study participants were patients who attended two respiratory clinics in Canada. Those among them with DM were identified by linkage to the database of the Ontario Health Insurance Plan. Geographic information systems methodology was used to assign individual estimates of NO₂ based on a network of samplers in each city. Logistic regression was used to estimate the relations between NO₂ exposures and the odds of DM. After adjusting for age, body mass index and neighborhood income, there were weak positive effects in women (odds ratio 1.04) but not among men.
Journal of Occupational and Environmental Medicine, Jan. 2008, Vol.50, No.1, p.32-38. Illus. 45 ref.

CIS 09-69 Chou C.F., Johnson P.J.
Health disparities among Americas' health care providers: Evidence from the integrated health interview series, 1982 to 2004
The objective of this study was to examine whether health status and obesity prevalence differ by race or ethnicity and work classification among health care workers in the United States. Data representing health care workers aged 20 to 64 between 1982 and 2004 were retrieved from the Integrated Health Interview Series. Data were analyzed using logistic regression. Over time, there was a decline in the self-reported health status of health care workers, together with a rise in the prevalence of obesity. Moreover, there was a clear social gradient across workforce categories, which is widening over time. Finally, within workforce categories, there were significant race-related relationships in health status and prevalence of obesity.
Journal of Occupational and Environmental Medicine, June 2008, Vol.50, No.6, p.696-704. Illus. 36 ref.

CIS 08-586 Vieira E.R., Kumar S., Narayan Y.
Smoking, no exercise, overweight and low back disorder in welders and nurses
This study assessed the association between smoking, lack of exercise, being overweight and low back disorder among welders and nurses. A total of 111 workers (64 welders and 47 nurses working in a steel company and a hospital respectively) completed a questionnaire on their personal and occupational factors. The annual and lifetime rates of work-related low back disorder were respectively 3.4% and 58%. Forty percent of the workers smoked and 49% did not exercise regularly. The lifetime rate of low back disorder was 86% for the workers that smoked and did not exercise, and 66% for the overweight workers. This study shows that low back disorder is common among welders and nurses. Low back disorder preventive programs in industry should include smoking cessation, regular physical activity campaigns and the promotion of healthy eating habits.
International Journal of Industrial Ergonomics, Feb. 2008, Vol.38, No.2, p.143-149. Illus. 31 ref.

2007

CIS 09-1063 Finkelstein E.A., Linnan L.A., Tate D.F., Birken B.E.
A pilot study testing the effect of different levels of financial incentives on weight loss among overweight employees
To test the effectiveness of modest financial incentives to encourage weight loss among overweight employees, a randomized design was applied with measurements at baseline, three and six months, and three levels of financial incentives (none, USD 7.00 and USD 14.00 per percentage point of weight lost). Payments were structured so that all participants had equal ability to obtain the incentives during the study period. At three months, participants with no financial incentive lost 2.0 pounds, those in the USD 7.00 group lost approximately 3.0 pounds and those in the USD 14.00 group lost 4.7 pounds. However after six months, weight losses were similar across groups. Implications of these findings are discussed.
Journal of Occupational and Environmental Medicine, Sep. 2007, Vol.49, No.9, p.981-989. Illus. 16 ref.

CIS 09-48 Schneider C.A., Herold G., Gysan D., Albus C., Bjarnason-Wehrens B., Predel H.G.
Prevalence of cardiovascular risk factors in middle-aged type 2 diabetic automobile employees assessed at the workplace - The Praeford study
The purpose of this study was to assess cardiovascular risk factors among employees of German automotive plants who identified themselves as having type two diabetes mellitus. The proportion of subjects exceeding the target values for haemoglobin A1c (HbA1c), systolic blood pressure and low-density lipoprotein (LDL) cholesterol was identified. Among 4234 employees, 91 employees with diabetes were identified (mean age 52 years). Only seven of these diabetic employees met all three recommended target values: blood pressure target values were achieved by 26%, HbA1c target values by 54% and LDL target values by 31% of employees. These findings call for new treatment and monitoring strategies for employees with diabetes.
Journal of Occupational and Environmental Medicine, May 2007, Vol.49, No.5, p.481-483. Illus. 6 ref.

CIS 08-1349 Hignett S., Chipchase S., Tetley A., Griffiths P.
Health and Safety Executive
Risk assessment and process planning for bariatric patient handling pathways
The obese population in the United Kingdom is growing and this group is considerably over-represented in the use of health and social care services. This project aimed to identify and explore the manual handling risks presented by bariatric (severely obese) patients during emergency admissions. Work involved: reviewing public health data to provide an estimate of the current and future bariatric patient population; surveying strategic, clinical and operational policies and procedures for bariatric patient handling; and obtaining case studies of specific incidents and risk management actions. Findings revealed that 40%-70% of health care institutions did not have a bariatric policy. Other findings are discussed.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2007. xiv, 89p. Illus. 57 ref.
http://www.hse.gov.uk/research/rrpdf/rr573.pdf [en inglés]

2006

CIS 07-568 Suwazono Y., et al.
Estudio longitudinal de larga duración sobre la relación entre el trabajo a turnos rotatorios y la aparición de una diabetes mellitus entre trabajadores japoneses varones
Long-term longitudinal study on the relationship between alternating shift work and the onset of diabetes mellitus in male Japanese workers [en inglés]
Este estudio longitudinal, realizado sobre trabajadores japoneses, examina el efecto de los turnos rotatorios (TR) en comparación con los turnos de día (TD) respecto de la aparición de una diabetes mellitus. El estudio se efectuó sobre un grupo de 3.203 trabajadores en TR y 2.426 trabajadores en TD, todos ellos empleados en una empresa siderúrgica. Los datos se obtuvieron entre los años 1991 y 2001, durante los reconocimientos médicos anuales. La asociación entre el tipo de horario del turno y la aparición de una diabetes mellitus (hemoglobina glicosilada Alc=6,0% o tratamiento médico) se analizó mediante regresión logística multivariable. El odds ratio para el desarrollo de diabetes mellitus en el grupo con TR era de 1,35 respecto del grupo que trabajaba en TD. Este estudio ha permitido poner de manifiesto que el trabajo a turnos rotatorios constituye un factor de riesgo independiente para el desarrollo de una diabetes mellitus.
Journal of Occupational and Environmental Medicine, May 2006, Vol.48, No.5, p.455-461. 36 ref.

2005

CIS 06-812 Morikawa Y., Nakagawa H., Miura K., Soyama Y., Ishizaki M., Kido T., Naruse Y., Suwazono Y., Nogawa K.
Trabajo a turnos y riesgo de diabetes mellitus entre trabajadores japoneses de sexo masculino.
Shift work and the risk of diabetes mellitus among Japanese male factory workers [en inglés]
Este estudio trataba de establecer en qué medida el trabajo a turnos constituye un factor de riego de diabetes mellitus. Para ello, se realizo el seguimiento de 2.860 hombres durante ocho años, los obreros trabajando según un horario fijo diurno y en trabajos a turnos, y los empleados de oficina trabajando según un horario fijo diurno. El criterio determinante para una diabetes mellitus entre los trabajadores era que tuviesen una tasa de hemoglobina glicosilada D6,1 o un diagnostico establecido por un medico. La incidencia de diabetes mellitus más alta, ajustada por edad, correspondió a los trabajadores que tenían dos turnos, y la mas baja a los empleados de oficinas. Utilizando a estos últimos como grupo de referencia, se observo un aumento significativo del riesgo de diabetes mellitus entre los trabajadores que realizaban dos turnos (riesgo relativo de 2,01 tras el correspondiente ajuste para todos los factores de confusión), pero no así para los que tenían tres turnos de trabajo ni para los trabajadores que tenían un horario fijo diurno. Estos observaciones sugieren la existencia de factores de riesgo diferentes según el tipo de horario.
Scandinavian Journal of Work, Environment and Health, June 2005, Vol.31, No.3, p.179-183. 32 ref.

2004

CIS 05-197 García Callejo F.J., García Callejo F., Velert Vila M.M., de Paula Vernetta C., Morant Ventura A., Marco Algarra J.
Hipoacusia inducida por ruido laboral en diabéticos insulinodependientes
La diabetes mellitus altera las propiedades reológicas de la sangre, y está relacionada con un riesgo de hipoacusia neurosensora. Se llevó a cabo este estudio para examinar si el nivel de ruido en entornos profesionales presentaba un efecto más pronunciado sobre la pérdida de audición entre trabajadores diabéticos insulin-dependientes y si había una correlación entre la magnitud de la pérdida de audición y la viscosidad de la sangre. En el estudio participaron 19 trabajadores diabéticos de los cuales existían resultados de pruebas audiométricas realizadas cinco años antes, junto con un grupo de control de 19 trabajadores sanos expuestos a niveles de ruidos similares. Los resultados muestran un incremento estadísticamente significativo en la pérdida de audición binaural entre los sujetos diabéticos, junto con incremento en la viscosidad de la sangre. Se encontró también una correlación significativa entre la magnitud de la hipoacusia y los valores de viscosidad en sangre a altas velocidades de high sheer velocities. Al parecer los diabéticos presentan un incremento de predisposición a la hipoacusia inducida por el ruido, lo cual puede deberse al síndrome de hiperviscosidad asociado con este trastorno metabólico.
Medicina y seguridad del trabajo, June 2004, Vol.L, No.195, p.15-23. Illus. 23 ref.

CIS 04-312 Weijman I., Kant I., Swaen G.M., Ros W.J.G., Rutten G.E.H.M., Schaufeli W.B., Schabracq M.J., Winnubst J.A.M.
Diabetes, empleo y quejas relacionadas con el cansancio: comparación entre los trabajadores diabéticos, los trabajaores que gozan de "buena salud" y los trabajadores que padecen otras afecciones crónicas
Diabetes, employment and fatigue-related complaints: A comparison between diabetic employees, "healthy" employees, and employees with other chronic diseases [en inglés]
Los factores profesionales y las quejas relacionadas con el cansancio de 141 trabajadores diabéticos fueron comparados con los de 8.941 trabajadores con buena salud y 1.883 trabajadores aquejados de otras afecciones crónicas. Para ello se recurrió a los datos básicos facilitados por el estudio de cohorte de los Países Bajos sobre el cansancio en el entorno laboral, con el fin de comprobar las diferencias entre las variables de fondo, los factores profesionales, los factores relacionados con el modo de vida, y las quejas relacionadas con el cansancio. Se calcularon los odds ratios para el cansancio prolongado, la necesidad de recuperarse, la depresión por agotamiento y la angustia psicológica. Los resultados demuestran que los trabajadores que padecen diabetes trabajan más días y hacen menos horas extras que los demás grupos. En ausencia de co-morbilidad (otras afecciones crónicas concomitantes), no son más propensos a declarar problemas de cansancio que los trabajadores con buena salud. Sin embargo, lo co-morbilidad está asociada a un aumento de las quejas relacionadas con el cansancio.
Journal of Occupational and Environmental Medicine, Aug. 2004, Vol.46, No.8, p.828-836. 54 ref.

2003

CIS 03-965 Leynen F., Moreau M., Pelfrene E., Clays E., De Backer G., Konrnitzer M.
Estrés en el trabajo y prevalencia de la diabetes: Resultados del Estudio Belstress
Job stress and the prevalence of diabetes: Results from the Belstress Study [en inglés]
Como parte de una investigación más general para la determinación de vínculos entre el estrés en el trabajo y enfermedades cardiovasculares, este estudio evaluó la relación entre el estrés en el trabajo y la diabetes, uno de los principales factores de riesgo coronario. La población de estudio estaba formada por una gran cohorte de 16.335 hombres y 5.084 mujeres belgas, con edades comprendidas entre los 35-59 años, que trabajaban en una gran diversidad de profesiones. Los participantes completaron un cuestionario sobre su trabajo y se les realizaron exámenes clínicos. La prevalencia de la diabetes del tipo II fue de 2,6% y 2,1% entre hombres y mujeres, respectivamente. Los resultados también mostraron la existencia de una relación inversa entre el control en el trabajo y la diabetes, y una asociación positiva entre la tensión en el trabajo y la diabetes en las mujeres. Estos resultados apoyan la idea de una posible asociación entre el estrés en el trabajo, definido como una combinación de elevadas exigencias psicológicas en el trabajo y un control bajo o una falta de control en el trabajo, y la prevalencia de la diabetes.
Archives belges de médecine sociale, hygiène, médecine du travail et médecine légale - Belgisch Archief van Sociale Geneeskunde, Hygiëne, Arbeidsgeneeskunde en Gerechtelijke Geneeskunde, 2003, Vol.61, No.1-2, p.75-90. 33 ref.

2002

CIS 03-653 Nakanishi N., Sato M., Shirai K., Nakajima K., Murakami S., Takatorige T., Suzuki K., Tatara K.
Cifra de leucocitos y características del síndrome metabólico entre los oficinistas japoneses
Associations between white blood cell count and features of the metabolic syndrome in Japanese male office workers [en inglés]
Este estudio examina la relación entre el recuento de glóbulos blancos y los diferentes componentes del síndrome metabólico en 5.275 varones japoneses de 23 a 59 años de edad. Los resultados indicaron una relación significativa entre la cifra de leucocitos y los siguientes parámetros: índice de masa corporal, tensión arterial sistólica y diastólica, colesterol total, lipoproteínas de alta densidad, triglicéridos, glucemia en ayunas y ácido úrico. Tras el ajuste de los posibles factores de confusión, el recuento medio de leucocitos fue significativamente más elevado entre los sujetos que presentaban alguna característica del síndrome metabólico (obesidad, hipertensión, hipercolesterolemia, niveles bajos de lipoproteínas de alta densidad, hipertrigliceridemia, niveles elevados de glucemia en ayunas e hiperuricemia). El incremento de la cifra de leucocitos ajustada entre los sujetos que presentaban 1, 2, 3, 4 y ?5 características del síndrome metabólico fueron 0,28, 0,45, 0,68, 0,76 y 1,40x109 células/l, respectivamente, en comparación con los sujetos sin ninguna de esas características. Estos datos indican una fuerte asociación entre la cifra de leucocitos y algunos de los trastornos característicos del síndrome metabólico entre los varones japoneses.
Industrial Health, July 2002, Vol.40, No.3, p.273-277. 15 ref.

2001

CIS 02-651 Škerjanc A.
Absentismo por enfermedad en empleados diabéticos
Sickness absence in diabetic employees [en inglés]
Se ha llevado a cabo un estudio caso-control transversal con el fin de analizar el absentismo por enfermedad entre los empleados diabéticos y no diabéticos. Se comparó el absentismo por enfermedad, en 1996, de una muestra aleatoria de 400 empleados diabéticos, con edades comprendidas entre 21 y 50 años, con el absentismo de un grupo de empleados no diabéticos, que presentaban las mismas características de edad, sexo y profesión. El absentismo fue comparado en su globalidad pero también en subgrupos definidos en función del sexo, edad, profesión y minusvalía. La muestra aleatoria estaba constituida por un 61,2% de hombres (245) y un 38,8% de mujeres (155), cuya edad media era de 42,5 años; el 30,2% eran trabajadores no cualificados y menos del 16,4% tenían estudios. La frecuencia media del absentismo por enfermedad en 1996 era de 0,89 para los diabéticos y de 0,56 para los no diabéticos. La duración media del absentismo por enfermedad era de 31,71 jornadas para los diabéticos frente a 16,57 para los no diabéticos. Este estudio confirma que la diabetes tiene una influencia en la capacidad laboral.
Occupational and Environmental Medicine, July 2001, Vol.58, No.7, p.432-436. 36 ref.

1999

CIS 01-113 Kalff K.G., Maya-Pelzer P., Andexser A., Deuber H.J.
Prevalencia del síndrome metabólico en el personal de navegación aérea civil y militar
Prevalence of the metabolic syndrome in military and civilian flying personnel [en inglés]
El síndrome metabólico (MS) afecta al 20-30 % de la población de mediana edad en los países desarrollados. Consiste en un agrupamiento de enfermedades entre las que se incluyen la obesidad, la hipertensión, la dislipoproteinemia y la intolerancia a la glucosa. El objetivo de este estudio era determinar el riesgo de desarrollar un MS en el colectivo de pilotos, y las posibles consecuencias para la vigilancia médica. Se obtuvieron datos de aproximadamente 10.000 pilotos civiles y militares. Se pudo identificar un subgrupo de pilotos militares con un riesgo más elevado de desarrollar posteriormente en su vida un MS. Este grupo fue denominado "posibles futuros metabólicos" (PFM). El estudio comparativo entre los PFMs y el grupo de control de pilotos militares y civiles puso claramente de relieve el hecho de que la obesidad, la dislipoproteinemia y la hipertensión constituyen los principales factores de riesgo, solos o combinados. Los datos correspondientes a los pilotos militares señalaron una posible asociación entre la disfunción tiroidea y la prevalencia de factores de riesgo de MS.
Aviation, Space, and Environmental Medicine, dic. 1999, vol.70, n°12, p.1223-1226. Ilus. 13 ref.

CIS 00-1057 Baccarelli A.
Agentes nocivos asociados al trabajo y función endocrina: actualización de los datos experimentales y con humanos
Agenti occupazionali e funzione endocrina: aggiornamento delle evidenze sperimentali e nell'uomo [en italiano]
Este artículo examina los efectos endocrinos de los agentes físicos y químicos en el hombre, los animales de laboratorio y en los experimentos in vitro. Se analizan los efectos sobre el hipotálamo, la hipófisis, la glándula pineal, el tiroides, la paratiroides, y el metabolismo del calcio, las glándulas suprarrenales y el metabolismo de la glucosa. Los metales (plomo, manganeso, cadmio y los compuestos organoestannicos), los solventes (benceno, dioxano, estireno, tetracloroetileno, tolueno), los compuestos organoclorados (PCB, TCDD) y los agentes físicos que se han revelado inductores de alteraciones en los niveles sanguíneos y con influencia sobre el ritmo circadiano. La exposición profesional puede producir una diabetes mellitus e incrementar la susceptibilidad a las enfermedades profesionales.
Medicina del lavoro, set.-oct. 1999, vol.90, n°5, p.650-670. 115 ref.

CIS 00-1015 Madden V.
Endulzar la píldora
Sugaring the pill [en inglés]
A pesar de la reciente adopción de disposiciones legislativas en el Reino Unido, numerosos trabajadores enfermos de diabetes continúan quejándose de un trato injusto en el mercado laboral. Sin embargo, el aumento del número de casos supone que los expertos en salud laboral tienen cada vez mayor conocimiento de las condiciones y necesidades de los trabajadores diabéticos.
Occupational Health, abr. 1999, vol.51, n°4, p.20-21. Ilus. 4 ref.

CIS 00-471 Calvert G.M., Sweeney M.H., Deddens J., Wall D.K.
Evaluación de la diabetes mellitus, la glicemia y la función tiroidea en trabajadores americanos expuestos a la 2,3,7,8-tetraclorodibenzo-p-dioxina
Evaluation of diabetes mellitus, serum glucose, and thyroid function among United States workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin [en inglés]
Temas tratados: tetraclorodibenzodioxina; determinación en sangre; diabetes mellitus; estudio transversal; función tiroidea; tasa de glucosa en sangre; USA.
Occupational and Environmental Medicine, abr. 1999, vol.56, n°4, p.270-276. 21 ref.

1995

CIS 96-360 Kolopp-Sarda M.N., Béné M.C., Gobert B., Massin N., Faure G.C.
Exposición profesional a la harina y detección de la enfermedad celiaca
Occupational flour exposure and screening for coeliac disease [en inglés]
Esta comunicación describe brevemente un estudio realizado sobre los índices de anticuerpos anti-globulina IgG e IgA en 158 molineros y panaderos expuestos a los polvos de harina, a los que nunca se les había diagnosticado la enfermedad celiaca y que no habían manifestado síntoma alguno de esta enfermedad. Las IgG e IgA fueron positivas en un 37 % y 21% de los individuos expuestos respectivamente (2% y 5% en un grupo control). Según estos datos, los antecedentes profesionales de las personas que presentan tales anticuerpos séricos deberían tenerse en cuenta a la hora de interpretar las pruebas de detección de la enfermedad celiaca.
Lancet, 1 jul. 1995, vol.346, n°8966, p.57-58. 5 ref.

1994

CIS 95-2139 Jung D., Konietzko J., Reill-Konietzko G., Muttray A., Zimmermann-Hölz H.J., Doss M., Beck H., Edler L., Kopp-Schneider A.
Estudio de la porfirina en los trabajadores expuestos a la TCDD
Porphyrin studies in TCDD-exposed workers [en inglés]
La Tetracloro-2,3,7,8 dibenzo-p-dioxina se conoce por su papel inhibidor de la actividad de la decarboxilasa uroporfirinógena causando así una porfiria hepática crónica. En un estudio transversal realizado entre 170 trabajadores de la industria química, 68 tenían niveles altos de coproporfirina lo que sugería una coproporfirinuria secundaria. Tres personas sufrían una porfiria hepática crónica en estados subclínicos. Ninguno de estos trabajadores presentaba signos evidentes de porfiria cutánea tardía. En tres individuos se constató una débil protoporfirinemia. Se pudo evaluar a cuarenta y tres de los 170 trabajadores para estudiar el efecto de la TCDD sobre los niveles de porfirina. No se observó ninguna correlación significativa entre la concentración de esta sustancia en los tejidos adiposos y los niveles de uroporfirina y coproporfirina. Se describe la influencia de antecedentes de cloroacné.
Archives of Toxicology, 1994, vol.68, n°9, p.595-598. 18 ref.

CIS 95-2083 Petrides P.
El paciente diabético en el trabajo
The diabetic patient at work [en inglés]
Recopilación de artículos sobre la etiología, patogénesis, tratamiento médico y control de los trabajadores afectados de diabetes mellitus. Se trata también sobre la capacidad de trabajo de los empleados diabéticos y las repercusiones del trabajo por turnos sobre su salud. Los autores describen, desde sus respectivos países, la situación profesional de los diabéticos en Alemania, Francia, España, Reino Unido y EE.UU., teniendo en cuenta que en estos países, los diabéticos no pueden ni pilotar un avión ni conducir un tren.
Ecomed Verlagsgesellschaft mbH & Co. KG, Rudolf-Diesel-Strasse 3, 86899 Landsberg/Lech, Alemania, 1994. 123p. Ref.bibl.

1993

CIS 95-2072 Perrelli G., Pettinati L.
Reflexiones sobre el tema diabetes y trabajo
Alcune considerazioni in tema di diabete e lavoro [en italiano]
Rivista di medicina del lavoro ed igiene industriale, 1993, vol.17, p.39-46. 25 ref. ###

CIS 95-1415 McConnell R., Anderson K., Russell W., Anderson K.E., Clapp R., Silbergeld E.K., Landrigan P.J.
Angiosarcoma, porfiria cutánea tarda y cloroacné probable en un trabajador expuesto a aceites usados contaminados con la 2,3,7,8-tetraclordibenzoparadioxina
Angiosarcoma, porphyria cutanea tarda, and probable chloracne in a worker exposed to waste oil contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin [en inglés]
British Journal of Industrial Medicine, ago. 1993, vol.50, n°8, p.699-703. 31 ref. ###

CIS 94-1253 Jeffery R.W., Forster J.L., French S.A., Kelder S.H., Lando H.A., McGovern P.G., Jacobs D.R., Baxter J.E.
The healthy worker project - A work-site intervention for weight control and smoking cessation
A randomized trial was conducted to evaluate the effectiveness of a work-site health promotion programme in reducing obesity and cigarette smoking. Thirty-two worksites were randomized to treatment or no treatment for two years. Treatment consisted of health education classes combined with a payroll-based incentive system. Evaluation was based on cohort and cross-sectional surveys. Results showed that of 10,000 total employees in treatment worksites, 2,041 and 270 participated in weight control and smoking cessation programmes, respectively. Weight loss averaged 4.8lbs, and 43% of smoking participants quit. Net two-year reductions in smoking prevalence in treatment compared to control worksites were 4.0% and 2.1% in cross-sectional and cohort surveys, respectively. No treatment effect was found for weight. Treatment effects for smoking prevalence and weight were both positively correlated with participation rates in the intervention programmes (r=0.45 for smoking and r=0.55 for weight).
American Journal of Public Health, Mar. 1993, Vol.83, No.3, p.395-401. 54 ref.

1992

CIS 93-129 Jones C.A., Klag M.J., Sakai Y., Itoh I., Comstock G.W.
Skinfold thickness and cardiovascular risk factors in American and Japanese telephone company executives
Data from a cross-sectional study of cardiovascular disease risk factors in 962 American and 827 Japanese male telephone company executives were used to determine the associations of skinfold thickness measurements with blood pressure, blood glucose, serum cholesterol, and serum triglycerides. Most skinfolds showed association with risk factors in univariate regression. After adjusting for age and body mass index, the abdominal skinfold continued to be significantly associated with blood pressure and triglycerides in both groups of executives, while the subscapular skinfold showed associations only with triglycerides. After adjustment, the peripheral skinfolds showed no association with risk factors in the American men; however, in the Japanese men the ulnar skinfold continued to be associated with blood pressure. These findings suggest that abdominal and ulnar skinfold measurement may be useful in adjusting for the effect of obesity on coronary heart disease risk in epidemiological studies.
International Journal of Epidemiology, Apr. 1992, Vol.21, No.2, p.229-235. 29 ref.

CIS 93-123 Nathan P.A., Keniston R.C., Myers L.D., Meadows K.D.
Obesity as a risk factor for slowing of sensory conduction of the median nerve in industry - A cross-sectional and longitudinal study involving 429 workers
As part of a study of the aetiology of carpal tunnel syndrome, the weight and body mass index (BMI) was evaluated as risk factors for the slowing of sensory conduction of the median nerve. The hands of 316 industrial workers were evaluated in 1984 and again in 1989. Weight and BMI were strongly and positively correlated with the maximum latency difference (MLD). In 1984 and 1989 the risk for abnormal nerve conduction averaged 3.5-fold and 4.1-fold greater, respectively, in the obese workers than in the slim workers. In step-wise regression analysis for 1989 MLD based on 1984 factors, the BMI was the number one factor selected, followed by age, wrist depth/width ratio, hand dominance, and exercise level. None of three 1984 job-related factors (occupational hand use, duration of employment, or industry) was an independent predictor of 1989 MLD. This study suggests that individual characteristics, not job-related factors, are the primary determinants in the slowing of sensory conduction of the median nerve and in carpal tunnel syndrome.
Journal of Occupational Medicine, Apr. 1992, Vol.34, No.4, p.379-383. Illus. 35 ref.

1991

CIS 94-896 Diabetes, diet and occupation
Survey of the special health needs of diabetics, in particular as they apply to their diet and workplace activities in a tropical developing country such as India. Titles of articles: diabetes and occupation (Surendranath Lal M.B.); notes from a diabetologist's diary (Aruyir S.); biochemical parameters in diabetes mellitus (Gopalakrishna V.); role of health education in the work-site diabetes control programme (Samikkannu K.C.); dietary change in India. In annex: hypoglycaemia (causes, treatment); leg exercises for diabetics.
The OHS tide, Oct. 1991, Vol.9, No.2, p.1-16 (special issue). Illus.

CIS 92-1888 Yao C.H., Slattery M.L., Jacobs D.R., Folsom A.R., Nelson E.T.
Anthropometric predictors of coronary heart disease and total mortality - Findings from the US Railroad Study
Prospective data from the US Railroad study were used to investigate the relationships of several anthropometric variables to coronary heart disease and all-cause mortality in males initially free of cardiovascular disease. Anthropometric indicators of total body fat and central body fat were significantly and directly associated with age-adjusted coronary heart disease mortality. When systolic blood pressure, serum cholesterol, cigarette smoking, and vital capacity were also taken into account, the ratio chest circumference/shoulder diameter (central body fat) remained significantly associated with coronary heart disease mortality. Total, central, and peripheral body fat had a "U"-shaped relation with all-cause mortality. These results indicate that certain anthropometric measurements, especially those that may indicate central adiposity, are positively related to the development of fatal coronary heart disease and quadratically related to all-causes death rates.
American Journal of Epidemiology, 1 Dec. 1991, Vol.134, No.11, p.1278-1289. 31 ref.

CIS 92-1595 Wingren G., Persson B., Thorén K., Axelson O.
Mortality pattern among pulp and paper mill workers in Sweden: A case-reference study
The mortality pattern among Swedish pulp and paper mill workers was evaluated in a case-referent study encompassing 4,070 men deceased during the period 1950-1987. The subjects were identified from the register of deaths and burials in six parishes. A significantly increased mortality was seen for diabetes mellitus and for secondary tumours of the lung and liver among the pulp and paper mill workers. Indications of excess risks were also found for obstructive lung disorders, pulmonary emboli, accidents, and pneumonia, as well as for malignant lymphomas, leukaemias, and cancer of the pancreas and stomach. In the only parish where a sulfite process was exclusively used, cancer of the digestive tract and especially of the rectum was found to be in excess. Except for this parish, the sulfate process predominated in the plants included. The mortality pattern found in this study is in reasonable agreement with findings in various studies from this type of industry.
American Journal of Industrial Medicine, Dec. 1991, Vol.20, No.6, p.769-774. 23 ref.

CIS 92-861 Erfurt J.C., Foote A., Heirich M.A.
The cost-effectiveness of work-site wellness programs for hypertension control, weight loss, and smoking cessation
The cost-effectiveness of work-site wellness programmes for reducing cardiovascular disease risks of employees was examined at 3 manufacturing plants. A fourth plant was used as a control site to estimate levels of risk reduction achieved from wellness screening and pre-existing services, without further interventions. The disease risks studied were hypertension, obesity, and cigarette smoking. Two of the 3 experimental sites were more effective and cost effective than the other, both in terms of engaging employees at risk of cardiovascular disease into treatment or programme participation and of reducing their risks or preventing relapse. Programme costs were held constant in this report for comparison across programme models.
Journal of Occupational Medicine, Sep. 1991, Vol.33, No.9, p.962-970. 29 ref.

1989

CIS 90-212 Hodgson M.J., Van Thiel D.H., Lauschus K., Karpf M.
Liver injury tests in hazardous waste workers: The role of obesity
The prevalence of fatty liver disease at autopsy ranges from 40% to 80% in Europe and North America, and liver injury tests are abnormal in up to 8% of healthy populations. Liver injury tests were therefore examined in a group of 325 workers without exposure to hepatotoxins to identify the influence of obesity and sex. There were clear correlations between obesity and serum levels of arginine aminotransferase, alanine aminotransferase and alkaline phosphatase. Women generally demonstrated lower levels of these enzymes. Workers with morbid obesity were substantially more likely to have abnormal liver injury tests. Obesity and sex must be considered in the interpretation of abnormal liver injury tests in hazardous waste workers.
Journal of Occupational Medicine, Mar. 1989, Vol.31, No.3, p.238-242. 23 ref.

1988

CIS 89-1290 Poór G., Mituszova M.
Hyperuricaemia and gout among people with long-term exposure to lead
Hyperurikémia és köszvény előfordulása tartós ólomexpozíció esetén [en húngaro]
A comparison of 105 males with long-term exposure to lead in a battery manufacturing plant (with no symptoms of lead poisoning) and of 97 healthy male controls showed a significantly higher number of cases of hyperuricaemia (31) among the exposed men than among the controls (9). There were 4 cases of gout among the exposed workers, showing a prevalence rate of 3.8%, much higher than among adult males in Hungary (0.25%). There were no cases of gout among the controls. The literature of the subject is discussed.
Magyar Reumatológia, 1988, Vol.29, p.69-76. Illus. 30 ref.

1987

CIS 88-1177 Hodgson M.J., Talbott E., Helmkamp J.C., Kuller L.H.
Diabetes, noise exposure, and hearing loss
To examine relation between diabetes, noise exposure, and hearing loss, data were reanalysed from a cross-sectional investigation on noise exposure, hearing loss, and blood pressure conducted in a high-noise and a low-noise plant. 28 of 348 participants met the criteria for diabetes. Diabetics were evenly distributed between high- and low-noise exposure. They demonstrated no evidence of higher hearing threshold shifts than non-diabetics at the same noise levels. Noise and diabetes together do not appear to produce more neuropathic damage than does one insult alone.
Journal of Occupational Medicine, July 1987, Vol.29, No.7, p.576-579. 19 ref.

CIS 88-868 El trabajador diabético y su puesto en la empresa, Papel del médico de empresa
In Spain there are more than half a million diabetics, whose proportion in the population is about the same as worldwide. The disease should, however, not be considered as a handicap. In this article, it is stressed that the occupational physician must pay special attention to the diabetic worker: weight control, visual fatigue, infections and eruptions. He or she must also supervise the diet of these workers and must always be prepared for the possible appearance of comas. A list of 10 basic rules to be followed by diabetics is included.
Medicina y seguridad del trabajo, Jan.-Mar. 1987, Vol.34, No.134, p.61-66. 20 ref.

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