Raíla de Souza Santos1, Rosane Härter Griep2, Maria de Jesus Mendes da Fonseca1, Dóra Chor1, Itamar de Souza Santos3, Enirtes Caetano Prates Melo1. 1. Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil. 2. Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil. 3. Center of Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo 05508-000, Brazil.
Abstract
Evidence of psychosocial stress at work as a risk factor for diabetes and prediabetes is restricted. OBJECTIVES: Analyze the independent and combined association of the models, demand-control and social support (DC-SS) and the effort-reward imbalance and overcommitment (ERI-OC), and the incidence of glycemic alterations (prediabetes and diabetes). METHODS: A prospective study was carried out with data from 7503 active workers from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) study in the period 2008-2014. Work stress was measured by two stress models. Glycemic levels were evaluated by glycated hemoglobin (HbA1c) in two moments and classified in four groups: normal, maintenance of prediabetes, incident prediabetes, and incident diabetes. Multinomial logistic regression was analyzed with 5% significance levels stratified by sex, and multiplicative interactions were investigated. RESULTS: Work stress and glycemic alterations were more frequent in women. Psychosocial stress at work was shown to be associated to the risk of prediabetes and diabetes only among women. For women, the combination of models enlarged the magnitude of the association: prediabetes (DC-ERI = OR 1.51, 95% CI 1.15-1.99) and diabetes (DC-ERI = OR 2.10, 95% CI 1.20-3.65). Highly-educated women exposed to ERI-OC were four times more likely to have diabetes. CONCLUSION: Both models may contribute to explaining the psychosocial stress load according to each pattern of glycemic alteration among women.
Evidence of psychosocial stress at work as a risk factor for diabetes and prediabetes is restricted. OBJECTIVES: Analyze the independent and combined association of the models, demand-control and social support (DC-SS) and the effort-reward imbalance and overcommitment (ERI-OC), and the incidence of glycemic alterations (prediabetes and diabetes). METHODS: A prospective study was carried out with data from 7503 active workers from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) study in the period 2008-2014. Work stress was measured by two stress models. Glycemic levels were evaluated by glycated hemoglobin (HbA1c) in two moments and classified in four groups: normal, maintenance of prediabetes, incident prediabetes, and incident diabetes. Multinomial logistic regression was analyzed with 5% significance levels stratified by sex, and multiplicative interactions were investigated. RESULTS: Work stress and glycemic alterations were more frequent in women. Psychosocial stress at work was shown to be associated to the risk of prediabetes and diabetes only among women. For women, the combination of models enlarged the magnitude of the association: prediabetes (DC-ERI = OR 1.51, 95% CI 1.15-1.99) and diabetes (DC-ERI = OR 2.10, 95% CI 1.20-3.65). Highly-educated women exposed to ERI-OC were four times more likely to have diabetes. CONCLUSION: Both models may contribute to explaining the psychosocial stress load according to each pattern of glycemic alteration among women.
Entities:
Keywords:
demand–control model; diabetes mellitus type 2; effort–reward imbalance; health status disparities; occupational stress; prediabetes state
Authors: Ana Paula B Pena-Gralle; Denis Talbot; Caroline S Duchaine; Mathilde Lavigne-Robichaud; Xavier Trudel; Karine Aubé; Matthias Gralle; Mahée Gilbert-Ouimet; Alain Milot; Chantal Brisson Journal: Scand J Work Environ Health Date: 2021-09-28 Impact factor: 5.024