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1
THE EFFECTS OF WORK-RELATED
STRESS IN DEVELOPING TYPE 2
DIABETES: A META-ANALYSIS
REYNOLD M. STA ANA, MD1; MARICAR C. DUMBAB, RMT2; RAIZA T. ABANADOR, RMT2 1Senior Occupational Health Officer; 2Medical Technologist
Occupational Safety and Health Center
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER 2
INTRODUCTION
Figure 1. Top 10 causes of years lived with disability in 2017 and % change, 2007-2017, all ages, number. (IHME, 2018).
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INTRODUCTION
Figure 2. Prevalence of high fasting blood glucose among adults, 20.0 yrs. And over, by sex and age group: Phils. 2008-2013 (NNS, 2016).
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER 4
OBJECTIVE
• To determine the association of work-related stress in developing the risk for DM2.
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METHODOLOGY
• PEOS
– Population – working population
– Exposure – Work-related stress
– Outcome – Type 2 Diabetes Mellitus
– Study – Longitudinal cohort
6
META-ANALYSIS FLOW DIAGRAM
Effects of Work-related Stress in Developing Type 2 Diabetes Mellitus
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Risk of Bias(RoB) Assessment ROBINS-I Assessment Tool
STUDY ID
1. Bacquer 2009…………….……
2. Eriksson 2013…………….……
3. Garbarino 2015………………
4. Heraclides 2009……………..
5. Heraclides 2011……………..
6. Huth 2014………………………
7. Mutambudzi 2016…….……
8. Mutambudzi 2017……….…
9. Pan 2017……………….….……
10. Bannai 2016………….…….
11. Costa 2015……………….….
12. Ika 2012………………….…..
13. Mohebbi 2012………….…
14. Pan 2011………………….…
15. Vimalananda 2015……….
16. Yu 2015………………………..
17. Lian 2015……………………..
18. Wiernik 2016……………….
RoB legend:
(A) Bias due to confounding
(B) Bias in selection of participants into
the study
(C) Bias due to missing data
(D) Bias in measurement of outcomes
(E) Bias in selection of the reported
result
(F) Overall risk of bias judgement
Color legend:
Green – Low risk
Yellow – Unclear risk
Red – High risk
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Forest Plot: Work-related factors
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Forest Plot: Basal Metabolic Index (BMI)
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Forest Plot: Sex
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Forest Plot: Lifestyle factors
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Forest Plot: Family history of diabetes
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OCCUPATIONAL SAFETY AND HEALTH CENTER 13 Institute for Labor Studies • 30 Years of Bridging Research, Policy and Practice.
CONCLUSION
• work related stress and sex are associated with DM2
• insufficient evidence
• Work-related factors (OR=0.65; 95% CI: [0.53-0.80])
• Sex (OR=1.40; 95% CI: [1.11-1.76]).
• BMI, lifestyle habits, and family history are associated with DM2.
• BMI (OR=0.22; 95% CI:[0.19-0.26])
• Lifestyle (OR=0.88; 95% CI:[0.76-1.04])
• Family History (OR=0.58; 95% CI:[0.39-0.88])
• heterogeneity,
• inconsistency of findings
• high risk of bias
• insufficient evidence with respect to the association of work-related
stress to DM2.
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OCCUPATIONAL SAFETY AND HEALTH CENTER 14 Institute for Labor Studies • 30 Years of Bridging Research, Policy and Practice.
RECOMMENDATION
• Higher quality longitudinal studies that have
minimal biases.
• Well-defined work characteristics are needed
to establish association of DM2 in relation to
work.
• Further researches on lifestyle behaviors in relation to work stress.
