title: Impact of diabetes on work cessation: data from the GAZEL cohort study.
abstract: OBJECTIVE
  To 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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  Employment 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.
  
  
  CONCLUSIONS
  Our 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.
authors.affiliation: INSERM, UMRS 1018, CESP, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France.
authors.forename: Eléonore
authors.initials: E
authors.lastname: Herquelot
authors.forename: Alice
authors.initials: A
authors.lastname: Guéguen
authors.forename: Sébastien
authors.initials: S
authors.lastname: Bonenfant
authors.forename: Rosemary
authors.initials: R
authors.lastname: Dray-Spira
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000191:economics* / Q000401:mortality; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012179:Retirement / Q000706:statistics & numerical data; D012306:Risk; D014937:Work / Q000706:statistics & numerical data*