title: Impact of diabetes mellitus onset on sickness absence from work--a 15-year follow-up of the GAZEL Occupational Cohort Study.
abstract: OBJECTIVE
  Previous studies do not provide an accurate estimate of the burden of diabetes on sickness absence. The aim of this study was to measure the impact of diabetes onset on absenteeism starting from the earliest occurrence of the disease.
  
  
  METHODS
  The authors used data from a subsample of the French GAZEL cohort of 506 employees with incident diabetes and 2530 matched diabetes-free participants. Medically certified sickness absence data were obtained from company records (1989-2007). Number of sickness absence days and incidence rates of overall and cause-specific absence spells were compared according to diabetes status across three 5-year periods ranging from 10 years before to 5 years after onset of cases' diabetes.
  
  
  RESULTS
  The mean number of sickness absence days was persistently higher in participants with diabetes compared with those without diabetes. This difference increased from 16.4 days (95% confidence interval 7.2-25.5) during the 5-year period preceding diabetes onset to 28.5 days (95% CI 16.1-40.9) during the following 5-year period (P = 0.04). This was due to a steeper relative increase in the incidence of long (but not short) absence spells in participants with diabetes versus those without diabetes [incidence rate ratios 1.33 (95% CI 1.08-1.64) and 1.75 (95% CI 1.43-2.14), respectively; P = 0.02]. Diabetes onset was associated with increased rates of circulatory and metabolic absence spells.
  
  
  CONCLUSIONS
  Onset of diabetes is associated with a substantial increase in sickness absence. This suggests that in addition to its burden on work cessation, diabetes weighs heavily on working ability among people who manage to remain employed.
authors.affiliation: INSERM, UMRS 1018, CESP, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France. Rosemary.Dray-Spira@inserm.fr
authors.forename: R
authors.initials: R
authors.lastname: Dray-Spira
authors.forename: E
authors.initials: E
authors.lastname: Herquelot
authors.forename: S
authors.initials: S
authors.lastname: Bonenfant
authors.forename: A
authors.initials: A
authors.lastname: Guéguen
authors.forename: M
authors.initials: M
authors.lastname: Melchior
mesh_terms: D000041:Absenteeism; D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000191:economics / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health / Q000191:economics / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors