title: Psychosocial factors associated with work disability in men and women with diabetes: a pooled analysis of three occupational cohort studies.
abstract: OBJECTIVE
  To examine the extent to which adverse psychosocial factors, such as living alone, psychological distress, job strain and low support from supervisor, increase the risk of work disability (sickness absence and disability pension) among employees with diabetes.
  
  
  METHODS
  In this pooled analysis of individual-participant data from three occupational cohort studies (the Finnish Public Sector Study, the British Whitehall II study, and the French GAZEL study), 1088 women and 949 men with diabetes were followed up to determine the duration (number of days) and frequency (number of spells) of work disability. The mean follow-up periods were 3.2 years in the GAZEL study, 4.6 years in the Whitehall II study and 4.7 years in the Finnish Public Sector Study. Psychosocial factors and potential confounding factors were assessed at baseline using standard questionnaires. Study-specific estimates were pooled using fixed-effects meta-analysis.
  
  
  RESULTS
  In analysis adjusted for sociodemographic factors, health behaviours and comorbidities, participants with psychological distress had longer (rate ratio 1.66; 95% CI 1.31-2.09) and more frequent absences (rate ratio 1.33; 95% CI 1.19-1.49) compared with those with no psychological distress. Job strain was associated with slightly increased absence frequency (rate ratio 1.19 95% CI 1.05-1.35), but not with absence duration. Living alone and low supervisor support were not associated with absence duration or frequency. We observed no sex differences in these associations.
  
  
  CONCLUSIONS
  Psychological distress was associated with increased duration and frequency of work disability among employees with diabetes. Job strain was associated with increased absence frequency but not with absence duration.
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Ervasti
authors.affiliation: Department of Epidemiology and Public Health, University College London, UK.|Clinicum, Faculty of Medicine, University of Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Kivimäki
authors.affiliation: INSERM, UMR S 1136, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR S 1136, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Dray-Spira
authors.affiliation: Department of Epidemiology and Public Health, University College London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Head
authors.affiliation: UMS 011, Population-based Cohorts Unit, INSERM, Villejuif, France.|University Versailles Saint Quentin en Yvelines, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Goldberg
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Pentti
authors.affiliation: Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Jokela
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland.|University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Vahtera
authors.affiliation: UMS 011, Population-based Cohorts Unit, INSERM, Villejuif, France.|University Versailles Saint Quentin en Yvelines, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Zins
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Virtanen
mesh_terms: D000041:Absenteeism; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D048909:Diabetes Complications / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D006233:Persons with Disabilities / Q000523:psychology; D000066498:Emotional Adjustment; D004651:Employment / Q000523:psychology; D005191:Family Characteristics; D005260:Female; D005387:Finland / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D057566:Self Report; D012847:Single Person; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D006113:United Kingdom / Q000453:epidemiology; D017132:Workplace / Q000523:psychology