title: Association between occupational stressors and type 2 diabetes among Chinese police officers: a 4-year follow-up study in Tianjin, China.
abstract: OBJECTIVE
  To explore the relationship between occupational stressors and the incidence of type 2 diabetes mellitus among police officers.
  
  
  METHODS
  Baseline data were collected from policemen who completed the Occupational Stress Inventory-Revised (OSI-R) questionnaire, a self-designed questionnaire, and underwent free clinical measurements at the Medical Center of Police Hospital in Tianjin, China, in April 2007. A total of 5811 policemen participated in follow-up with the dynamic observation of new-onset diabetes (NOD) events occurring annually between 2008 and 2011. Occupational stress was measured by the OSI-R questionnaire, which contains 14 different scales. Cox proportional hazards regression was used to calculate the hazard ratios (HR) of the incidence of type 2 diabetes mellitus (T2DM) by occupational stressors.
  
  
  RESULTS
  A total of 3.1% of the participants (n = 179) developed NOD in the follow-up period from 2008 to 2011, and the incidence rates of NOD were 0.58% in 2008, 0.98% in 2009, 0.52% in 2010, and 1.01% in 2011. Role overload (RO), role boundary (RB), physical environment (PE), interpersonal strain (IS), and physical strain (PHS) were associated with the incidence of T2DM (RO: HR = 1.574, 95% CI = 1.071-2.372; RB: HR = 1.645, 95% CI = 1.144-2.365; PE: HR = 2.292, 95% CI = 1.545-3.400; IS: HR = 1.537, 95% CI = 1.079-2.191; and PHS: HR = 1.680, 95% CI = 1.167-2.006) after adjustment for confounding factors. A subgroup Cox regression analysis among traffic control police officers showed the specific work stressors remained robust except RO.
  
  
  CONCLUSIONS
  Several aspects of stressors were independent predictors of T2DM in a prospective cohort study in Tianjin, China. This practical information can be applied to the development of psychological interventions against T2DM.
authors.affiliation: Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
authors.forename: Jin-chuan
authors.initials: JC
authors.lastname: Liu
authors.affiliation: Department of Toxicology, School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
authors.forename: Ya-jiao
authors.initials: YJ
authors.lastname: Fan
authors.affiliation: Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Toxicology, School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
authors.forename: Li-xin
authors.initials: LX
authors.lastname: Zhang
authors.affiliation: Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.affiliation: Medical Center of Police Hospital, No. 78, Nanjing Road, Heping District, Tianjin, 300042, China.
authors.forename: Song
authors.initials: S
authors.lastname: Yue
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
authors.forename: Wen-li
authors.initials: WL
authors.lastname: Lu
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
authors.forename: Xi-lin
authors.initials: XL
authors.lastname: Yang
authors.affiliation: Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China. tangnaijun@tmu.edu.cn.
authors.forename: Nai-jun
authors.initials: NJ
authors.lastname: Tang
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016495:Police / Q000523:psychology* / Q000706:statistics & numerical data; D024382:Professional Role / Q000523:psychology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology
keywords: Occupational stress; Police officers; Prospective cohort study; Type 2 diabetes mellitus