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Abstract
Objective According to the International Diabetes Federation, the most important challenge for prevention is now to identify social and environmental modifiable risk factors of diabetes. In this regard, long work hours have recently been linked with diabetes, but more high-quality prospective studies are needed. We evaluated the relationship between long work hours and the incidence of diabetes among 7065 workers over a 12-year period in Ontario, Canada.
Research design and methods Data from Ontario respondents (35–74 years of age) to the 2003 Canadian Community Health Survey were prospectively linked to the Ontario Health Insurance Plan database for physician services and the Canadian Institute for Health Information Discharge Abstract Database for hospital admissions. Our sample consisted of actively employed participants with no previous diagnoses of diabetes. Cox proportional hazard regression models were then performed to evaluate the relationship between long work hours (≥45 hours per week) and the incidence of diabetes.
Results Long work hours did not increase the risk of developing diabetes among men. However, among women, those usually working 45 hours or more per week had a significantly higher risk of diabetes than women working between 35 and 40 hours per week (HR: 1.63 (95% CI 1.04 to 2.57)). The effect was slightly attenuated when adjusted for the potentially mediating factors which are smoking, leisure time physical activity, alcohol consumption and body mass index.
Conclusion Working 45 hours or more per week was associated with an increased incidence of diabetes among women, but not men. Identifying modifiable risk factors such as long work hours is of major importance to improve prevention strategies and orient policy making.
- Occupational Health
- Epidemiology
- Sex Difference
- Public Health Promotion
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Footnotes
Contributors MG-O and PS designed the study, generated the hypotheses, and wrote the first draft. All authors contributed to the interpretation of the data and critically reviewing the paper, and approved the final version. HM did the analyses. HM had full access to anonymized data from the 2003 Canadian Community Health Survey (CCHS), the Ontario Health Insurance Plan (OHIP) database, as well as the Canadian Institute for Health Information Discharge Abstract Database (CIHI-DAD) for hospital admission. MG-O is the guarantor of this work.
Funding This work was supported by the Canadian Institutes of Health Research (CIHR), and by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions and statements expressed herein are those of the authors and not necessarily those of the CIHI. PS was supported by a Research Chair in Gender, Work and Health from the Canadian Institutes for Health Research (CIHR). RG was supported as a Clinician Scientist in the Department of Family and Community Medicine at the University of Toronto and at St Michael's Hospital. MGO held a CIHR research grant for her postdoctoral fellowship.
Conflicts of interest None declared.
Patient consent Not required.
Ethics approval Approval for the secondary data analyses was obtained through the University of Toronto, Health Sciences Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Data statement The linked data used for this study is held securely in coded form at the Institute for Clinical Evaluative Sciences (ICES). ICES is a not-for-profit research institute encompassing a secure and accessible array of Ontario's health-related data. While data sharing agreements prohibit ICES from making the data set publicly available, access may be granted to those who meet pre-specified criteria for confidentialaccess, available at www.ices.on.ca/DAS. Data will be made available to interested researchers in the same fashion in which it was made available to the authors.