Occupations and work-related factors in relation to the incidence of type 2 diabetes: an exploratory study among 274,662 Dutch workers.

INTRODUCTION: This study aimed to explore occupations at risk of type 2 diabetes and investigate associations between work-related factors (ie, night shift work, psychosocial factors and physical demands) and the risk of developing type 2 diabetes. METHODS: Self-reported data on demographics, current occupation (ISCO-08) and work-related factors from 274 662 Dutch workers were retrieved from the annual Netherlands Working Conditions Survey (2014-2021). These data were linked to Statistics Netherlands' register of dispensed medication to obtain information on initiation of diabetes medication, which was used to define incident type 2 diabetes. Occupations at highest risk of developing diabetes were identified using LASSO (least absolute shrinkage and selection operator) models with complementary pairs stability selection. Cox models were used to determine HRs for the identified occupations and to study the association between the work-related factors and the incidence of type 2 diabetes. RESULTS: During a median follow-up of 2.2 years (711 991 person-years), 3044 workers developed type 2 diabetes. Occupations at highest risk of developing type 2 diabetes included professional drivers (including car, taxi and van drivers), security guards and assembling labourers (HR (95% CI) compared with all other occupations: 1.94 (1.46 to 2.57), 1.80 (1.36 to 2.38) and 1.88 (1.31 to 2.70), respectively). Workers who sometimes or often worked night shifts had a higher risk of type 2 diabetes than those who never did (HR (95% CI) 1.16 (1.03 to 1.31) and 1.14 (1.00 to 1.30), respectively), as did workers with low job autonomy (HR (95% CI) 1.14 (1.06 to 1.23)) or high emotional job demands (HR (95% CI) 1.20 (1.07 to 1.36)). No associations were observed for psychological job demands or physical work demands. The investigated work-related factors did not fully explain the associations between identified occupations and risk of developing type 2 diabetes. CONCLUSION: This study identified specific occupations and work-related factors associated with an increased risk of developing type 2 diabetes.