Effort-reward imbalance at work assessed at midlife and prediabetes prevalence assessed 18 years later in a prospective cohort of white-collar workers

Ann Work Expo Health. 2024 Nov 25;68(9):940-950. doi: 10.1093/annweh/wxae071.

Abstract

Objectives: Evidence suggests that workers exposed to psychosocial stressors at work from the effort-reward imbalance (ERI) model are at increased risk for type 2 diabetes mellitus (T2DM). However, evidence about the effect of ERI on prediabetes is scarce. This study aimed to examine the association between effort-reward imbalance at work, glycated hemoglobin level and the prevalence of prediabetes in women and men from a prospective cohort study.

Methods: This study was conducted among 1354 white-collar workers followed for an average of 18 years. Effort-reward imbalance at work was measured in 1999 to 2001 using a validated instrument. Glycated hemoglobin was assessed at follow-up (2015 to 2018). Differences in mean glycated hemoglobin levels were estimated with linear models. Prediabetes prevalence ratios (PRs) were computed using robust Poisson regression models.

Results: In women, those exposed to effort-reward imbalance at work at baseline had a higher prevalence of prediabetes (PR = 1.60, 95% confidence interval: 1.02-2.49) at follow-up following adjustment for sociodemographic, lifestyle-related, clinical, and other occupational risk factors. There was no difference in mean glycated hemoglobin levels.

Conclusion: Among women, effort-reward imbalance at work at midlife was associated with the prevalence of prediabetes, at older age. Preventive workplace interventions aiming to reduce the prevalence of effort-reward imbalance at work may be effective to reduce the prevalence of prediabetes among women.

Keywords: HbA1c; effort-reward imbalance; prediabetes; psychosocial stressors at work; type 2 diabetes mellitus.

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / etiology
  • Diabetes Mellitus, Type 2 / psychology
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Male
  • Middle Aged
  • Occupational Stress / epidemiology
  • Occupational Stress / psychology
  • Prediabetic State* / epidemiology
  • Prediabetic State* / psychology
  • Prevalence
  • Prospective Studies
  • Reward*
  • Risk Factors
  • Stress, Psychological / epidemiology
  • Stress, Psychological / psychology
  • Workplace / psychology

Substances

  • Glycated Hemoglobin

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