Does Occupation Impact Diabetes Mortality? 

In South Africa, diabetes mellitus (DM) is an escalating non-communicable disease (NCD) and a leading cause of death.

Diabetes mellitus is characterised by a chronic hyperglycemia-induced triad of symptoms (polydipsia, polyuria and polyphagia) caused by elevated blood glucose levels and metabolic dysregulation.

In 2009, more than 2 million people aged 30 years and older were diagnosed with DM. This is attributable to several factors such as South Africa’s increased urbanisation and unhealthy lifestyle behaviors including poor nutritional intake and a lack of exercise.

There seems to be a possibility that workplace factors, such as stress attributable to physically strenuous work and erratic working hours, can potentially impede optimal self-management, thereby contributing to an elevated risk of adverse health effects.

This study aimed to identify those occupations associated with an increased risk of DM mortality in South Africa.

Materials and Methods

The South African Standard Classification of Occupations (SASCO) categorises occupations hierarchically into four groups namely: major group, sub-major group, minor group and unit group. There are nine major groups, which are the broadest level of job classification.

For this analysis major occupation group data in the StatsSA mortality dataset was used. Data collected from the working-age population, 16—76 years and older, for the periods 2009—2016 were included in this analysis.

Results

From 2009 to 2016, a total of 4 147 326 deaths were recorded in South Africa. Diabetes mellitus deaths increased
from 2009 to 2016 by approximately 21%. Kwa-Zulu-Natal Province had the highest DM deaths
(48 413), followed by Gauteng Province with 31 470 DM deaths. The highest proportional DM mortalities were
recorded among those aged 56 to 65 and 66 to 70 years (8.39% and 9.8% respectively). The Indian or
Asian population group (14.4%) accounted for the highest proportion of DM deaths.

Nine major occupations were associated with increased odds of DM mortality compared to skilled agricultural
and fishery workers. The lowest increased odds were observed for the elementary occupations and unspecified
occupations groups. Plant machine operators and assemblers had the highest odds of DM mortality. This was
followed by professionals, technicians and associate professionals, and service-and-sales workers.

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