Diabetes mellitus; prevalansı gittikçe artan, multifaktöriyel etkilenimi olan bir metabolizma bozukluğudur. Tedavi sürecinin iyi yönetilmemesi hâlinde komplikasyonlar gelişir. Hastanın hem sosyal yaşamı hem de iş yaşamı olumsuz etkilenir. Diyabet gelişimini kolaylaştıran düzeltilebilir faktörlerin bilinmesi, hastanın bu konuda eğitilmesi, hastalığın gelişmesinin geciktirilmesi ve önlenmesi için önemlidir. Son yüzyılda üretim, imalat, işleme, inşaat ve hizmet sektörü gibi birçok iş kolunda çalışan nüfus artmıştır. Artan endüstriyel üretim, aynı zamanda iş yaşamında rekabet ortamı, daha yoğun ve stresli çalışma koşulları, çalışanların kaygı düzeylerinde ve iş streslerinde artışı da beraberinde getirmiştir. Çalışanlar, günlerinin büyük bir kısmını iş yerinde geçirmektedir. Çalışma hayatının tümüyle riskten arındırılması çoğu zaman mümkün değildir; önemli olan, ortamdaki risklerin etkili şekilde kontrol altına alınması, çalışanların sağlığının korunmasıdır. Diyabet gelişimi ve seyri çevresel birçok faktörden etkilenmektedir. Bu nedenle iş yerindeki sağlık ve güvenlik tehlikelerinin (fiziksel risk etmenleri, kimyasal risk etmenleri, stres, vardiyalı çalışma vb.) değerlendirilmesi ve kontrol altına alınması son derece önemlidir. Mesleki maruziyetlerin diyabet hastalığı üzerine etkileri olduğu gibi diyabet hastalığının da çalışanın iş yaşamı üzerinde etkileri vardır. Çalışanın iş gücünde azalmalara, presentizm de artışa neden olabilmekte, ayrıca mikrovasküler ve makrovasküler komplikasyonlara bağlı olarak iş kazaları daha sık görülmektedir. Bunun için diyabetli bir çalışanın yapmakta olduğu işe uygunluğunun belirlenmesi, çalışma koşullarının düzeltilebilmesi için iş ortamında yapılabilecek düzenlemeler ve periyodik muayenelerinde dikkat edilecek hususlar önem taşımaktadır.
Anahtar Kelimeler: Diabetes mellitus; mesleki maruziyetler; iş sağlığı
Diabetes mellitus is a metabolic disorder with a multifactorial effect, the prevalence of which is increasing gradually. If the treatment process is not managed carefully, complications develop. Both the social and working life of the patients are adversely affected. Learning the correctable factors that facilitate the development of diabetes and educating the patient on this issue are important for delaying and preventing the development of the disease. In the last century, the population working in many employment sectors such as production, manufacturing, processing, construction and service sectors has increased. Increasing industrial production has also brought with the competitive environment in working life, more intense and stressful working conditions, increasing in the anxiety levels and work stress of the employees. Employees spend most of their day at work. It isn't often possible to completely eliminate risks from the working life, the important thing is to effectively control the risks in the environment and to protect the health of the employees. The development and follow-up of diabetes is affected by many environmental factors. For this reason, it is extremely important to evaluate and control health and safety hazards (physical risk factors, chemical risk factors, stress, shift work, etc.) in the workplace. As occupational exposures have effects on diabetes, diabetes also has effects on the working life of the employees. It can cause reductions in the workforce and an increase in presentism, and occupational accidents are more common due to microvascular and macrovascular complications. For this, it is important to determine the suitability of employees with diabetes for the job which they are doing, the arrangements that can be made in the work environment in order to improve the working conditions and the points to be considered in the periodic examinations.
Keywords: Diabetes mellitus; occupational exposure; occupational health
- Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu. 14. Baskı. Ankara: TEMD; 2020. Erişim tarihi: 24 Kasım 2021. Erişim linki: [Link]
- International Diabetes Federation [Internet]. © 2022 International Diabetes Federation [Cited: November 4, 2021]. About diabetes-Diabetes facts and figures. Available from: [Link]
- Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28(2):169-80. [Crossref] [PubMed] [PMC]
- UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ. 1998;317(7160):703-13. [Crossref] [PubMed] [PMC]
- Bilir N. İş Sağlığı ve Güvenliğinde Genel İlkeler. İş sağlığı ve Güvenliği. 2. Baskı. Ankara: Güneş Tıp Kitabevleri; 2019.
- Ariemma F, D'Esposito V, Liguoro D, Oriente F, Cabaro S, Liotti A, et al. Low-dose bisphenol-A impairs adipogenesis and generates dysfunctional 3T3-L1 adipocytes. PLoS One. 2016;11(3):e0150762. [Crossref] [PubMed] [PMC]
- Hwang S, Lim JE, Choi Y, Jee SH. Bisphenol A exposure and type 2 diabetes mellitus risk: a meta-analysis. BMC Endocr Disord. 2018;18(1):81. [Crossref] [PubMed] [PMC]
- Resmî Gazete (31.5.2016, 26200) 5510 sayılı Sosyal Sigortalar ve Genel Sağlık Sigortası Kanunu. Erişim tarihi: 24 Kasım 2021.Erişim linki: [Link]
- Resmî Gazete (20.6.2012, 28339) 6331 sayılı İş Sağlığı ve Güvenliği Kanunu. Erişim tarihi: 24 Kasım 2021. Erişim linki: [Link]
- Şimşek C. Giriş. Meslek Hastalıkları ve İş ile İlgili Hastalıklar Tanı Rehberi. Ankara: T.C. Çalışma ve Sosyal Güvenlik Bakanlığı; 2012. p.9-10. Erişim tarihi: 24 Kasım 2021. Erişim linki: [Link]
- Careghini A, Mastorgio AF, Saponaro S, Sezenna E. Bisphenol A, nonylphenols, benzophenones, and benzotriazoles in soils, groundwater, surface water, sediments, and food: a review. Environ Sci Pollut Res Int. 2015;22(8):5711-41. [Crossref] [PubMed] [PMC]
- Akyüz S, Yarat A, Egil E. Bisfenol-A içerikli dental materyallere güncel yaklaşım [Dental materials containing bisphenol-A: current approach]. Clinical and Experimental Health Sciences. 2011;1(3):190-5. [Link]
- Quitmeyer A, Roberts R. Babies, bottles, and bisphenol A: the story of a scientist-mother. PLoS Biol. 2007;5(7):e200. [Crossref] [PubMed] [PMC]
- Rosenfeld CS. Bisphenol A and phthalate endocrine disruption of parental and social behaviors. Front Neurosci. 2015;9:57. [Crossref] [PubMed] [PMC]
- United States Environmental Protection Agency. Arsenic, inorganic (CASRN 7440-38-2): Carcinogenicity assessment for life time exposure. Washington, DC: Integrated Risk Information System (IRIS), U.S. Environmental Protection Agency; 1998. Cited: November 24, 2021. Available from: [Link]
- ATSDR. Toxicological profile for arsenic. Atlanta, GA: Agency for Toxic Substances and Disease Registry. U.S. Department of Health and Human Services, Public Health Service; 2007. [Link]
- Gomez-Caminero A, Howe P, Hughes M, Kenyon E, Lewis DR, Moore M. et al. Arsenic and arsenic compounds. Geneva: World Health Organization; 2001. Cited: November 24, 2021. Available from: [Link]
- Kirkley AG, Carmean CM, Ruiz D, Ye H, Regnier SM, Poudel A, et al. Arsenic exposure induces glucose intolerance and alters globalenergy metabolism. Am J Physiol Regul Integr Comp Physiol. 2018;314(2):R294-303. [Crossref] [PubMed] [PMC]
- He K, Xun P, Liu K, Morris S, Reis J, Guallar E. Mercury exposure in young adulthood and incidence of diabetes later in life: the CARDIA Trace Element Study. Diabetes Care. 2013;36(6):1584-9. [Crossref] [PubMed] [PMC]
- Buha A, Đukić-Ćosić D, Ćurčić M, Bulat Z, Antonijević B, Moulis JM, et al. Emerging links between cadmium exposure and insulin resistance: human, animal, and cell study data. Toxics. 2020;8(3):63. [Crossref] [PubMed] [PMC]
- Guo FF, Hu ZY, Li BY, Qin LQ, Fu C, Yu H, et al. Evaluation of the association between urinary cadmium levels below threshold limits and the risk of diabetes mellitus: a dose-response meta-analysis. Environ Sci Pollut Res Int. 2019;26(19):19272-81. [Crossref] [PubMed]
- Xiao L, Li W, Zhu C, Yang S, Zhou M, Wang B, et al. Cadmium exposure, fasting blood glucose changes, and type 2 diabetes mellitus: a longitudinal prospective study in China. Environ Res. 2021;192:110259. [Crossref] [PubMed]
- Cempel M, Nikel G. Nickel: a review of its sources and environmental toxicology. Polish J Environ Stud. 2006;15(3):375-82. [Link]
- Haber LT, Erdreicht L, Diamond GL, Maier AM, Ratney R, Zhao Q, et al. Hazard identification and dose response of inhaled nickel-soluble salts. Regul Toxicol Pharmacol. 2000;31(2 Pt 1):210-30. [Crossref] [PubMed]
- Sarkar B. Heavy Metals in the Environment. 1st ed. New York: CRC Press; 2002. [Crossref]
- Li G, Hu Y, Pan X. Prevalence and incidence of NIDDM in Daqing City. Chin Med J (Engl). 1996;109(8):599-602. [PubMed]
- Gu D, Reynolds K, Duan X, Xin X, Chen J, Wu X, et al. Prevalence of diabetes and impaired fasting glucose in the Chinese adult population: International Collaborative Study of Cardiovascular Diseasein Asia (InterASIA). Diabetologia. 2003;46(9):1190-8. [Crossref] [PubMed]
- Chen YW, Yang CY, Huang CF, Hung DZ, Leung YM, Liu SH. Heavy metals, islet function and diabetes development. Islets. 2009;1(3):169-76. [Crossref] [PubMed]
- Kubrak OI, Rovenko BM, Husak VV, Storey JM, Storey KB, Lushchak VI. Nickel induces hyperglycemia and glycogenolysis and affects the antioxidant system in liver and white muscle of goldfish Carassius auratus L. Ecotoxicol Environ Saf. 2012;80:231-7. [Crossref] [PubMed]
- Kadota I, Kurita M. Hyperglycemia and islet cell damage caused by nickelous chloride. Metabolism. 1955;4(4):337-42. [PubMed]
- Carta-à J, Arola L. Nickel-induced hyperglycaemia: the role of insulin and glucagon. Toxicology. 1992;71(1-2):181-92. [Crossref] [PubMed]
- Tikare SN, Das Gupta A, Dhundasi SA, Das KK. Effect of antioxidants L-ascorbic acid and alpha-tocopherol supplementation in nickel exposed hyperglycemic rats. J Basic Clin Physiol Pharmacol. 2008;19(2):89-101. [Crossref] [PubMed]
- Liu G, Sun L, Pan A, Zhu M, Li Z, Zhen zhen Wang Z, et al. Nickel exposure is associated with the prevalence of type 2 diabetes in Chinese adults. Int J Epidemiol. 2015;44(1):240-8. [Crossref] [PubMed]
- Dzhambov AM. Long-term noise exposure and the risk for type 2 diabetes: a meta-analysis. Noise Health. 2015;17(74):23-33. [Crossref] [PubMed] [PMC]
- Sørensen M, Andersen ZJ, Nordsborg RB, Becker T, Tjønneland A, Overvad K, et al. Long-term exposure to road traffic noise and incident diabetes: a cohort study. Environ Health Perspect. 2013;121(2):217-22. [Crossref] [PubMed] [PMC]
- Eriksson C, Hilding A, Pyko A, Bluhm G, Pershagen G, Östenson CG. Long-term aircraft noise exposure and body mass index, waist circumference, and type 2 diabetes: a prospective study. Environ Health Perspect. 2014;122(7):687-94. [Crossref] [PubMed] [PMC]
- Kacem I, Kahloul M, Maoua M, Hafsia M, Brahem A, Limam M, et al. Occupational noise exposure and diabetes risk. J Environ Public Health. 2021;2021:1804616. [Crossref] [PubMed] [PMC]
- Meo SA, Alsubaie Y, Almubarak Z, Almutawa H, AlQasem Y, Hasanato RM. Association of exposure to radio-frequency electromagnetic field radiation (RF-EMFR) generated by mobile phone base stations with glycated hemoglobin (HbA1c) and risk of type 2 diabetes mellitus. Int J Environ Res Public Health. 2015;12(11):14519-28. [Crossref] [PubMed] [PMC]
- Sirinivasan K, Mohan S, Raj T JB. Occupational heat stress: a tecnical scan. Occupational Health. 5th ed. IntechOpen; 2020. [Crossref]
- Björntorp P. Body fat distribution, insulin resistance, and metabolic diseases. Nutrition. 1997;13(9):795-803. [Crossref] [PubMed]
- Björntorp P. Visceral fat accumulation: the missing link between psychosocial factors and cardiovascular disease? J Intern Med. 1991;230(3):195-201. [Crossref] [PubMed]
- Smith LCJ, Weinger K. Stress and diabetes: a review of the links. Diabetes Spectrum. 2005;18(2):121-7. [Crossref]
- Antunes LC, Levandovski R, Dantas G, Caumo W, Hidalgo MP. Obesity and shift work: chronobiological aspects. Nutr Res Rev. 2010;23(1):155-68. [Crossref] [PubMed]
- McCubbin JA, Pilcher JJ, Moore DD. Blood pressure increases during a simulated night shift in persons at risk for hypertension. Int J Behav Med. 2010;17(4):314-20. [Crossref] [PubMed]
- Gangwisch JE, Feskanich D, Malaspina D, Shen S, Forman JP. Sleep duration and risk for hypertension in women: results from the nurses' health study. Am J Hypertens. 2013;26(7):903-11. [Crossref] [PubMed] [PMC]
- Waldhauser F, Dietzel M. Daily and annual rhythms in human melatonin secretion: role in puberty control. Ann N Y Acad Sci. 1985;453:205-14. [Crossref] [PubMed]
- Claustrat B, Brun J, Chazot G. The basic physiology and pathophysiology of melatonin. Sleep Med Rev. 2005;9(1):11-24. [Crossref] [PubMed]
- Picinato MC, Hirata AE, Cipolla-Neto J, Curi R, Carvalho CR, Anhê GF, et al. Activation of insulin and IGF-1 signaling pathways by melatonin through MT1 receptor in isolated rat pancreatic islets. J Pineal Res. 2008;44(1):88-94. [Crossref] [PubMed]
- Bonnefond A, Clément N, Fawcett K, Yengo L, Vaillant E, Guillaume JL, et al; Meta-Analysis of Glucose and Insulin-Related Traits Consortium (MAGIC). Rare MTNR1B variants impairing melatonin receptor 1B function contribute to type 2 diabetes. Nat Genet. 2012;44(3):297-301. [Crossref] [PubMed] [PMC]
- Morikawa Y, Nakagawa H, Miura K, Soyama Y, Ishizaki M, Kido T, et al. Shift work and the risk of diabetes mellitus among Japanese male factory workers. Scand J Work Environ Health. 2005;31(3):179-83. [Crossref] [PubMed]
- Rajagopalan S, Brook RD. Air pollution and type 2 diabetes: mechanistic insights. Diabetes. 2012;61(12):3037-45. [Crossref] [PubMed] [PMC]
- Krämer U, Herder C, Sugiri D, Strassburger K, Schikowski T, Ranft U, et al. Traffic-related air pollution and incident type 2 diabetes: results from the SALIA cohort study. Environ Health Perspect. 2010;118(9):1273-9. [Crossref] [PubMed] [PMC]
- Pearson JF, Bachireddy C, Shyamprasad S, Goldfine AB, Brownstein JS. Association between fine particulate matter and diabetes prevalence in the U.S. Diabetes Care. 2010;33(10):2196-201. [Crossref] [PubMed] [PMC]
- Fabricio G, Malta A, Chango A, De Freitas Mathias PC. Environmental contaminants and pancreatic beta-cells. J Clin Res Pediatr Endocrinol. 2016;8(3):257-63. [Crossref] [PubMed] [PMC]
- Meo SA, Al-Khlaiwi T, Abukhalaf AA, Alomar AA, Alessa OM, Almutairi FJ, et al. The nexus between workplace exposure for wood, welding, motor mechanic, and oil refinery workers and the prevalence of prediabetes and type 2 diabetes mellitus. Int J Environ Res Public Health. 2020;17(11):3992. [Crossref] [PubMed] [PMC]
- Meo SA, Muneif YAB, BenOmran NA, AlSadhan MA, Hashem RF, Alobaisi AS. Prevalence of pre diabetes and type 2 diabetes mellitus among cement industry workers. Pak J Med Sci. 2020;36(2):32-6. [Crossref] [PubMed] [PMC]
- Ganesan S, Sangeetha R, Arivazhagan R, Swaminathan S. Exposure to coal mine dust predisposes mine workers to oxidative stress and diabetes mellitus. Research Journal of Pharmacy and Technology. 2009;12(9):4107-10. [Crossref]
- American Diabetes Association. Economic costs of diabetes in the U.S. in 2017. Diabetes Care. 2018;41(5):917-28. [Crossref] [PubMed] [PMC]
- Tabano DC, Anderson ML, Ritzwoller DP, Beck A, Carroll N, Fishman PA, et al. Estimating the ımpact of diabetes mellitus on worker productivity using self-report, electronic health record and human resource data. J Occup Environ Med. 2018;60(11):e569-74. [Crossref] [PubMed] [PMC]
- Herquelot E, Guéguen A, Bonenfant S, Dray-Spira R. Impact of diabetes on work cessation: data from the GAZEL cohort study. Diabetes Care. 2011;34(6):1344-9. [Crossref] [PubMed] [PMC]
- Robinson N, Yateman NA, Protopapa LE, Bush L. Employment problems and diabetes. Diabet Med. 1990;7(1):16-22. [Crossref] [PubMed]
- Anderson JE, Greene MA, Griffin JW Jr, Kohrman DB, Lorber D, et al; American Diabetes Association, Diabetes and employment. Diabetes Care. 2014;37 Suppl 1:S112-7. [Crossref] [PubMed]
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