Epilepsy, diabetes mellitus and accidental injury at work

• Published in: Occupational medicine (Oxford) Vol. 64; no. 6; pp. 448 - 453
• Main Authors: PALMER, K. T, D'ANGELO, S, HARRIS, E. C, LINAKER, C, COGGON, D
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.09.2014
• Subjects: Adolescent; Adult; Biological and medical sciences; Case-Control Studies; Diabetes Mellitus - drug therapy; Diabetes Mellitus - physiopathology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Epilepsy - complications; Epilepsy - drug therapy; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Hypoglycemic Agents - therapeutic use; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Occupational Injuries - drug therapy; Occupational Injuries - etiology; Occupational Injuries - prevention & control; Occupational medicine; Public health. Hygiene-occupational medicine; United Kingdom - epidemiology; United Kingdom; Europe; Endocrinopathy; Human; Nervous system diseases; Personal injury; Injury; Diabetes mellitus; Epilepsy; Case control study; Epidemiology; Trauma; Cerebral disorder; Occupational accident; Central nervous system disease; Risk factor; diabetes; Occupational medicine; Accidents; epilepsy; injury
• ISSN: 0962-7480; 1471-8405
• DOI: 10.1093/occmed/kqu079

To assess the contribution of epilepsy and diabetes to occupational injury. The Clinical Practice Research Datalink logs primary care data for 6% of the British population, coding all consultations and treatments. Using this, we conducted a population-based case-control study, identifying patients aged 16-64 years, who had consulted over two decades for workplace injury, plus matched controls. By conditional logistic regression, we assessed risks for diabetes and epilepsy overall, several diabetic complications and indices of poor control, occurrence of status epilepticus and treatment with hypoglycaemic and anti-epileptic agents. We identified 1348 injury cases and 6652 matched controls. A total of 160 subjects (2%) had previous epilepsy, including 29 injury cases, whereas 199 (2.5%) had diabetes, including 77 with eye involvement and 52 with a record of poor control. Odds ratios (ORs) for occupational injury were close to unity, both in those with epilepsy (1.07) and diabetes (0.98) and in those prescribed anti-epileptic or hypoglycaemic treatments in the previous year (0.87-1.16). We found no evidence of any injury arising directly from a seizure and no one had consulted about their epilepsy within 100 days before their injury consultation. Two cases and six controls had suffered status epilepticus (OR versus never had epilepsy 1.61). Risks were somewhat higher for certain diabetic complications (OR 1.44), although lower among those with eye involvement (OR 0.70) or poor diabetic control (OR 0.50). No associations were statistically significant. No evidence was found that diabetes or epilepsy are important contributors to workplace injury in Britain.