Diabetes and Cardiovascular risk factors among Oil Sector Workers in the State of Kuwait (2013 KOC Periodical Medical Exam.)

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1 Diabetes and Cardiovascular risk factors among Oil Sector Workers in the State of Kuwait (2013 KOC Periodical Medical Exam.) Mohammad Hasan, RN, CMIOSH

2 Brief about KOC Kuwait Oil Company (KOC) is a state owned subsidiary of Kuwait Petroleum Corporation (KPC) that explores, produces and exports crude oil from the State of Kuwait. With average production of 3 mill/day, it is one among the largest oil producing companies in the world. Its activities spread all over the Kuwait, with 21 Gathering Centers, 4 Booster Stations in 3 producing assets, North Kuwait (NK), West Kuwait (WK) and South and East Kuwait (SEK), and head office in Ahmadi city.

3 Background - World 1. Diabetes: One of top 6 Global Risks (World Economic Forum) 2. Global estimates of diabetes (8.7%, 420 million in 2014) 3. Associated with Coronary heart disease(especially in women) and renal failure 4. CVD risk factors include: age, ethnicity, BMI, smoking status, physical activity, hypertension, dyslipidemia (abnormal, HDL, LDL, cholesterol, triglycerides)

4 Background Kuwait & Oil industry 1. Kuwait general population: High levels of diabetes Type II: 6 th in world ~ International Disease Federation, Prevalence specifically among Kuwaitis: 14.6% ~ World Health Survey of Kuwait, WHSK(2013) 17.9% ~ Alarouj et al.,(2013) 3. Oil industry prevalence and CVD associations mostly unexplored; Asi (2003) explored diabetes prevalence only 4. Overall AIM(s) of this study: a) Obtain up-to-date prevalence of diabetes & b) Show associations with CVD risk factors within the Kuwait oil Company

5 Background Periodical Medical Exam (PME) 1. Ten oil companies in Kuwait: Served by Ahmadi hospital and clinics located within a maximum distance of minutes 2. Hospital provides primary and secondary health care 3. Periodical Medical Exam is a mandatory clinical exam carried out every two years. Measures clinical and non-clinical variables

6 Specific Research Objectives 1. Explore the prevalence of diabetes (Type 1 or 2) in relation to cardiovascular risk factors for Kuwaiti and Non-Kuwaiti oil sector employees (PME 2013). 2. Explore diabetes epidemiology: Develop multivariate logistic regression models of the relationship between diabetes in relation to cardiovascular risk factors among these employees 3. Compare results of the PME 2013 to other surveys: e.g. Previous oil sector survey (PME, ASI (2003))

7 Ethical Considerations Ethical Approval sought and obtained from the Medical Group in January 2015

8 Design: Recruitment/ Sampling: Measures: Data Collection period: Data Sources: Methodology A cross sectional study of 7000 employees of a major oil company (94% of employee population included, ~5% did not do blood investigation due to unavailability of reagents) This was a mandatory health survey which all employees had to undertake Clinical: (blood samples/physician meeting) Non-clinical: (weight, height and medically diagnosed conditions) 1 st April st March 2014 Company employee database, clinic, lab (after fasting)

9 PME 2013: Results Objective 1: Diabetes Prevalence etc. Prevalence of diabetes: 15.6% Physical inactivity: 30.3% Prevalence of obesity: 33.3% Hypertension: 14.8%

10 Results Objective 2: Diabetes Epidemiology / Risk Factors In a multivariate analysis (controlling for all other variables), increased risk of diabetes was significantly associated with: 1. Advancing age (ref=<40): OR: (Total: 7.45) 2. Hypertension (ref=normal): OR: (Total: 3.27; Female: 6.10; Male: 2.99) 3. Obesity (ref=normal): OR: (Total: 2.16) 4. High triglycerides (ref=normal): OR: (Total: 2.00) 5. Male gender (ref=female): OR: (Total: 1.67) 6. Physical inactivity (ref=active): OR (Total: 1.33)

11 Results Objective 3: Comparison of PME 2003 & PME 2013 Diabetes/ Risk Factor PME 2003 % PME 2013 % p-value Diabetes Hypertension <.001 Overweight <.001 Obesity <.001

12 Limitations of study PME 2013: - Cross-sectional study - Type I and Type II diabetes not distinguished Comparisons of PME 2013 with other studies: - Different measures of diabetes were used - Different risk factors were used - Different risk factor measurement scales were used

13 Conclusions Among cardiovascular Risk Factors in the Kuwait Oil Industry: Hypertension remains high (15-17%) Hypertension is particularly important predictor of diabetes, especially in women Health behaviours did not show expected (i.e. smoking) or consistent (i.e. physical activity) associations with diabetes, across gender and nationality The full opportunities of the PME (a mandatory potentially longitudinal study), have yet to be taken advantage of

14 Possible Implications Because of different prevalence's and risk factors and different associations of CVD risk factors with prevalence's, a tailored demographic-specific approach to interventions is suggested. Some associations need to be better understood in certain sub-groups i.e. associations with health behaviours smoking/physical activity.

15 Questions Thanks for listening. Any questions? Hasan, M. (2015). Exploration of Diabetes and Cardiovascular risks factors among Oil Sector Workers in the State of Kuwait: the 2013 Periodical Medical Exam and comparisons to the general population. Msc. Thesis.

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