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TOPLINE:

High emotional demands and confrontational interactions in person-related work were associated with a substantial 15%-24% increased risk for type 2 diabetes (T2D) in both men and women, with low social support at the workplace further intensifying these associations.

METHODOLOGY:

• Although adverse psychosocial working conditions have been linked to an increased risk for T2D, the effect of person-related roles — those involving interactions with patients, customers, clients, passengers, or students — remains unexplored.
• Researchers in Sweden conducted a register-based cohort study of 2,950,186 employed individuals aged 30-60 years (50.9% women) who had no history of any type of diagnosed diabetes or a prescription of anti-diabetic medication in or before 2005 to examine the association between person-related work and the incidence of T2D.
• Three dimensions of person-related work — general contact with people, emotional demands, and confrontation ─ and the degree of workplace social support were assessed using job exposure matrices.
• Occupations with the highest levels of exposure across these dimensions for both men and women belonged to the following sectors: Healthcare, education, service industry, hospitality, social work, legal services, security services, and transportation.
• The outcome of interest was the first diagnosis of T2D, identified via inpatient and outpatient registers, the cause-of-death register, or the first prescription of anti-diabetic medication from 2006 to 2020; participants were followed up until 2020.

TAKEAWAY:

• During the study period, 216,640 individuals (60.0% men) developed T2D. Compared with those who did not develop T2D, these individuals were older, more likely to be born outside Sweden, and less educated and had lower job control.
• Among men, high exposures to emotional demands, confrontation, and general contact with people were associated with 20% (95% CI, 1.17-1.21), 15% (95% CI, 1.13-1.16), and 14% (95% CI, 1.12-1.15) increased risks for T2D, respectively.
• Women with high exposures to emotional demands and confrontation had 24% (95% CI, 1.22-1.26) and 20% (95% CI, 1.18-1.22) increased risks for T2D, respectively.
• The association of emotional demands and confrontation with the risk for T2D was stronger among employees with low workplace social support than among those with high support, peaking among women facing high emotional demands and low social support (hazard ratio, 1.47; 95% CI, 1.42-1.51).

IN PRACTICE:

"Workers in human service occupations, such as healthcare professionals and social workers, take responsibility for the fundamental human needs of clients and witness human suffering, and in most cases, there is no reciprocity in relations with clients and patients. These are potential stressors that can result in compassion fatigue, burnout, and mental health problems among workers in such occupations," the authors wrote.

SOURCE:

This study was led by Kuan-Yu Pan, PhD, Karolinska Institutet, Stockholm, Sweden. It was published online on June 24, 2025, in Occupational and Environmental Medicine.

LIMITATIONS:

This study did not capture variations in individuals' experiences or work environment within specific occupations, potentially leading to the underestimation of the true associations. It used only one item to measure each dimension of person-related work. Moreover, it lacked information about participants' complete occupational history and potential job changes over time, and it could not adjust for potential confounding effects of personality traits.

DISCLOSURES:

This study was supported by AFA Insurance and the Swedish Research Council for Health, Working Life, and Welfare. The authors declared no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.