Measuring The Non-communicable Disease Health Loss Of Workforce Among Enterprise Employees

Objective:This study intends to measure the health loss of workforce among the employees of a large oilfield in Northwest China due to non-communicable diseases(NCDs),as well as NCDs pattern and their prevalence.It tries the disability-adjusted life years(DALY)method—which was used by WHO in the global burden of disease study(GBD)—to measure the health loss among workforce of the oilfield for the purpose of providing some recommendations for the enterprise's health related decision-making and employees' personal health management.Furthermore,it is better to make some references for follow-up studies.Methods:The data sources were composed of two parts: one was death data of the enterprise in 2015,which was extracted from the social security system;and the other was survey data containing two thousand cases about non-communicable diseases of working-age employees,which was conducted through a questionnaire during November and December,2015 at the oil production area.Besides the questionnaires,we made interviews with each respondent at the oilfield.Health loss of workforce was calculated with the method of GBD 2010,mainly through disability-adjusted life years,as well as some other measurements like the prevalence of NCDs,disease duration,EQ-5D score(EQ-5D health system and the EQ-VAS),long-term medication etc.The health loss focused on those who were on their working age(male for 60 years old and female 55)and those who had retired were excluded.Disability-adjusted life years consist of two parts: YLL—years of life lost due to premature mortality—and YLD—years lived with disability.YLL was computed based on the 2015 death data from social security system and the expected working ages were 65 years and 60 years for men and women respectively(the current retirement ages for men and women are 60 and 55,respectively,and these are being pushed back in the revision of labor laws by the government).Disability weight of the NCDs referred to GBD 2010.DALY,YLD and YLL were calculated based on each individual employee with the consideration of comorbidities.EQ-5D index score was calculated based on the EQ-5D health questionnaire which was incorporated into the questionnaire.Finally,logistic regression anylysis,multiple linear regression analysis and ordinal probit analysis were used to explore the risk factors of NCDs.Results:Totally,thirty-one cases died in 2015 within the oilfield because of NCDs,with the death rate of 0.46 per thousand and an average age of 48.7 ±7.3,according to the death database.There were 765 individuals among 1964 employees included in the survey suffered from at least one kind of NCDs,with the prevalence of 39 percent and an average age of 42.2±7.7(based on disease times).The median of disease duration(right skewed distribution)was equal to 4.9(P25~P75,2.9~7.9)years.303 individuals among 765 NCDs patients had at least 2 kinds of chronic diseases,with the comorbidity prevalence of 15.4%;and 139(7.1%)employees were suffering from 3 kinds of NCDs or even more.Both EQ-5D index scores and EQ-VAS scores among the patients were significantly lower than those among the non-disease group(Mann-Whitney U test P<0.01),and the proportion of patients with chronic disease in long-term medication were large(480,24.4%).The health loss was great.From the point of disability-adjusted life years,the oilfield lost 2486.3 DALYs in 2015 due to non-communicable diseases,and 37.0 DALYs every thousand employees.31 dead cases caused a total loss of 489.5 YLLs,which resulted in 7.3 YLLs per thousand according to the number of whole staff.There were 58.3 YLDs occurred among the 1964 respondents,with an average loss of 29.7 YLDs per thousand.Health loss for men and women were 31.7 YLDs per thousand employees and 27.2 per thousand employees respectively,with males 4.5 YLDs more than females.While compared with Chinese general public in 2010(about 67.1 YLDs per thousand),the oil workers YLD loss were much lower,even less than half of ordinary residents.Though most NCDs were consistent with this trend,urolithiasis and peptic ulcer disease(gastric ulcer,intestinal ulcer)caused more YLDs among the workers than the general public,with the former even astonishingly 54 times and 1.3 times higher than the later.The three most prevalent NCDs were hypertension(8.1%),hyperlipidemia(8.1%)and osteoporosis(5.5%);while neoplasm,gout,urolithiasis,and coronary heart disease had the greatest burden in terms of YLDs;YLLs were primarily caused by neoplasms,cardiovascular and cerebrovascular diseases,and pulmonary diseases.No matter prevalence and DALYs,they all increased steadily with age in most sub-plants.Regression analysis showed that age,smoking,drinking,mental stress and poor sleep quality etc.were significantly associated with chronic conditions.Conclusion:Disability-adjusted life years based on individual calculation can be used to measure the health loss of employees.This study showed high prevalence of NCDs among the oilfield employees,so we recommend health administrators to implement specific prevention and control measures for different NCDs: measures for hypertension,hyperlipidemia and osteoporosis,etc.are better focused on reducing prevalence among the whole population,whereas for neoplasms,car diovascular and cerebrovascular diseases,musculoskeletal disorders and lung diseases,etc.interventions are better aimed at providing comprehensive medical care and relevant support for patients by medical institutions,families and through self-management to minimize the impact of the disease.The oilfield should better create a good production and living environment for their employees and advocate a healthy lifestyle.Meanwhile,it is better to improve the disease monitoring system and strengthen the health data management.