Investigating the health profile of employees at a pharmaceutical company in Johannesburg

Abstract

BACKGROUND: Obesity is a pandemic that has grown dramatically over the recent thirty years. It is a disease that is associated with non-communicable diseases and is considered a public health concern. Populations in the sub-Saharan African region are particularly vulnerable to obesity and co-morbid diseases. Existing and emerging research demonstrates that employed African populations are also at risk for obesity and related cardiometabolic diseases, which can negatively impact workplace health and productivity. Further research is required to address these concerns. AIM: The master’s research project aimed to determine the health profile and risk factors associated with obesity and related cardiometabolic diseases amongst employees in a pharmaceutical company in Johannesburg, South Africa. METHODS: The study used a cross-sectional, observational study design. This study recruited 145 study participants, who were employees at Ascendis Health Supply Chain and of which 86 were female. Anthropometric data (height, weight, waist, hip, and calf circumference), automated blood pressure, total cholesterol, and random glucose were measured using standard protocols. The following self-reported questionnaires were also conducted: The Global Physical Activity Questionnaire (GPAQ) was used to determine physical activity and sitting time; estimated beverage consumption was collected with the Beverage Intake Questionnaire (BEV-Q 15), while self reported sleep duration was determined using the Pittsburgh Sleep Questionnaire Index (PSQI); the Centre for Epidemiologic Studies Depression Scale (CESD-R) was used to determine self reported depression; smoking, alcohol consumption, and basic dietary behaviour were collected using the Discovery Health Index Questionnaire; and absolute absenteeism was determined using the Health and Work Performance Questionnaire. Objective free-living data, physical activity, inactivity, and sleep were collected using Axivity wrist-worn monitors. Descriptive data were presented as mean ± standard deviation or median (interquartile range) in tables. Univariate analysis and multiple linear regression analysis were performed to determine the association of behavioural factors with anthropometry, obesity, cardiometabolic diseases, and sickness absence. vii RESULTS: The mean ± standard deviation (SD) age of the study population was 39.4 ± 10.1 years, with mean years at work for all participants being 5.9 ±7 years. The total number of sick leave days was 14.4 ± 14.2 days, with females taking more days off than males 16.4 ± 14.4 vs 11.3 ± 13.6, p = 0.032. Axivity monitors demonstrated lower MVPA and higher inactivity levels than self-reported measures, with the greatest discrepancy noted in vigorous activity (median of 2.92 (0.99 – 5.89) mins/day (objective measure) versus median of 60 (0-360) mins/day (subjective measure). Objective inactivity measures of 498.1 (450.7 – 563.8) mins/day were higher than self reported inactivity with mean of 180 (120 – 300) mins/day. Of the total study population, 34.5% had an inadequate fruit and vegetables intake per day. The overall prevalence of hypertension was 42.8%. Females presented with a mean BMI of 31.5 ± 6.96, indicative of obesity, with males showing to be overweight with a mean BMI of 26.8 ± 4.99. Altogether, 42.1% of the total population showed to be obese with a BMI >30 kg˙m² and 32.4% were at risk of obesity with a BMI between 25 and 29.9 kg˙m². The total population glucose levels were 6.47 ± 1.53, with a low prevalence of self-reported diabetes type 2 at 3.4% of the total sample size. The total prevalence of self-reported cholesterol was 6.9%, with a total population cholesterol level mean of 4.65 ± 0.68. Alcohol consumption was considerably higher in males than females (88.5 ± 185 vs 39.3 ± 109 (p = 0.047), respectively). A higher mean depression score was seen in females (8.97 ± 6.15) than 5.71 ± 4.66 in males, (p = 0.001). Females showed a higher PSQI score (6.2 ± 3.62) demonstrating lower quality of sleep when compared to males (5.08 ± 2.82, p = 0.049). However, both males and females obtained similar hours of sleep per night at a self-reported mean of 7.30 ± 1.19 hours of the total population, 42.8% struggled to cope with stress, with 31.7% indicative of depression. According to the Framingham 10-year CVD risk algorithm, a total of 21.4% of study population showed to be at a moderate – high risk of developing cardiovascular disease. Moderate to vigorous physical activity (mins/day) showed to decrease obesity risk by being inversely associated with waist circumference (β: - 0.07, p = 0.02), CVD risk (β: - 0.04, p = 0.02) and sick leave (β: - 0.26, p = 0.04). Current smoking status was positively associated with total cholesterol (β: 0.71, p = 0.005) whereas subjective light physical activity was negatively associated with total cholesterol (β: - 0.00, p = 0.01). Total years at work (β: 0.27, p = 0.02), semi-skilled work (β: 0.27, p = 0.02), depression total score (β: 0.22, p = 0.03) and subjective LPA (β: 0.25, p = 0.04), were positively associated with total sick leave. viii CONCLUSION: The findings of this study show a high prevalence of obesity and hypertension within this study population, demonstrating the need for these diseases to be addressed in the workplace. Females showed to be at a greater risk for obesity and cardiometabolic disease in comparison to males. Discrepancies were noted between subjective and objective measures of physical activity, indicative of possible overestimation for self-reported physical activity levels. Light physical activity and high depression scores were associated with sick leave, confirming the urgent need to address mental health in employees within the workplace. Interventions to reduce sugar intake, increase activity, particularly vigorous activity and address mental health in the workplace could show beneficial in reducing risk factors and possibly improve absenteeism rates.