Epilepsy, diabetes mellitus and accidental injury at work

A community based survey was undertaken to assess the work record of patients with epilepsy in an area of high unemployment. One hundred and thirty seven epileptic patients were identified from a population of 23,837 persons of employable age registered with three urban group practices in North East England. The unemployment rate for economically active patients with epilepsy was 46% compared with 19% for an age and sex matched control population (p less than 0.01). Fifty nine per cent of patients with active epilepsy were unemployed. In those with an associated neurological or psychiatric handicap and those who were unskilled manual workers the unemployment rates were 79% and 77%, respectively. Patients with epilepsy were less likely to leave school with qualifications or undergo subsequent training or apprenticeships. They were more likely to be unskilled manual workers, single and living in rented accommodation. In an area of high unemployment patients with epilepsy have disproportionately greater difficulty finding work. High unemployment rates among patients with epilepsy are only one aspect of a spectrum of social and economic disadvantage.

One area of life quality known to be compromised by having epilepsy is employment, and one factor contributing to the employment problems of people with epilepsy (PWE) is employer attitudes. Much research on this topic is now outdated and given the changing legal, medical, and social contexts in which PWE live, we therefore reexamined employer attitudes in the United Kingdom.

Unemployment was examined in a random sample of diabetic clinic attenders and a group of non-diabetic control subjects aged 17-65 years, selected from eight different centres in Great Britain. Data on employment were obtained using a postal questionnaire and medical details were collected from diabetic clinic notes. Out of a 61% response rate, 22% of males and 12% of females with diabetes were unemployed compared with 8 and 5% of the control group (both p less than 0.001). A greater percentage of people with diabetes were economically inactive, that is retired, unable to work, ill or housewives compared with the control group (29 vs 14%, p less than 0.001). Young people with diabetes (16-25 years) had the highest rates of unemployment. A matched pairs analysis confirmed that diabetic men had higher unemployment rates than their controls (14 vs 7%, p less than 0.001). Comparisons were made between unemployment rates for the eight geographical areas and published unemployment statistics; unemployment rates were significantly higher for men with diabetes except at one centre. A stepwise multiple logistic regression analysis indicated that variables which were predictive of unemployment were similar to those expected for people without diabetes. Unemployment is apparently a problem for the person with diabetes, especially for the young.