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Health & safety KateWalker, Director at Diabetes Safety Organisation (DSO), says that the rapid increase in the number of people with diabetes means that it is very likely that some employees on site will have the condition. Employers, therefore, must understand the risks and know how to support affected employees and their colleagues. DIABETES: THE INVISIBLE EPIDEMIC CREATING MAJOR HEALTH AND SAFETY RISKS 14 www.thefis.org F or those of us who don’t have diabetes, we may think of the condition as an annoyance to everyday life – having to inject or take insulin, having to watch what we eat and sacrificing sugary treats. But for those who do have the condition, diabetes can be a daily tightrope: continuously balancing diet and medication levels against the risk of a hypoglycaemic (‘hypo’) episode. A hypo is where the body’s blood sugar levels drop too low. Symptoms range in severity, from palpitations, sweating, blurred vision, loss of sensation in hands and feet, dizziness, shaking and tremors to seizures, loss of consciousness and even death. Clearly, even a mild hypo incident for a worker onsite is a danger. Hypos can cause loss of control of machinery and equipment, falls, driving accidents and other serious injuries, to the person with diabetes, to their colleagues and to the public. That’s what makes the global diabetes epidemic such a significant health and safety risk for employers. In the UK, one in 11 people have diabetes, and one in three people are estimated to be ‘pre-diabetic’. This is growing fast: Diabetes UK estimates that the number of people with diabetes will increase from 4.6 million currently to 5.5 million people by 2030. Almost one million people with diabetes right now do not know they have it. Diabetes is a serious condition because of the large number of related conditions that people with diabetes are at increased risk of: heart disease, stroke, cancer, liver disease. Diabetes is the leading cause of non-accidental blindness. There are 170 amputations a week due to diabetes. 75% of men with diabetes suffer from erectile dysfunction. To prevent or delay these conditions from developing, people with diabetes take medication, often insulin, to help reduce the body’s blood sugar levels. The more aggressively you can medicate diabetes and keep blood sugar low, the more you can delay and prevent these conditions. However, the higher the levels of medication the higher risk of a hypo. This is the daily tightrope walked by many people with diabetes. Rapid growth of diabetes Recent research has attempted to quantify the number and severity of hypos that people with diabetes experience. The data is alarming. For every 1,000 employees, 93 will have diabetes and 28 will be at risk of a hypo. This results in an estimated 48 mild hypos per month, and three to six severe hypos – i.e. a hypo which requires assistance from another person – per month. Diabetes is often described as the “invisible epidemic” because its rapid growth is not matched by public awareness and so many people with diabetes do not know they have the disease until serious conditions develop. Diabetes is also currently invisible in health and safety data: incidents that are caused by diabetes are rarely attributed to diabetes. Understanding diabetes risks at work Health and safety legislation requires that employers do what is reasonably practical to ensure the health and safety of their employees and the public. This means understanding and mitigating the risks of diabetes in the workplace. People with diabetes must also comply with certain driving regulations prescribed by the UK’s driving authority, the DVLA. This is particularly important for organisations that employ drivers – a large national delivery and logistics company recently realised their driving shift patterns did not allow employees with diabetes to manage their condition effectively and were non- compliant with DVLA regulations. Recent health and safety incidents involving diabetes have also been accompanied by significant legal costs to employers, where employers have failed to understand and mitigate diabetes risks and provide support to employees with diabetes to manage their condition. Supporting employees Not every person who has diabetes will experience hypos and it is important that the condition is not stigmatised. In some instances, diabetes is considered a disability so it is important that employers ensure employees with diabetes are not discriminated against, as this would contravene UK equality legislation. Instead, employers need to create supportive workplaces which encourage people with diabetes to disclose this and to be comfortable to tell colleagues. The most important way of reducing hypo risk in the workplace is through awareness training. During a severe hypo,