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Impact of Workplace Diabetes Screening on Diabetes Detection among Formal-Sector Workers in Nigeria

Abstract

Diabetes mellitus remains an important public health concern among adults in Nigeria and contributes significantly to morbidity, cardiovascular complications, kidney disease, visual impairment, disability, and premature mortality. Formal-sector workers may be exposed to several risk factors for diabetes, including physical inactivity, unhealthy dietary patterns, overweight and obesity, prolonged sitting, work-related stress, family history, and other lifestyle-related factors. Diabetes may develop gradually without obvious symptoms, resulting in delayed diagnosis and treatment. Undetected diabetes can increase the risk of serious complications and place a substantial burden on individuals, families, employers, and the healthcare system. Early detection is therefore essential for initiating appropriate treatment, lifestyle modification, regular monitoring, and preventive care. Workplace diabetes screening provides an opportunity to bring diabetes detection services directly to formal-sector workers through occupational health programmes, periodic employee medical examinations, workplace health fairs, and wellness initiatives. Such screening may include blood glucose testing, risk assessment, body mass index measurement, blood pressure assessment, and other relevant health evaluations. However, inadequate employer support, limited screening facilities, shortage of trained healthcare personnel, irregular screening schedules, concerns about confidentiality, financial constraints, and low worker participation may limit the effectiveness of workplace diabetes screening programmes in Nigeria. Against this background, this study investigates the impact of workplace diabetes screening on diabetes detection among formal-sector workers in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Occupational Health Theory. The Health Belief Model explains how workers' perceptions of susceptibility to diabetes, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in workplace diabetes screening. The Social Ecological Model emphasizes the interaction between individual, interpersonal, organizational, community, and policy-level factors in shaping health behaviours and preventive healthcare utilization. Occupational Health Theory focuses on protecting and promoting workers' physical, mental, and social well-being through workplace-based preventive health measures and healthy working environments. Collectively, these theoretical perspectives provide a suitable framework for explaining how workplace diabetes screening may influence diabetes detection among formal-sector workers in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise formal-sector workers employed in selected public and private organizations across Nigeria. A multistage sampling technique will be used to select states, organizations, institutions, departments, and eligible workers. Workplace diabetes screening will be measured using indicators such as availability of workplace screening programmes, frequency of screening activities, blood glucose testing, diabetes risk assessment, body mass index assessment, blood pressure measurement, availability of trained healthcare personnel, availability of screening equipment, health education, screening coverage, and referral arrangements. Diabetes detection will be assessed using indicators such as abnormal blood glucose results, newly identified suspected diabetes cases, confirmed diabetes diagnoses following appropriate clinical or laboratory assessment, impaired glucose regulation where applicable, referral for further assessment, and initiation of appropriate management. Data will be collected using structured questionnaires, workplace screening registers, occupational health records, laboratory reports, employee medical examination records, referral registers, and relevant organizational documents. Descriptive statistics will be used to summarize workers' characteristics, screening coverage, blood glucose findings, and patterns of diabetes detection. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the impact of workplace diabetes screening on diabetes detection. Where appropriate, diabetes detection rates before and after implementation of workplace screening programmes may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that workplace diabetes screening has a significant positive impact on diabetes detection among formal-sector workers in Nigeria. Workers who participate in workplace diabetes screening are expected to have a higher likelihood of having previously undiagnosed diabetes or abnormal glucose levels identified than workers without access to such services. Regular workplace screening may facilitate early identification of elevated blood glucose and provide opportunities for confirmatory assessment, lifestyle modification, nutritional counselling, medical treatment, and continued monitoring. Conducting screening within the workplace may reduce time, accessibility, and convenience barriers associated with seeking preventive healthcare outside working hours. Workplace diabetes screening may also increase awareness of diabetes risk factors and encourage workers to adopt healthier lifestyles. Conversely, inadequate screening coverage, limited diagnostic resources, shortage of trained healthcare personnel, low worker participation, concerns about confidentiality, and weak referral and follow-up systems may reduce the effectiveness of workplace diabetes screening programmes. The study therefore expects accessible, regular, and well-organized workplace diabetes screening to contribute significantly to improved detection and early management of diabetes among formal-sector workers in Nigeria. The study is expected to contribute to the literature on workplace diabetes screening, diabetes detection, occupational health, employee wellness, non-communicable disease prevention, workplace health promotion, preventive healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Labour and Employment, employers, human resource managers, occupational health practitioners, healthcare providers, workplace health and safety officers, trade unions, development partners, and policymakers regarding strategies for improving diabetes prevention and detection among formal-sector workers. The study will also provide evidence-based recommendations for expanding workplace diabetes screening programmes, improving access to affordable blood glucose testing, strengthening employee health education, increasing availability of trained healthcare personnel and screening equipment, protecting confidentiality of screening results, strengthening referral and follow-up systems, promoting healthy workplace environments, and integrating diabetes screening into comprehensive workplace health promotion programmes across Nigeria.

Keywords: Workplace diabetes screening, diabetes detection, formal-sector workers, diabetes mellitus, blood glucose screening, occupational health, employee wellness, workplace health promotion, non-communicable diseases, preventive healthcare, Nigeria, public health.