Prevalence and predictors of infected diabetic foot ulcers (DFU) and DFU-related osteomyelitis amongst industrial workers wearing occupational safety footwear
Abstract Professionals like deep-miners and factory-workers wear specialized safety-shoes to protect against occupational hazards (OF). The risk factors, clinico-microbiologic profile and complications of diabetic foot ulcers (DFU) in these professionals remain unexplored. A cross-sectional observat...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-025-86013-y |
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| author | Sunetra Mondal Moushumi Lodh Sambit Sahoo Kaushik Paul Debasis Biswas Chaitanya Krishna Ashok Parida Arunangshu Ganguly Riddhi DasGupta |
| author_facet | Sunetra Mondal Moushumi Lodh Sambit Sahoo Kaushik Paul Debasis Biswas Chaitanya Krishna Ashok Parida Arunangshu Ganguly Riddhi DasGupta |
| author_sort | Sunetra Mondal |
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| description | Abstract Professionals like deep-miners and factory-workers wear specialized safety-shoes to protect against occupational hazards (OF). The risk factors, clinico-microbiologic profile and complications of diabetic foot ulcers (DFU) in these professionals remain unexplored. A cross-sectional observational study was conducted to describe the unique clinico-microbiologic profile of DFU in those wearing occupational-footwear (OF) and find risk factors for DFU related osteomyelitis in them. Of 331 DFU cases seen over 5 years, those wearing OF (n = 107, 68 underground-miners and 39 steel-factory-workers) had high prevalence of forefoot-DFU (81.3%), dorsal-DFU ( 58.9%), recurrent-DFU (31.8%) and of polymicrobial infections (16.8%). Those with osteomyelitis in the OF group ( n = 53) were younger (53.3 vs. 57, p = 0.02), had higher prevalence of peripheral arterial disease (41.5% vs. 24.1%), past-amputation (28.3% vs. 11.1%), higher SINBAD scores, and were also less likely to change occupational-footwear at < = 6-month-interval (22.6% vs. 55.6%) than those without osteomyelitis (p < 0.05 for all). Increasing age, history of past amputation, CRP and reduced frequency of changing the OF were significant positive risk factors for osteomyelitis. OF change at < = 6-month-interval had a protective effect against osteomyelitis (OR : 0.21, C.I 0.07–0.54, p = 0.002) as well as for recurrence (OR : 15, C.I.: 0.04–0.46, p = 0.002) of DFU. Existing national standards for OF manufacturing and regulations regarding their use in India are inadequate and must be made more stringent for professionals with diabetes, especially those at high risk for DFU like the elderly, history of past amputation or those with LOPS. They need detailed foot-measurements for proper fit, should wear OF always at their work-place and change OF frequently for adequate against DFU-related osteomyelitis as also, recurrent DFU. |
| format | Article |
| id | doaj-art-165ffb518a624580b224b0afcdcf1c02 |
| institution | Kabale University |
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| language | English |
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| spelling | doaj-art-165ffb518a624580b224b0afcdcf1c022025-01-26T12:34:04ZengNature PortfolioScientific Reports2045-23222025-01-0115111210.1038/s41598-025-86013-yPrevalence and predictors of infected diabetic foot ulcers (DFU) and DFU-related osteomyelitis amongst industrial workers wearing occupational safety footwearSunetra Mondal0Moushumi Lodh1Sambit Sahoo2Kaushik Paul3Debasis Biswas4Chaitanya Krishna5Ashok Parida6Arunangshu Ganguly7Riddhi DasGupta8Department of Endocrinology, NRS Medical College and HospitalDepartment of BiochemistryDepartment of MicrobiologyDepartment of Plastic Surgery, HealthWorld hospitalsDepartment of OrthopaedicsDepartment of OrthopaedicsDepartment of Cardiology, HealthWorld hospitalsDepartment of Cardiology, HealthWorld hospitalsDepartment of Endocrinology, NRS Medical College and HospitalAbstract Professionals like deep-miners and factory-workers wear specialized safety-shoes to protect against occupational hazards (OF). The risk factors, clinico-microbiologic profile and complications of diabetic foot ulcers (DFU) in these professionals remain unexplored. A cross-sectional observational study was conducted to describe the unique clinico-microbiologic profile of DFU in those wearing occupational-footwear (OF) and find risk factors for DFU related osteomyelitis in them. Of 331 DFU cases seen over 5 years, those wearing OF (n = 107, 68 underground-miners and 39 steel-factory-workers) had high prevalence of forefoot-DFU (81.3%), dorsal-DFU ( 58.9%), recurrent-DFU (31.8%) and of polymicrobial infections (16.8%). Those with osteomyelitis in the OF group ( n = 53) were younger (53.3 vs. 57, p = 0.02), had higher prevalence of peripheral arterial disease (41.5% vs. 24.1%), past-amputation (28.3% vs. 11.1%), higher SINBAD scores, and were also less likely to change occupational-footwear at < = 6-month-interval (22.6% vs. 55.6%) than those without osteomyelitis (p < 0.05 for all). Increasing age, history of past amputation, CRP and reduced frequency of changing the OF were significant positive risk factors for osteomyelitis. OF change at < = 6-month-interval had a protective effect against osteomyelitis (OR : 0.21, C.I 0.07–0.54, p = 0.002) as well as for recurrence (OR : 15, C.I.: 0.04–0.46, p = 0.002) of DFU. Existing national standards for OF manufacturing and regulations regarding their use in India are inadequate and must be made more stringent for professionals with diabetes, especially those at high risk for DFU like the elderly, history of past amputation or those with LOPS. They need detailed foot-measurements for proper fit, should wear OF always at their work-place and change OF frequently for adequate against DFU-related osteomyelitis as also, recurrent DFU.https://doi.org/10.1038/s41598-025-86013-yOccupational-footwearDiabetic foot ulcerOsteomyelitisMinersFactory workers |
| spellingShingle | Sunetra Mondal Moushumi Lodh Sambit Sahoo Kaushik Paul Debasis Biswas Chaitanya Krishna Ashok Parida Arunangshu Ganguly Riddhi DasGupta Prevalence and predictors of infected diabetic foot ulcers (DFU) and DFU-related osteomyelitis amongst industrial workers wearing occupational safety footwear Scientific Reports Occupational-footwear Diabetic foot ulcer Osteomyelitis Miners Factory workers |
| title | Prevalence and predictors of infected diabetic foot ulcers (DFU) and DFU-related osteomyelitis amongst industrial workers wearing occupational safety footwear |
| title_full | Prevalence and predictors of infected diabetic foot ulcers (DFU) and DFU-related osteomyelitis amongst industrial workers wearing occupational safety footwear |
| title_fullStr | Prevalence and predictors of infected diabetic foot ulcers (DFU) and DFU-related osteomyelitis amongst industrial workers wearing occupational safety footwear |
| title_full_unstemmed | Prevalence and predictors of infected diabetic foot ulcers (DFU) and DFU-related osteomyelitis amongst industrial workers wearing occupational safety footwear |
| title_short | Prevalence and predictors of infected diabetic foot ulcers (DFU) and DFU-related osteomyelitis amongst industrial workers wearing occupational safety footwear |
| title_sort | prevalence and predictors of infected diabetic foot ulcers dfu and dfu related osteomyelitis amongst industrial workers wearing occupational safety footwear |
| topic | Occupational-footwear Diabetic foot ulcer Osteomyelitis Miners Factory workers |
| url | https://doi.org/10.1038/s41598-025-86013-y |
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