Inguinal hernia repair among men in relation to occupational mechanical exposures and lifestyle factors: a longitudinal study

TY - JOUR

T1 - Inguinal hernia repair among men in relation to occupational mechanical exposures and lifestyle factors

T2 - a longitudinal study

AU - Vad, Marie Vestergaard

AU - Frost, Poul

AU - Rosenberg, Jacob

AU - Andersen, Johan Hviid

AU - Svendsen, Susanne Wulff

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2017

Y1 - 2017

N2 - Objectives To evaluate exposure-response relationships between occupational mechanical exposures and first-time lateral and medial inguinal hernia repair and effects of lifestyle factors. To estimate if occupational mechanical exposures advance the repairs. Methods This longitudinal study was based on a cohort of men aged 18-65 years with questionnaire data from the Musculoskeletal Research Database at the Danish Ramazzini Centre. We estimated occupational mechanical exposures using a job exposure matrix. First-time inguinal hernia repairs from 1998 to 2014 were identified in the Danish Hernia Database. We used Cox regression analyses and calculated excess fractions among the exposed and rate advancement periods (RAPs). Results Among 17 967 men, we identified 382 lateral and 314 medial repairs. The risk of lateral repairs increased with time spent standing/walking with an HR of 1.45 (95% CI 1.12 to 1.88) for ≥6 hours/day versus <4 hours/day, corresponding to an excess fraction of cases of 31% in the group with ≥6 hours/day. This group had a RAP of 6.7 (95% CI 2.6 to 10.8) years. Medial repairs were not associated with occupational mechanical exposures. A body mass index ≥30 kg/m 2 showed lower HRs for both repair types. Leisure-time physical activity and smoking status were not related to any of the outcomes. Conclusions Assuming a causal relationship, the results suggest that around 30% of all first-time lateral inguinal hernia repairs in the highest exposure category would be preventable if the time spent standing/walking could be reduced from ≥6 to <4 hours/day. The repairs might even be postponed by 6-7 years.

AB - Objectives To evaluate exposure-response relationships between occupational mechanical exposures and first-time lateral and medial inguinal hernia repair and effects of lifestyle factors. To estimate if occupational mechanical exposures advance the repairs. Methods This longitudinal study was based on a cohort of men aged 18-65 years with questionnaire data from the Musculoskeletal Research Database at the Danish Ramazzini Centre. We estimated occupational mechanical exposures using a job exposure matrix. First-time inguinal hernia repairs from 1998 to 2014 were identified in the Danish Hernia Database. We used Cox regression analyses and calculated excess fractions among the exposed and rate advancement periods (RAPs). Results Among 17 967 men, we identified 382 lateral and 314 medial repairs. The risk of lateral repairs increased with time spent standing/walking with an HR of 1.45 (95% CI 1.12 to 1.88) for ≥6 hours/day versus <4 hours/day, corresponding to an excess fraction of cases of 31% in the group with ≥6 hours/day. This group had a RAP of 6.7 (95% CI 2.6 to 10.8) years. Medial repairs were not associated with occupational mechanical exposures. A body mass index ≥30 kg/m 2 showed lower HRs for both repair types. Leisure-time physical activity and smoking status were not related to any of the outcomes. Conclusions Assuming a causal relationship, the results suggest that around 30% of all first-time lateral inguinal hernia repairs in the highest exposure category would be preventable if the time spent standing/walking could be reduced from ≥6 to <4 hours/day. The repairs might even be postponed by 6-7 years.

KW - Adolescent

KW - Adult

KW - Aged

KW - Body Mass Index

KW - Denmark

KW - Exercise

KW - Hernia, Inguinal/etiology

KW - Humans

KW - Life Style

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Occupational Diseases/etiology

KW - Occupational Exposure/adverse effects

KW - Posture

KW - Proportional Hazards Models

KW - Risk Factors

KW - Smoking

KW - Stress, Mechanical

KW - Surveys and Questionnaires

KW - Walking

KW - Young Adult

U2 - 10.1136/oemed-2016-104160

DO - 10.1136/oemed-2016-104160

M3 - Journal article

C2 - 28546321

SN - 1351-0711

VL - 74

SP - 769

EP - 775

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

IS - 11

ER -