Varicose veins in the lower extremities in relation to occupational mechanical exposures: a longitudinal study

TY - JOUR

T1 - Varicose veins in the lower extremities in relation to occupational mechanical exposures

T2 - a longitudinal study

AU - Tabatabaeifar, Sorosh

AU - Frost, Poul

AU - Andersen, Johan Hviid

AU - Jensen, Lone Donbæk

AU - Thomsen, Jane Frølund

AU - Svendsen, Susanne Wulff

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Objectives: To evaluate if occupational mechanical exposures are associated with an increased risk of surgery for varicose veins (VV) in the lower extremities. Methods: We conducted a longitudinal study of persons from the Musculoskeletal Research Database at the Danish Ramazzini Centre who were 18.65 years old when they provided baseline questionnaire data during 1993.2004. Exposure estimates were obtained from a job exposure matrix based on expert ratings. The register information on first-time surgery for VV was retrieved. We used Cox regression analyses. Results: During 416 317 person-years of follow-up among 38 036 persons, 851 first-time operations for VV occurred. Using standing/walking <4 h/day and uncommon lifting as references, exposure.response relationships with risk of surgery were found for men. For women, the risk increased too, but without clear exposure.response patterns. The adjusted HRs for ≥6 h/day spent standing/walking were 3.17 (95% CI 2.06 to 4.89) and 2.34 (95% CI 1.72 to 3.19) for men and women, respectively. For high lifting exposures (≥1000 kg/day), the adjusted HRs were 3.95 (95% CI 2.32 to 6.73) for men and 2.54 (95% CI 1.95 to 3.31) for women. Other risk factors were increasing age for men and parity for women. Minimal leisure-time physical activity, a high body mass index and smoking were not associated with increased risk. Conclusions: The results suggested an increased risk of surgery for VV in relation to prolonged standing/walking and heavy lifting and a preventive potential of more than 60% of all cases in exposed occupations.

AB - Objectives: To evaluate if occupational mechanical exposures are associated with an increased risk of surgery for varicose veins (VV) in the lower extremities. Methods: We conducted a longitudinal study of persons from the Musculoskeletal Research Database at the Danish Ramazzini Centre who were 18.65 years old when they provided baseline questionnaire data during 1993.2004. Exposure estimates were obtained from a job exposure matrix based on expert ratings. The register information on first-time surgery for VV was retrieved. We used Cox regression analyses. Results: During 416 317 person-years of follow-up among 38 036 persons, 851 first-time operations for VV occurred. Using standing/walking <4 h/day and uncommon lifting as references, exposure.response relationships with risk of surgery were found for men. For women, the risk increased too, but without clear exposure.response patterns. The adjusted HRs for ≥6 h/day spent standing/walking were 3.17 (95% CI 2.06 to 4.89) and 2.34 (95% CI 1.72 to 3.19) for men and women, respectively. For high lifting exposures (≥1000 kg/day), the adjusted HRs were 3.95 (95% CI 2.32 to 6.73) for men and 2.54 (95% CI 1.95 to 3.31) for women. Other risk factors were increasing age for men and parity for women. Minimal leisure-time physical activity, a high body mass index and smoking were not associated with increased risk. Conclusions: The results suggested an increased risk of surgery for VV in relation to prolonged standing/walking and heavy lifting and a preventive potential of more than 60% of all cases in exposed occupations.

KW - Adolescent

KW - Adult

KW - Aged

KW - Female

KW - Humans

KW - Lifting

KW - Longitudinal Studies

KW - Lower Extremity

KW - Male

KW - Middle Aged

KW - Occupational Diseases

KW - Occupational Exposure

KW - Posture

KW - Proportional Hazards Models

KW - Risk Factors

KW - Sex Factors

KW - Surveys and Questionnaires

KW - Varicose Veins

KW - Walking

KW - Young Adult

U2 - 10.1136/oemed-2014-102495

DO - 10.1136/oemed-2014-102495

M3 - Journal article

C2 - 25575530

SN - 1351-0711

VL - 72

SP - 330

EP - 337

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

IS - 5

ER -