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Occup Environ Med. 2019 Aug 12. pii: oemed-2019-105912. doi: 10.1136/oemed-2019-105912. [Epub ahead of print]

Association between occupational exposure and Dupuytren's contracture using a job-exposure matrix and self-reported exposure in the CONSTANCES cohort.

Author information

1
Unité Hospitalo-Universitaire de Santé professionnelle Hôpitaux Universitaires de Paris Ile-de-France Ouest, site Raymond Poincaré, AP-HP, UVSQ, IIMTPIF, Garches, France marc.fadel@ens.uvsq.fr.
2
UVSQ, U1168 (VIMA: Aging and chronic diseases. Epidemiological and public health approaches), UMS 011 (Population-based Epidemiologic Cohorts Unit), Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, Villejuif, France.
3
Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
4
Univ Angers, UMR_S1085, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Angers, France.
5
Unité Hospitalo-Universitaire de Santé professionnelle Hôpitaux Universitaires de Paris Ile-de-France Ouest, site Raymond Poincaré, AP-HP, UVSQ, IIMTPIF, Garches, France.

Abstract

BACKGROUND:

Although several studies highlighted an association between occupational exposure and Dupuytren's contracture (DC), they were often limited by the highly selected population. We aimed to study this association using a job-exposure matrix (JEM) and self-reported exposure in a large cohort.

METHODS:

From CONSTANCES, a French population-based prospective cohort, we retrieved sex, age, social position, alcohol/tobacco intake and diabetes. Lifetime exposures were assessed by two different methods: with the biomechanical JEM 'JEM Constances', we assessed exposure to vibration and/or forearm rotation for participants whose work history was available, and from a self-administered questionnaire, we retrieved self-reported exposure to arduous work and/or carrying heavy loads. Surgery for DC was collected from the French Health Administrative database from 2009 to 2016. Multivariate logistic regression models adjusted for confounders were built to assess association between surgery for DC and occupational exposures.

RESULTS:

Work history was retrieved for 23 795 subjects among whom 98 underwent surgery for DC. Adjusted OR (aOR) was 2.08 (1.03-4.2) for being ever exposed to vibration and/or forearm rotation for subjects <60 years and 1.20 (0.69-2.08) for subjects ≥60 years. Data for self-reported exposure were available for 81 801 participants among whom 367 underwent surgery for DC. aOR for being exposed more than 20 years to arduous work and/or carrying heavy loads was 2.01 (1.32-3.04) for subjects <60 years and 1.04 (0.7-1.54) for subjects ≥60.

CONCLUSIONS:

Manual work is associated with surgery for DC among younger subjects. Monitoring exposed workers is important to prevent future functional limitations.

KEYWORDS:

dupuytren’s contracture; epidemiology; job-exposure matrix; occupational

PMID:
31405909
DOI:
10.1136/oemed-2019-105912

Conflict of interest statement

Competing interests: None declared.

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