title: Risk factors associated with inguinal hernias: a case control study.
abstract: OBJECTIVE
  To assess reported risk factors for the development of inguinal hernias, to develop a method of quantifying physical effort, and to correlate them.
  
  
  METHODS
  Case control study.
  
  
  METHODS
  District hospital, Valencia, Spain.
  
  
  METHODS
  290 selected patients who had undergone inguinal hernia repair, and 290 age and sex matched controls.
  
  
  METHODS
  Each patient was interviewed and data collected on a specially designed questionnaire, and an "effort score" calculated.
  
  
  METHODS
  Incidence of specified risk factors.
  
  
  RESULTS
  The only significant risk factor was physical effort (lifting heavy objects repeatedly over long periods of time), relative risk 2.92, 95% confidence interval 2.11 to 4.04. In addition, there were significant differences between index cases and controls in standard of education (p < 0.001), consumption of alcohol (p = 0.02), chronic cough (p < 0.001), net monthly income (p = 0.04), and amount of physical effort expended (p < 0.001). Patients with indirect hernias expended significantly more physical effort and were both heavier and taller, and patients with femoral hernias waited significantly longer than the others before having their hernias repaired.
  
  
  CONCLUSIONS
  Inguinal hernias are associated with the expenditure of a considerable amount of physical effort, and are commoner among younger, poorly educated manual workers.
authors.affiliation: Department of Surgery, Hospital Peset Aleixandre, Valencia, Spain.
authors.forename: J F
authors.initials: JF
authors.lastname: Carbonell
authors.forename: J L
authors.initials: JL
authors.lastname: Sanchez
authors.forename: R T
authors.initials: RT
authors.lastname: Peris
authors.forename: J C
authors.initials: JC
authors.lastname: Ivorra
authors.forename: M J
authors.initials: MJ
authors.lastname: Del Baño
authors.forename: C S
authors.initials: CS
authors.lastname: Sanchez
authors.forename: J I
authors.initials: JI
authors.lastname: Arraez
authors.forename: P C
authors.initials: PC
authors.lastname: Greus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006552:Hernia, Inguinal / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors