Occupational relevance of subclavian vein thrombosis in association with thoracic outlet syndrome.
OBJECTIVE
Primary subclavian vein thrombosis ("effort thrombosis") is not generally recognized as a work-related disorder, and more knowledge is required on the particular biomechanical risks. An extensive biomechanical risk analysis was performed for a possible work-related case.


METHODS
A hard-working 43-year-old race-course farrier received successful surgical treatment for subclavian vein thrombosis. No congenital abnormalities were apparent. At work, the farrier spent 75% of his time with his back bent (generally at > 70 degrees) with his right shoulder flexed and abducted, a position that thereby increased the pressure on the subclavian vein. High average (and peak) stress ratings for the neck and shoulder postures are accompanied by high levels of force and considerable repetitiveness.


CONCLUSIONS
Taken together, these forms of biomechanical overload suggest that the leading cause of the subclavian thrombosis suffered by this farrier could have been occupational. Case-control studies on this neglected topic are needed to investigate possible associations between subclavian vein thrombosis and specific occupational activities.
Fiorentini
Cristiana
C
Occupational Medicine Unit, Sant'Orsola-Malpighi Hospital, Bologna, Italy. cristiana.fiorentini@unibo.it
Mattioli
Stefano
S
Graziosi
Francesca
F
Bonfiglioli
Roberta
R
Armstrong
Thomas J
TJ
Violante
Francesco S
FS
D000328:Adult; D001696:Biomechanical Phenomena; D006801:Humans; D008297:Male; D008669:Metallurgy; D009784:Occupational Diseases / Q000209:etiology / Q000503:physiopathology*; D016273:Occupational Exposure / Q000009:adverse effects*; D005082:Physical Exertion / Q000502:physiology; D011187:Posture / Q000502:physiology; D018570:Risk Assessment; D012307:Risk Factors; D013350:Subclavian Vein / Q000503:physiopathology*; D013901:Thoracic Outlet Syndrome / Q000503:physiopathology*; D020246:Venous Thrombosis / Q000209:etiology / Q000503:physiopathology*