title: Should we consider Dupuytren's contracture as work-related? A review and meta-analysis of an old debate.
abstract: BACKGROUND
  In view of the conflicting opinions published, a meta-analysis was undertaken on epidemiological studies in order to assess any association between Dupuytren's contracture and work exposure.
  
  
  METHODS
  Using the key words: "occupational disease", "work" and "Dupuytren contracture" without limitation on language or year of publication, epidemiological studies were selected from four databases (Pub-Med, Embase, Web of science, BDSP) after two rounds (valid control group, valid work exposure). A quality assessment list was constructed and used to isolate papers with high quality methodological criteria (scores of 13 or above, HQMC). Relevant associations between manual work, vibration exposure (at work) and Dupuytren's contracture were extracted from the articles and a metarisk calculated using the generic variance approach (meta-odds ratios, meta-OR).
  
  
  RESULTS
  From 1951 to 2007, 14 epidemiological studies (including 2 cohort studies, 3 case-control studies, and 9 cross-sectional studies/population surveys) were included. Two different results could be extracted from five studies (based on different types of exposure), leading to 19 results, 12 for manual work (9 studies), and 7 for vibration exposure (5 studies). Six studies met the HQMC, yielding 9 results, 5 for manual work and 4 for vibration exposure. Five studies found a dose-response relationship. The meta-OR for manual work was 2.02[1.57;2.60] (HQMC studies only: 2.01[1.51;2.66]), and the meta-OR for vibration exposure was 2.88 [1.36;6.07] (HQMC studies only: 2.14[1.59;2.88]).
  
  
  CONCLUSIONS
  These results support the hypothesis of an association between high levels of work exposure (manual work and vibration exposure) and Dupuytren's contracture in certain cases.
authors.affiliation: Inserm U1018, Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France. alexis.descatha@rpc.aphp.fr
authors.forename: Alexis
authors.initials: A
authors.lastname: Descatha
authors.forename: Pénélope
authors.initials: P
authors.lastname: Jauffret
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Chastang
authors.forename: Yves
authors.initials: Y
authors.lastname: Roquelaure
authors.forename: Annette
authors.initials: A
authors.lastname: Leclerc
mesh_terms: D004387:Dupuytren Contracture / Q000453:epidemiology*; D006801:Humans; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D014732:Vibration / Q000009:adverse effects*