Dupuytren's contracture and occupational exposure to hand-transmitted vibration.
OBJECTIVE
The relation between Dupuytren's contracture and occupational exposure to hand-transmitted vibration (HTV) has frequently been debated. We explored associations in a representative national sample of workers with well-characterised exposure to HTV.


METHODS
We mailed a questionnaire to 21 201 subjects aged 16-64 years, selected at random from the age-sex registers of 34 general practices in Great Britain and to 993 subjects chosen randomly from military pay records, asking about occupational exposure to 39 sources of HTV and about fixed flexion contracture of the little or ring finger. Analysis was restricted to men at work in the previous week. Estimates were made of average daily vibration dose (A(8) root mean squared velocity (rms)) over that week. Associations with Dupuytren's contracture were estimated by Poisson regression, for lifetime exposure to HTV and for exposures in the past week >A(8) of 2.8 ms(-2) rms. Estimates of relative risk (prevalence ratio (PR)) were adjusted for age, smoking status, social class and certain manual activities at work.


RESULTS
In all 4969 eligible male respondents supplied full information on the study variables. These included 72 men with Dupuytren's contracture, 2287 with occupational exposure to HTV and 409 with A(8)>2.8 ms(-2) in the past week. PRs for occupational exposure to HTV were elevated 1.5-fold. For men with an A(8)>2.8 ms(-2) in the past week, the adjusted PR was 2.85 (95% CI 1.37 to 5.97).


CONCLUSIONS
Our findings suggest that risk of Dupuytren's contracture is more than doubled in men with high levels of weekly exposure to HTV.
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Keith T
KT
Palmer
Stefania
S
D'Angelo
Holly
H
Syddall
Michael J
MJ
Griffin
Cyrus
C
Cooper
David
D
Coggon
D000293:Adolescent; D000328:Adult; D004387:Dupuytren Contracture / Q000209:etiology*; D005385:Fingers; D006225:Hand; D053421:Hand-Arm Vibration Syndrome / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D016059:Range of Motion, Articular; D012307:Risk Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014732:Vibration; D055815:Young Adult