title: Occupational mechanical exposures and reoperation after first-time inguinal hernia repair: a prognosis study in a male cohort.
abstract: OBJECTIVE
  The aim of this study was to evaluate exposure-response relationships between occupational mechanical exposures and risk of reoperation after inguinal hernia repair.
  
  
  METHODS
  Using register information, we identified all men born in Denmark 1938-1988, who had their first inguinal hernia repair 1998-2008, and who were 18-65 years old and active in the labour market at the time of surgery. The Danish Hernia Database provided information on repairs and reoperations. We used registered occupational codes and a job exposure matrix based on experts' ratings to estimate total load lifted per day, frequency of heavy lifting, and number of hours per day spent standing/walking. We also obtained register information on sickness absence. Multivariable Cox regression analysis was used.
  
  
  RESULTS
  The cohort comprised 34,822 patients. We did not reveal exposure-response relationships between occupational mechanical exposures and the hazard ratio (HR) of reoperation. The percentage of patients with >2 weeks of sickness absence within 8 weeks after surgery increased with total load lifted per day from 15 to 53%. Longer sickness absence was associated with an increased HR of reoperation, but within strata of sickness absence, we found no increase in the HR of reoperation with increasing exposures.
  
  
  CONCLUSIONS
  We did not find indications that the HR of reoperation was related to occupational mechanical exposures, even after accounting for a potential protective effect of sickness absence. Hence, the exposure-related prolonged duration of sickness absence could not be explained by exposure-related complications that led to reoperation.
authors.affiliation: Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland-University Research Clinic, Herning, Denmark. marivd@rm.dk.|Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. marivd@rm.dk.
authors.forename: M V
authors.initials: MV
authors.lastname: Vad
authors.affiliation: Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Frost
authors.affiliation: Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland-University Research Clinic, Herning, Denmark.
authors.forename: S W
authors.initials: SW
authors.lastname: Svendsen
mesh_terms: D000328:Adult; D003718:Denmark / Q000453:epidemiology; D006552:Hernia, Inguinal / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000601:surgery*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D011379:Prognosis; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors
keywords: Hernia repair; Inguinal hernia; Occupational exposure; Prognosis; Reoperation; Sickness absence