title: Varicose veins in the lower extremities in relation to occupational mechanical exposures: a longitudinal study.
abstract: OBJECTIVE
  To evaluate if occupational mechanical exposures are associated with an increased risk of surgery for varicose veins (VV) in the lower extremities.
  
  
  METHODS
  We conducted a longitudinal study of persons from the Musculoskeletal Research Database at the Danish Ramazzini Centre who were 18-65 years old when they provided baseline questionnaire data during 1993-2004. Exposure estimates were obtained from a job exposure matrix based on expert ratings. The register information on first-time surgery for VV was retrieved. We used Cox regression analyses.
  
  
  RESULTS
  During 416,317 person-years of follow-up among 38,036 persons, 851 first-time operations for VV occurred. Using standing/walking <4 h/day and uncommon lifting as references, exposure-response relationships with risk of surgery were found for men. For women, the risk increased too, but without clear exposure-response patterns. The adjusted HRs for ≥6 h/day spent standing/walking were 3.17 (95% CI 2.06 to 4.89) and 2.34 (95% CI 1.72 to 3.19) for men and women, respectively. For high lifting exposures (≥1000 kg/day), the adjusted HRs were 3.95 (95% CI 2.32 to 6.73) for men and 2.54 (95% CI 1.95 to 3.31) for women. Other risk factors were increasing age for men and parity for women. Minimal leisure-time physical activity, a high body mass index and smoking were not associated with increased risk.
  
  
  CONCLUSIONS
  The results suggested an increased risk of surgery for VV in relation to prolonged standing/walking and heavy lifting and a preventive potential of more than 60% of all cases in exposed occupations.
authors.affiliation: Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: Sorosh
authors.identifier: http://orcid.org/0000-0001-8635-6523
authors.initials: S
authors.lastname: Tabatabaeifar
authors.affiliation: Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: Poul
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: Johan Hviid
authors.initials: JH
authors.lastname: Andersen
authors.affiliation: Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: Lone Donbæk
authors.initials: LD
authors.lastname: Jensen
authors.affiliation: Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
authors.forename: Jane Frølund
authors.initials: JF
authors.lastname: Thomsen
authors.affiliation: Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland-University Research Clinic, Herning, Denmark.
authors.forename: Susanne Wulff
authors.initials: SW
authors.lastname: Svendsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D017770:Lifting; D008137:Longitudinal Studies; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology* / Q000601:surgery; D016273:Occupational Exposure / Q000009:adverse effects*; D011187:Posture; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014648:Varicose Veins / Q000209:etiology* / Q000601:surgery; D016138:Walking; D055815:Young Adult