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  • Persistent postoperative pain after inguinal hernia repair in relation to occupational lifting and standing/walking: a 6-month follow-up study

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Original article
Persistent postoperative pain after inguinal hernia repair in relation to occupational lifting and standing/walking: a 6-month follow-up study
  1. Marie Vestergaard Vad1,
  2. Poul Frost2,
  3. Jacob Rosenberg3,
  4. Susanne Wulff Svendsen4
  1. 1 Occupational Medicine, Herning Hospital, Denmark and Occupational Medicine, Aarhus University Hospital, Danish Ramazzini Centre, Aarhus, Denmark
  2. 2 Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
  3. 3 Department of Surgical Gastroenterology D, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
  4. 4 Occupational Medicine, Herning Hospital, Herning, Denmark
  1. Correspondence to Marie Vestergaard Vad, Occupational Medicine, Herning Hospital, Denmark and Occupational Medicine, Aarhus University Hospital, Danish Ramazzini Centre, Aarhus 8200, Denmark; marivd{at}rm.dk

Abstract

Objectives This study aims to evaluate the risk of persistent postoperative pain after inguinal hernia repair in relation to occupational lifting and standing/walking.

Methods We conducted a 6-month follow-up study that included all men with an inguinal hernia repair registered in the Danish Hernia Database from 1 January 2015 to 31 October 2016, who were born from 1 October 1949 to 1 October 1998, and who were alive, living in Denmark, and active in the labour market in the week before surgery. Members of the cohort received a questionnaire 6 months after surgery. Exposure estimates were allocated by combining self reported job titles with a job exposure matrix. Prevalence ratios of persistent postoperative pain during activity ≥2 on a numerical rating scale (range 0–10) according to occupational lifting and standing/walking were estimated using Poisson regression.

Results Of 4817 eligible patients, 2609 (54%) returned the questionnaire and 2508 contributed to the analyses. A total of 473 men (18.9%) reported persistent postoperative pain. In the group lifting >1000 to 6125 kg/day, the prevalence was 26.8% compared with 17.5% in the minimally exposed group; adjusted prevalence ratio: 1.44 (95% CI 1.16 to 1.79). For standing/walking >6 hours/day, the prevalence was 23.6% compared with 17.0% in the group standing <4 hours/day; adjusted prevalence ratio: 1.18 (95% CI 0.92 to 1.50).

Conclusions The risk of persistent postoperative pain after inguinal hernia repair was elevated among men with occupational lifting exposures >1000 kg/day. This finding suggests a preventive potential.

  • Body mass index
  • groin hernia
  • hernia repair
  • inguinal hernia
  • laparoscopic
  • Lichtenstein
  • leisure-time physical activity
  • occupational exposure
  • prognosis
  • smoking

https://doi.org/10.1136/oemed-2019-105919

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    Footnotes

    • Contributors MVV, PF, JR and SWS planned the study. MVV organised the data collection. MVV and PF conducted the analysis. All authors contributed to the interpretation of the results. MVV drafted the manuscript. All authors revised it critically with respect to important intellectual content. MVV and SWS prepared the final version that has been approved by all authors. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

    • Funding This work was supported by The Danish Working Environment Fund, project number 20130023392/5.

    • Competing interests All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: JR received personal fees from Merck and Bard outside the submitted work.

    • Patient consent for publication Not required.

    • Ethics approval The Danish Data Protection Agency approved the study (j.no.: 1-16-02-121-15). In Denmark, register and questionnaire studies do not require approval by health research ethics committees (request no. 1-10-72-22-15).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.