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Original research
Association between occupational exposure and Dupuytren’s contracture using a job-exposure matrix and self-reported exposure in the CONSTANCES cohort
  1. Marc Fadel1,2,
  2. Annette Leclerc2,
  3. Bradley Evanoff3,
  4. Ann-Marie Dale3,
  5. Laure Ngabirano4,
  6. Yves Roquelaure4,
  7. Alexis Descatha1,2,4
  1. 1 Unité Hospitalo-Universitaire de Santé professionnelle Hôpitaux Universitaires de Paris Ile-de-France Ouest, site Raymond Poincaré, AP-HP, UVSQ, IIMTPIF, Garches, France
  2. 2 UVSQ, U1168 (VIMA: Aging and chronic diseases. Epidemiological and public health approaches), UMS 011 (Population-based Epidemiologic Cohorts Unit), Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, Villejuif, France
  3. 3 Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
  4. 4 Univ Angers, UMR_S1085, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Angers, France
  1. Correspondence to Dr Marc Fadel, Pathologie Professionnelle, Hopital Raymond-Poincare, Garches 92380, France; marc.fadel{at}


Background Although several studies highlighted an association between occupational exposure and Dupuytren’s contracture (DC), they were often limited by the highly selected population. We aimed to study this association using a job-exposure matrix (JEM) and self-reported exposure in a large cohort.

Methods From CONSTANCES, a French population-based prospective cohort, we retrieved sex, age, social position, alcohol/tobacco intake and diabetes. Lifetime exposures were assessed by two different methods: with the biomechanical JEM ‘JEM Constances’, we assessed exposure to vibration and/or forearm rotation for participants whose work history was available, and from a self-administered questionnaire, we retrieved self-reported exposure to arduous work and/or carrying heavy loads. Surgery for DC was collected from the French Health Administrative database from 2009 to 2016. Multivariate logistic regression models adjusted for confounders were built to assess association between surgery for DC and occupational exposures.

Results Work history was retrieved for 23 795 subjects among whom 98 underwent surgery for DC. Adjusted OR (aOR) was 2.08 (1.03–4.2) for being ever exposed to vibration and/or forearm rotation for subjects <60 years and 1.20 (0.69–2.08) for subjects ≥60 years. Data for self-reported exposure were available for 81 801 participants among whom 367 underwent surgery for DC. aOR for being exposed more than 20 years to arduous work and/or carrying heavy loads was 2.01 (1.32–3.04) for subjects <60 years and 1.04 (0.7–1.54) for subjects ≥60.

Conclusions Manual work is associated with surgery for DC among younger subjects. Monitoring exposed workers is important to prevent future functional limitations.

  • dupuytren’s contracture
  • occupational
  • job-exposure matrix
  • epidemiology

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  • Funding The study was founded by the “Interuniversity Institution of Occupational health of Paris Ile-de-France” (IIMTPIF) which had no role in the collection of data, analyses and the writing of the manuscript. The CONSTANCES Cohort Study was supported and funded by the Caisse nationale d’assurance maladie (CNAM); it is an “Infrastructure nationale en Biologie et Santé” and benefits from ANR (ANR-11-INBS-0002) grant funding. CONSTANCES is also partly funded by MSD, AstraZeneca and Lundbeck.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement Data are available upon reasonable request.