RT Journal Article
SR Electronic
T1 Inguinal hernia repair among men in relation to occupational mechanical exposures and lifestyle factors: a longitudinal study
JF Occupational and Environmental Medicine
JO Occup Environ Med
FD BMJ Publishing Group Ltd
SP 769
OP 775
DO 10.1136/oemed-2016-104160
VO 74
IS 11
A1 Vad, Marie Vestergaard
A1 Frost, Poul
A1 Rosenberg, Jacob
A1 Andersen, Johan Hviid
A1 Svendsen, Susanne Wulff
YR 2017
UL http://oem.bmj.com/content/74/11/769.abstract
AB Objectives To evaluate exposure–response relationships between occupational mechanical exposures and first-time lateral and medial inguinal hernia repair and effects of lifestyle factors. To estimate if occupational mechanical exposures advance the repairs.Methods This longitudinal study was based on a cohort of men aged 18–65 years with questionnaire data from the Musculoskeletal Research Database at the Danish Ramazzini Centre. We estimated occupational mechanical exposures using a job exposure matrix. First-time inguinal hernia repairs from 1998 to 2014 were identified in the Danish Hernia Database. We used Cox regression analyses and calculated excess fractions among the exposed and rate advancement periods (RAPs).Results Among 17 967 men, we identified 382 lateral and 314 medial repairs. The risk of lateral repairs increased with time spent standing/walking with an HR of 1.45 (95% CI 1.12 to 1.88) for ≥6 hours/day versus <4 hours/day, corresponding to an excess fraction of cases of 31% in the group with ≥6 hours/day. This group had a RAP of 6.7 (95% CI 2.6 to 10.8) years. Medial repairs were not associated with occupational mechanical exposures. A body mass index ≥30 kg/m2 showed lower HRs for both repair types. Leisure-time physical activity and smoking status were not related to any of the outcomes.Conclusions Assuming a causal relationship, the results suggest that around 30% of all first-time lateral inguinal hernia repairs in the highest exposure category would be preventable if the time spent standing/walking could be reduced from ≥6 to <4 hours/day. The repairs might even be postponed by 6–7 years.