Background: Chronic venous insufficiency (CVI) in the occupational population is often poorly recognized. The dimensions of this problem have never been thoroughly investigated in the Netherlands. Objective: To study the epidemiology and risk factors of CVI in males with a standing position at work. To develop a simple diagnostic instrument for screening an (occupational) population for CVI. Methods: 387 male workers with a standing profession were examined by means of a questionnaire, physical examination, Doppler ultrasound investigation, light reflection rheography and optical leg volume measurements. Results: CVI was present in 29% of the subjects and correlated with age, weight and duration of standing work. Complaints of the legs were reported by 81% of the individuals with CVI but also by 63% of the persons without CVI. The questionnaire had a predictive value of 80% in detecting CVI. Conclusion: CVI was a major problem because of the quantity (29%) and the accompanying complaints. Neither the questionnaire nor other investigative measures proved to be as efficient in diagnosing CVI as physical examination in combination with Doppler ultrasound investigation.
Background: Chronic venous insufficiency (CVI) occurs frequently in the occupational population but is often not recognized. Objective: To evaluate leg volume measurements in the detection of CVI. Interventions: The lower leg volume was measured in 81 males with CVI and a standing occupation, at the beginning and end of 2 full working days using an optical leg volume meter. Results: A volume increase of over 50 ml was found in 60% of the legs. The mean volume change was +2.6% in legs with minor CVI and +3.6% in legs with major CVI. A high volume change was associated with a tired feeling and pain in the legs. In the detection of CVI, the predictive value of volume measurements was 71%, and in combination with a questionnaire 83%. Conclusion: A volume increase of the lower legs in the course of the day was common and associated with subjective complaints of the legs. As a predictor of CVI, isolated volume measurements were ineffective because an overlap was present with the distribution of volume changes in healthy workers.
Objective: To investigate the reproducibility of an adapted optical leg volume meter and to determine intraindividual volume changes of the lower legs on separate days and in the course of a working day in healthy volunteers. Design: Adaptation of a standard optical leg volume meter, ‘volometer’, and calibration on an artificial leg and on volunteers. Study of the behaviour of lower leg volume in volunteers. Setting: Free University Hospital, Amsterdam. Participants: Thirty-six healthy volunteers, workers in the hospital. Intervention: The lower leg volume was measured on five or six different days at the beginning and end of a full working day. Main outcome measures: Reproducibility of the adapted volometer, and volume changes of the lower legs at different times. Results: Adaptation of the volometer resulted in a reproducibility of 0.07% in an artificial leg and of 0.46% in volunteers. A significant increase ( p<0.0001) in the volume of the lower legs in the course of the day was observed. Conclusion: Adaptation of the optical leg volume meter resulted in reproducible recordings of the volume of lower legs. In the course of the day an increase in volume occurs.
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