Association between occupational exposure and Dupuytren’s contracture using a job-exposure matrix and self-reported exposure in the CONSTANCES cohort

Abstract

BackgroundAlthough 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.MethodsFrom 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.ResultsWork 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.ConclusionsManual work is associated with surgery for DC among younger subjects. Monitoring exposed workers is important to prevent future functional limitations.

Dupuytren’s disease is a work-related disorder: results of a population-based cohort study

“… 6 8 32 33 Many of these studies were inadequately powered and were performed in highly selected study populations (eg, only in men). Our findings are supported by a smaller population-based analysis by Fadel et al , 5 although in that study the authors included a limited number of potential confounders and only included patients who had had surgery for Dupuytren’s disease.…”

“…In the past decades, several studies have been conducted to test this hypothesis. Most reported a positive association between manual work and DD, 5 7 9 28–31 but several did not. 6 8 32 33 Many of these studies were inadequately powered and were performed in highly selected study populations (eg, only in men).…”

“…Several studies on the association between manual work exposure and Dupuytren's disease show conflicting results. [5][6][7][8][9] Although most publications on this subject report a positive association between manual work and Dupuytren's disease, 3 the majority of these studies were limited by a highly selected or small study population, and the lack of adjustment for important confounders. 10 Obtaining a definitive answer to the question of whether Dupuytren's disease is an occupational disease would give us more insight into its aetiology, and would be of great value in informing preventative strategies.…”

How to Use Biomechanical Job Exposure Matrices with Job History to Access Work Exposure for Musculoskeletal Disorders? Application of Mathematical Modeling in Severe Knee Pain in the Constances Cohort

“…Actually, models B and C are byproducts of the classical model A , standard in the literature dealing with cumulative exposure, such as smoking habits or cumulative exposure index at work [ 14 ]. More precisely, in Model B , in the sum of products “duration by exposure”, we neglect small exposures by thresholding to zero exposures smaller or equal to 1 [ 15 ]. In Model C , we just consider the total duration restricted to jobs physically very demanding (exposure larger than 3) [ 16 ].…”

M. Dupuytren – Rebellion am Ende einer faszialen Kette

“…Aktuell scheint es keine lokalen Techniken zur Behandlung des beim M. Dupuytren pathophysiologisch veränderten Gewebes in der Hohlhand zu geben. Mechanischer Stress ist ein Risikofaktor für die Entartung der Palmaraponeurose 7 . Ein mechanisches Bearbeiten bzw.…”