Lower limb venous and arterial peripheral diseases and work conditions: systematic review

Abstract

ObjectivesThe individual peripheral vascular disease risk factors are well documented, but the role of work conditions remains equivocal. This systematic review aims to assess relationships between lower limb peripheral venous diseases (lower limb varicose veins (LLVV), venous thromboembolism (VTE) comprising deep vein thrombosis and pulmonary embolism), peripheral arterial disease (intermittent claudication, aortic dissection, aortic aneurysm) and occupational constraints among working adults.MethodsSeveral databases were systematically searched until February 2019 for observational studies and clinical trials. Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was used for article selection. Quality assessment and risk of bias were evaluated using Strengthening the Reporting of Observational Studies in Epidemiology and Newcastle-Ottawa scales.ResultsAmong the 720 screened articles, 37 remained after full-text evaluation. Among the 21 studies on LLVV, prolonged standing was significantly associated to a higher risk of varicose veins with a threshold probably around >3 to 4 hours/day but exposure duration in years was not sufficiently considered. Seated immobility was often observed in workers, with no sufficient evidence to prove that prolonged sitting at work is related to VTE. Carrying heavy loads, stress at work and exposure to high temperatures have emerged more recently notably in relation to varicose veins but need to be better explored. Only three studies discussed the potential role of work on peripheral arterial disease development.ConclusionsAlthough some observational studies showed that prolonged standing can be related to varicose veins and that seated immobility at work could be linked to VTE, very little is known about peripheral arterial disease and occupational constraints. Clinical trials to determine preventive strategies at work are needed.PROSPERO registration numberCRD42019127652.

Emotional Intelligence and Burnout among Medical Students at a Public Saudi University

“…In literature, standing for long periods is the most mentioned risk factor for VV (17,37,(39)(40)(41)(42). In the current study, the duration of standing for 4 hours or more was significantly associated with a higher prevalence of VV.…”

“…They should be informed about the negative consequences of improper use of topical corticosteroids, including disease relapse and the occurrence of unfavorable adverse effects (40). They should be informed about the importance of topical corticosteroid maintenance therapy to minimize flare-ups or relapses (41).…”

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Gender differences and site-specific incident risks of musculoskeletal disorders among 224 506 workers in the food and beverage service industry in Taiwan: A 15-year Nationwide Population-Based Cohort Study

“…[21][22][23] A systematic review reported that workers who stood longer than 3-4 hours per day seemed to have an increased risk (~2.5-fold higher) of LLVV than those who were less exposed. 24 Several studies reported that women had higher prevalence 23 or risk (workers with prolonged standing vs no prolonged standing) than men. 25 Given that our reference group was the general population in which the above-mentioned occupational types had the same characteristic of prolonged standing as the FBSI workers, this might explain why female FBSI workers did not show an increased risk of peripheral vascular diseases, while male FBSI workers tended to experience prolonged standing and thus had higher risk of peripheral vascular diseases than the general population.…”

e-Thrombosis in the COVID-19 era: Collateral effects of confinement

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