Influence of prevalent occupational position during working day on occupational lower limb edema

Rubiana Neves Ramos,Roberto Augusto Caffaro,Amélia Cristina Seidel,Cleusa Ema Quilici Belczak,José Maria Pereira Godoy,Sergio Quilici Belczak

doi:10.1590/1677-5449.0079

Abstract

BACKGROUND: The lower limb edema observed in normal people at the end of their working days can vary in intensity and frequency depending on the predominant working positions required to perform different jobs.OBJECTIVES: To compare lower limb volumes of volunteers allocated to three study groups, depending on the predominant positions in which they work.METHODS: Volumetric assessments were conducted of both lower limbs of 51 people free from vascular disease, allocated to three groups of 17 individuals each by predominant working position: sitting, static standing or alternating between the two. Volumes were measured at the start and at the end of the working day and the differences in volumes were calculated for each group. Means and frequencies were compared using appropriate inferential statistics and correlation coefficients were calculated.RESULTS: The groups were homogenous in terms of sex distribution, age, skin color and BMI. The volumetric data from measurements taken before starting work revealed significant differences between all three groups. Volunteers who predominantly worked sitting down had largest volumes, followed by those who remained standing for long periods and then those who varied between these positions. The frequency of lower limb volume increase > 100 mL was significantly higher in the group of people who worked sitting down and maintained this position for long periods.CONCLUSIONS: Postural edema is more common among people who work sitting down for long periods, among whom it appears that there is a cumulative effect from the position, since they exhibit larger lower limb volumes at the start of the day.

Highlights

Since the end of the 1960s, researchers attempting to explain certain venous diseases of the lower limbs (LL) have investigated the predominant body position that people adopt during their normal working days
The earliest studies linked varicose veins with the static orthostatic postures demanded by jobs performed by textile workers[1] and retail salespeople,[2] while later studies confirmed an association between the predominant orthostatic position adopted throughout the day and chronic venous diseases (CVD).[3,4,5,6]
Still other studies failed to detect any type of correlation between CVD and an orthostatic working position,[7,8] which was later confirmed by the first prospective, population-based study of the subject, which found that the incidence of LL varicose veins was higher among women who spent 8 hours in sedentary activities than among those who spent 4 hours or less in such activities, with no influence on these results from the orthostatic position itself.[9]

Summary

Introduction

Since the end of the 1960s, researchers attempting to explain certain venous diseases of the lower limbs (LL) have investigated the predominant body position that people adopt during their normal working days. Because increased LL volume may cause true edema, while edema in turn is generally an early sign of CVD,[12] a new series of investigations have been conducted in attempts to improve understanding of the venous hemodynamic changes that take place in individuals free from symptoms of any type of vascular condition, as a function of the employment activities that they engage in. These studies measured LL volumes, using a variety of techniques, at the start and end of work shifts. Conclusions: Postural edema is more common among people who work sitting down for long periods, among whom it appears that there is a cumulative effect from the position, since they exhibit larger lower limb volumes at the start of the day

Objectives

Methods

Results

Conclusion