Prevalence and Aetiology of Leg Ulcers in a Defined Population of Industrial Workers

Abstract

Objective: To assess leg ulcer prevalence and aetiology in people below retirement age. Design: A validated cross-sectional questionnaire survey. Respondents with a history of leg ulcers were examined. Setting: A defined population of industrial workers. Subjects: All 2785 employees, aged 30–65 years, at the Volvo motor engine factories in Skövde were included. Men predominated (81%) and the median age was 44 years in both men and women. A questionnaire was used to select people with a history of ulceration. A leg ulcer was defined as ‘any wound below the knee (foot ulcers included) that did not heal within a 6-week period after onset of ulceration’. Main outcome measures: Point prevalence of open leg ulcers, overall prevalence of leg ulcer history and aetiological classification. Results: The overall response rate was 87%, and 131 out of 153 subjects with a ‘history of leg ulcers’ were examined (86%). In 98% of positive responders the answers were validated. The overall false-positive response rate was 64%. Fifty-four had a true history of ulcers, of whom 16 had open ulcers. Of the latter, 12 were self-caring (75%). Overall venous causation dominated (41%). The ratio of open to healed ulcers was 1:2. The point prevalence for open ulcers was 0.6% and the overall prevalence of ulcer history was 1.6%, if excluding pure traumatic ulcers. The point prevalence was tenfold higher in people aged below 50 years and seven times higher in the age decade 50–59 years if compared with previous estimates based on patients known to health-care professionals. Conclusion: Leg ulcer prevalence has been underestimated in people of working age because they are often self-caring. Since many ulcers have curable causes it is necessary to inform the public of the importance of seeking professional help early.