Venous Insufficiency of the Lower Limbs and Working Conditions

Abstract

Objectives: To determine the prevalence of venous insufficiency (VI) in a population of women working in the health and social sectors. In a second stage, we assessed the relative contributions of the different occupational and personal risk factors for venous disease. Design: Descriptive, randomized, multicentre, cross-sectional study during January to September 1995. Study group: One thousand eight hundred and twenty-three women working in four health sectors: operating rooms, hospital laundries, day-nurseries and offices. Methods: The study was based on a physical examination and a medical questionnaire (personal and family history of VI, symptoms, use of medical care). Working conditions, temperature and humidity recordings were studied for each activity. A typological analysis and a discriminant analysis were carried out to determine the contribution of personal and occupational factors to the course of VI. Findings: VI is highly prevalent: 76% of subjects and up to 84% in the surgical room and laundry population. Functional symptoms and the presence of varicosities (small varicose veins of the ankle and medial plantar arch) and large varicose veins are more frequent, with the highest prevalence among operating room staff (respectively, 68% and 41%). Seniority is the first and main factor to explain the severity of the disease, independently of age. The number of pregnancies is also an important factor for the severity of VI, while a family history is not. Occupational factors such as high temperature and load-carrying have a significant direct influence. Conclusion: We observed a strong relationship between occupational factors and severity of VI. Occupational factors and personal factors could be quantified on the basis of scores identified in the discriminant analysis.