To work in a hospital--a new risk factor for development of venous disease?

A Study on Prevalence and Risk Factors for Varicose Veins in Nurses at a University Hospital

Background

Lower-limb varicose veins (VVs) are common and known to have a higher prevalence among people who work in occupations requiring prolonged standing. In the Republic of Korea, however, VV-related occupational factors have seldom been examined. This study was conducted to assess the prevalence of VVs among nurses, an occupational group considered to be at high risk of VVs, and determine the occupational risk factors of prolonged standing.

Methods

Between March and August 2014, a questionnaire survey coupled with Doppler ultrasonography was conducted on the nurses working at a university hospital.

Results

A total of 414 nurses participated in the survey and diagnostic testing. From the survey analysis and test results, the prevalence of VVs in nurses was estimated to be 16.18%. Significant factors for venous reflux were age [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.03-1.10], pregnancy (OR = 2.15, 95% CI = 1.17-3.94), and delivery (OR = 2.02, 95% CI = 1.08-3.78). The statistical significance of these factors was verified after risk adjustment for sociodemographic factors (OR = 3.40, 95% CI = 1.27-9.09).

Conclusion

Factors significantly associated with venous reflux were increasing age and prolonged working hours (≥ 4 hours) in a standing position (OR = 2.80, 95% CI = 1.08-7.25), even after risk adjustment for sociodemographic factors. This study is significant in that an objective diagnosis of VVs preceded the analysis of the risk factors for VV incidence, thus verifying objectively that VVs are associated with occupations requiring prolonged hours of working in a standing position.

Prolonged standing at work and hospitalisation due to varicose veins: a 12 year prospective study of the Danish population

BACKGROUND

Recent studies suggest that prolonged standing at work is associated with the development of diseases of varicose veins (VV).

AIMS

To assess the risk of hospitalisation due to VV in the lower extremities prospectively in workers standing or walking at least 75% of their time at work.

METHODS

A representative random sample of 9653 working age adults was drawn from the Central Population Register of Denmark in 1991. Of these, 8664 accepted to be interviewed by telephone (response rate 90%). Respondents (2939 men and 2708 women) were 20-59 years old and employed in 1990. Risk ratios for VV were estimated by log-linear Poisson regression models separately for men and women with adjustment for smoking status, body mass index (BMI), heavy lifting, and, for females only, number of children at baseline.

RESULTS

During 12 years of follow up, 40 hospitalisations due to VV were observed among the men and 71 among the women. For employees with jobs that require prolonged standing or walking compared to all other employees, the relative risk was 1.75 (95% CI 0.92 to 3.34) for men and 1.82 (95% CI 1.12 to 2.95) for women. The pooled estimate of the relative risk was 1.78 (95% CI 1.19 to 2.68). The aetiological fraction of prolonged standing or walking at work was estimated as 22.5% for men and 22.6% for women.

CONCLUSIONS

This prospective study confirms that prolonged standing at work constitutes an excess risk of hospital treatment due to varicose veins and accounts for more than one fifth of all cases of working age.