PREVALENCE AND ETIOLOGY OF LEG ULCERS IN A DEFINED POPULATION OF INDUSTRIAL-WORKERS

Objective: To assess leg ulcer prevalence and aetiology in people belo w retirement age. Design: A validated cross-sectional questionnaire su rvey. Respondents with a history of leg ulcers were examined. Setting: A defined population of industrial workers. Subjects: All 2785 employ ees, aged 30-65 years, at the Volvo motor engine factories in Skovde w ere included. Men predominated (81%) and the median age was 44 years i n 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 th e knee (foot ulcers included) that did not heal within a 6-week period after onset of ulceration'. Main outcome measures: Point prevalence o f open leg ulcers, overall prevalence of leg ulcer history and aetiolo gical 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 ov erall false-positive response rate was 64%. Fifty-four had a true hist ory 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 wa s 0.6% and the overall prevalence of ulcer history was 1.6%, if exclud ing 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 bee n underestimated in people of working age because they are often self- caring. Since many ulcers have curable causes it is necessary to infor m the public of the importance of seeking professional help early.