Venous insufficiency of the lower limbs and working conditions

Objectives:To determine the prevalence of venous insufficiency (VI) in a po pulation of women working in the health and social sectors. In a second sta ge, we assessed the relative contributions of the different occupational an d 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 f our health sectors: operating rooms, hospital laundries, day-nurseries and offices. Methods: The study was based on a physical examination and a medical questi onnaire (personal and family history of VI, symptoms, use of medical care). Working conditions, temperature and humidity recordings were studied for e ach activity. A typological analysis and a discriminant analysis were carri ed out to determine the contribution of personal and occupational factors t o the course of VI. Findings: VI is highly prevalent: 76% of subjects and up to 84% in the surg ical room and laundry population. Functional symptoms and the presence of v aricosities (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 an d 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 temper ature 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 quan tified on the basis of scores identified in the discriminant analysis.