TY - JOUR
T1 - Work-relatedness of inguinal hernia: a systematic review including meta-analysis and GRADE
AU - Kuijer, P. P. F. M.
AU - Hondebrink, D.
AU - Hulshof, C. T. J.
AU - van der Molen, H. F.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Purpose: Clinicians need to know whether inguinal hernia (IH) can be attributed to work to answer questions regarding prevention and medical causation. This review describes whether work-related risk factors are associated with IH. Methods: A systematic review was performed in Medline via PubMed until February 3rd, 2020. Inclusion criteria were that IH was diagnosed by a clinician, and workers exposed to work-related risk factors were compared to workers less exposed or not at all. A quality assessment and a meta-analysis using Cochrane’s RevMan 5.3 were performed, including GRADE for quality of evidence. Results: The search resulted in 540 references. Fourteen studies fulfilled the inclusion criteria, of which three were included in a meta-analysis, all three being of high quality, including 621 workers diagnosed with IH. The meta-analysis revealed significant associations with physically demanding work (OR 2.30, 95% CI 1.56–3.40). Two prospective studies, including 382 and 22,926 cases revealed associations that this was true for male workers with a lateral IH that reported standing or walking for more than six hours per workday (OR 1.45, 95% CI 1.12–1.88) or lifting cumulative loads of more than 4000 kg per workday (OR 1.32, 95% CI 1.27–1.38). The level of certainty for the latter two work-related risk factors was moderate and high according to GRADE. Conclusion: Lateral IH among males is associated with work-related risk factors depending on the level of exposure to the time standing/walking per workday, or the amount of load lifted per workday.
AB - Purpose: Clinicians need to know whether inguinal hernia (IH) can be attributed to work to answer questions regarding prevention and medical causation. This review describes whether work-related risk factors are associated with IH. Methods: A systematic review was performed in Medline via PubMed until February 3rd, 2020. Inclusion criteria were that IH was diagnosed by a clinician, and workers exposed to work-related risk factors were compared to workers less exposed or not at all. A quality assessment and a meta-analysis using Cochrane’s RevMan 5.3 were performed, including GRADE for quality of evidence. Results: The search resulted in 540 references. Fourteen studies fulfilled the inclusion criteria, of which three were included in a meta-analysis, all three being of high quality, including 621 workers diagnosed with IH. The meta-analysis revealed significant associations with physically demanding work (OR 2.30, 95% CI 1.56–3.40). Two prospective studies, including 382 and 22,926 cases revealed associations that this was true for male workers with a lateral IH that reported standing or walking for more than six hours per workday (OR 1.45, 95% CI 1.12–1.88) or lifting cumulative loads of more than 4000 kg per workday (OR 1.32, 95% CI 1.27–1.38). The level of certainty for the latter two work-related risk factors was moderate and high according to GRADE. Conclusion: Lateral IH among males is associated with work-related risk factors depending on the level of exposure to the time standing/walking per workday, or the amount of load lifted per workday.
KW - Etiology
KW - Occupational disease
KW - Occupational exposure
KW - Prevention
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85085553746&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10029-020-02236-0
DO - https://doi.org/10.1007/s10029-020-02236-0
M3 - Review article
C2 - 32474653
SN - 1265-4906
VL - 24
SP - 943
EP - 950
JO - Hernia
JF - Hernia
IS - 5
ER -