Lucas Gérard, Brichet Anne, Roquelaure Yves, Leclerc Annette, Descatha Alexis
DRTEFP, Pays-de-Loire et Bretagne, France.
Am J Ind Med. 2008 Jan;51(1):9-15. doi: 10.1002/ajim.20542.
The etiology of Dupuytren's disease is unknown, and the role of occupational exposure is still debated. Our objective was to study the association between occupational exposures, personal risk factors and Dupuytren's disease.
In this cross-sectional survey, nine occupational physicians performed clinical examinations, focused on Dupuytren's disease, of 2,406 French male civil servants employed at the Equipment Ministry in 1998 and interviewed them about medical history, leisure manual exposure and occupational biomechanical exposure to vibrations and manual work. A cumulative occupational exposure score was defined, with three levels of exposure.
Dupuytren's disease was diagnosed in 212 men (8.8%). The occupational exposure score was significantly higher in this group of cases than in the rest of the sample (377 (SD280) vs. 223 (SD250), respectively; P < 0.0001). Occupational exposure was associated with Dupuytren's disease (adjusted Odds Ratio = 2.20 [1.39-3.45] for the intermediate and 3.10 [1.99-4.84] for the high exposure groups), with adjustment for age, leisure physical activities, alcohol consumption (> or =5 servings per day), history of diabetes, epilepsy, hand trauma, and familial history of Dupuytren's disease.
Manual work exposure was associated with Dupuytren's disease after adjustment for personal risk factors. Longitudinal studies are needed to confirm these results.
掌腱膜挛缩症的病因尚不清楚，职业暴露的作用仍存在争议。我们的目的是研究职业暴露、个人风险因素与掌腱膜挛缩症之间的关联。
在这项横断面调查中，九名职业医生对1998年受雇于装备部的2406名法国男性公务员进行了以掌腱膜挛缩症为重点的临床检查，并就他们的病史、休闲时手部接触情况以及职业性生物力学振动和手工工作暴露情况进行了访谈。定义了一个累积职业暴露评分，分为三个暴露水平。
212名男性（8.8%）被诊断为掌腱膜挛缩症。该病例组的职业暴露评分显著高于其余样本（分别为377（标准差280）和223（标准差250）；P<0.0001）。职业暴露与掌腱膜挛缩症相关（调整后的优势比，中等暴露组为2.20[1.39 - 3.45]，高暴露组为3.10[1.99 - 4.84]），并对年龄、休闲体育活动、饮酒量（每天≥5份）、糖尿病史、癫痫史、手部创伤史和掌腱膜挛缩症家族史进行了调整。
在对个人风险因素进行调整后，手工工作暴露与掌腱膜挛缩症相关。需要进行纵向研究以证实这些结果。
