Sancini A, Tomei G, Schifano M P, Nardone N, Andreozzi G, Scimitto L, Fiaschetti M, De Sio S, Scala B, Capozzella A, Suppi A, Cetica C, Tomei F, Ciarrocca M
Department of Anatomy, Histology, Medical-Legal and the Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome.
Ann Ig. 2012 Mar-Apr;24(2):131-44.
Chronic venous disorder is a public health problem that affects the western industrialized countries. The aim of this study is to evaluate the etiology and prevalence of venous disease of the lower limb in workers, and to identify some risk factors using a detailed and systematic analysis of the literature from 1964 to 2011. There is an important relationship between standing position at work and venous disease. The prolonged orthostatic position of the body implies: venostasis, high pressure and risks of blood clots and thrombosis; in standing workers there is an overproduction of reactive oxygen species (ROS) with oxidation of the components of cell membranes, endothelial damage and increase in vascular permeability. Other risk factors were investigated: sitting during work time, weight lifting-moving and exposure to heat sources, the data suggest that this risk factors are less important than orthostatic body position. Age, sex and familiarity are relevant as the extra-occupational risk factors. For a more accurate study of the role of the prolonged orthostatic position on the development of venous disease in the lover limb all authors should define exactly the population, the role and the length of standing time at work. They should also set a universal language to define the correct standing position (ie. within 1 m2 or steps) and time (ie. one hour or 50%-70% of work time). Attention should be given to prevention, to use early therapeutic measures in view of mortality as a consequence of venous disease, of the high social costs related to the loss of working days, of medical care and of residual disability.
慢性静脉疾病是一个影响西方工业化国家的公共卫生问题。本研究的目的是评估工人下肢静脉疾病的病因和患病率,并通过对1964年至2011年的文献进行详细和系统的分析来确定一些风险因素。工作时的站立姿势与静脉疾病之间存在重要关系。身体长时间的直立姿势意味着:静脉淤滞、高压以及血栓形成的风险;站立工作的工人中活性氧(ROS)过度产生,导致细胞膜成分氧化、内皮损伤和血管通透性增加。还对其他风险因素进行了调查:工作时间坐着、举重搬运和接触热源,数据表明这些风险因素不如直立身体姿势重要。年龄、性别和家族史作为职业外风险因素也具有相关性。为了更准确地研究长时间直立姿势对下肢静脉疾病发展中的作用,所有作者都应确切定义人群、站立工作的作用和时长。他们还应设定一种通用语言来定义正确的站立姿势(即1平方米范围内或步数)和时间(即一小时或工作时间的50%-70%)。应重视预防,鉴于静脉疾病导致的死亡率、与工作日损失相关的高昂社会成本、医疗护理以及残余残疾,应尽早采取治疗措施。