Netherlands Center for Occupational Diseases, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands.
Hernia. 2020 Oct;24(5):943-950. doi: 10.1007/s10029-020-02236-0. Epub 2020 May 30.
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.
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.
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.
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.
临床医生需要了解腹股沟疝（IH）是否与工作有关，以回答有关预防和医学因果关系的问题。本综述描述了与工作相关的危险因素是否与 IH 有关。
通过 Medline 中的 PubMed 进行系统综述，检索时间截至 2020 年 2 月 3 日。纳入标准为 IH 由临床医生诊断，比较暴露于与工作相关的危险因素的工人与暴露较少或完全不暴露于与工作相关的危险因素的工人。使用 Cochrane 的 RevMan 5.3 进行质量评估和荟萃分析，并进行 GRADE 质量证据评估。
搜索结果产生了 540 条参考文献。14 项研究符合纳入标准，其中 3 项研究纳入荟萃分析，均为高质量研究，共纳入 621 例经临床诊断为 IH 的工人。荟萃分析显示，与体力要求高的工作显著相关（OR 2.30，95%CI 1.56-3.40）。两项前瞻性研究，包括 382 例和 22926 例病例，发现对于报告每天工作中站立或行走超过 6 小时或每天举起累积负荷超过 4000 公斤的男性工人，这种情况适用于外侧 IH（OR 1.45，95%CI 1.12-1.88）或（OR 1.32，95%CI 1.27-1.38）。根据 GRADE，后两个与工作相关的危险因素的确定性水平为中度和高度。
男性外侧 IH 与工作相关的危险因素有关，具体取决于每天站立/行走的时间暴露水平，或每天举起的负荷量。
