Practice for Internal Medicine and Vascular Diseases, Vein Competency Centre, Halle (Saale), Germany.
BG Hospital Bergmannstrost Halle, Department of Internal Medicine, Halle (Saale), Germany.
Vasa. 2024 May;53(3):172-184. doi: 10.1024/0301-1526/a001116. Epub 2024 Mar 27.
Forced postures are common in the workplace. Work in the primary economic sector is characterised by a high degree of physical activity and movement; however, activities in the secondary and tertiary sectors commonly require workers to stand or sit. An expansion of the tertiary sector in recent decades has meant that people in industrialised and emerging economies primarily sit or stand at work. The aim of the systematic review was to identify occupational factors relating to the presence of chronic venous disease (CVD), to place these in the context of developments in the workplace, and to determine whether measures are in place to prevent CVD. We performed a systematic literature review to analyse studies assessing work-related risk factors for CVD. We searched for publications in the PubMed database, the clinic library of BG Hospital Bergmannstrost Halle, and the registry of the German Statutory Accident Insurance. Using occupation-specific keyword combinations, we identified 27,522 publications. The publications underwent an automatic and manual filtering process according to the PRISMA guidelines and 81 publications qualified for the review. Ultimately 25 studies were included in the systematic review. All of the subjects of the studies worked in the secondary and tertiary sectors. No studies looked at the relationship between venous disorders and primary sector occupations. Standing at work for more than four hours a day, repeated heavy lifting, and cumulative time working in a sitting or standing position are risk factors for the development of CVD. Sitting is less of a risk factor than standing or walking. Occupational history and the patient's activity profile are important diagnostic tools which can help confirm a diagnosis and justify treatment when findings are inconsistent. Compression therapy is the primary form of secondary and tertiary prevention. There continues to be a lack of primary preventive measures related to workplace design.
强制性姿势在工作场所很常见。第一产业的工作以高度的体力活动和运动为特征；然而，第二产业和第三产业的活动通常要求工人站立或坐着。近几十年来，第三产业的扩张意味着工业化和新兴经济体的人们主要在工作中坐着或站着。系统评价的目的是确定与慢性静脉疾病（CVD）存在相关的职业因素，将这些因素置于工作场所发展的背景下，并确定是否采取了预防 CVD 的措施。我们进行了系统的文献回顾，以分析评估与 CVD 相关的工作相关危险因素的研究。我们在 PubMed 数据库、BG 医院 Bergmannstrost Halle 的诊所图书馆和德国法定事故保险登记处搜索出版物。使用特定于职业的关键字组合，我们确定了 27522 篇出版物。根据 PRISMA 指南，这些出版物经历了自动和手动过滤过程，有 81 篇出版物符合审查条件。最终有 25 项研究被纳入系统评价。所有研究对象都在第二产业和第三产业工作。没有研究探讨静脉疾病与第一产业职业之间的关系。每天站立工作超过 4 小时、反复举重和累计坐姿或站姿工作时间是 CVD 发展的危险因素。与站立或行走相比，坐姿的风险因素较小。职业史和患者的活动概况是重要的诊断工具，当发现不一致时，有助于确认诊断并证明治疗的合理性。压缩疗法是二级和三级预防的主要形式。与工作场所设计相关的初级预防措施仍然缺乏。
