Yeo Ryann E, Eros Fanni R, Demers Paul A, Sritharan Jeavana
Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Am J Ind Med. 2025 Apr;68(4):344-357. doi: 10.1002/ajim.23700. Epub 2025 Jan 9.
Raynaud's phenomenon (RP) is linked to occupational exposures such as vibration, cold temperature, and chemicals. However, large cohort studies examining RP by occupation and sex are scarce. To address this gap, this study aimed to assess risk of RP by both occupation and sex in a large cohort of workers in Ontario, Canada.
Workers with accepted lost-time compensation claims were linked to physician billing records to identify diagnoses of RP between 2002 and 2020. A 3-year washout (disease-free) period was applied, and follow-up was limited to 5 years. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for diagnoses of RP, adjusted for age at start of follow-up, birth year, and stratified by sex.
A total of 7,131 RP cases were identified among 810,739 workers. Among men, higher risks were observed for truck drivers (HR = 1.23, 95% CI = 1.08-1.41), driver-salesmen (HR = 2.54, 95% CI = 1.21-5.34), those in mining and quarrying-related cutting, handling, and loading (HR = 2.57, 95% CI = 1.29-5.15), and construction trades laboring and elemental work (HR = 1.70, 95% CI = 1.24-2.34). Among women, higher risks were observed for those working in waitressing and related (HR = 1.70, 95% CI = 1.22-2.38), food and beverage preparation (HR = 1.34, 95% CI = 1.02-1.76), and electrical equipment fabricating and assembling (HR 1.96, 95% CI = 1.08-3.55).
Study findings show elevated risks of RP among various occupations, with notable differences between men and women. These differences may be attributable to variations in potential exposures and susceptibility to RP. Findings underscore the need for large cohort studies to examine RP across various occupational groups and both sexes.
雷诺现象(RP)与职业暴露有关,如振动、低温和化学物质。然而,按职业和性别对雷诺现象进行研究的大型队列研究较少。为填补这一空白,本研究旨在评估加拿大安大略省一大群工人中按职业和性别划分的雷诺现象风险。
将已接受误工赔偿申请的工人与医生计费记录相链接,以确定2002年至2020年期间的雷诺现象诊断情况。采用3年的洗脱期(无病期),随访限于5年。使用Cox比例风险模型估计雷诺现象诊断的风险比(HR)和95%置信区间(CI),并根据随访开始时的年龄、出生年份进行调整,并按性别分层。
在810,739名工人中,共确定了7,131例雷诺现象病例。在男性中,卡车司机(HR = 1.23,95% CI = 1.08 - 1.41)、司机兼推销员(HR = 2.54,95% CI = 1.21 - 5.34)、从事采矿和采石相关切割、搬运及装载工作的人员(HR = 2.57,95% CI = 1.29 - 5.15)以及建筑行业体力劳动和基础工作的人员(HR = 1.70,95% CI = 1.24 - 2.34)的风险较高。在女性中,从事餐饮及相关工作的人员(HR = 1.70,95% CI = 1.22 - 2.38)、食品和饮料制备工作的人员(HR = 1.34,95% CI = 1.02 - 1.76)以及电气设备制造和组装工作的人员(HR = 1.96,95% CI = 1.08 - 3.55)的风险较高。
研究结果表明,不同职业中雷诺现象的风险升高,男性和女性之间存在显著差异。这些差异可能归因于潜在暴露和对雷诺现象易感性的差异。研究结果强调需要进行大型队列研究,以考察不同职业群体和两性中的雷诺现象。