Chronic venous insufficiency in workers with a standing prof

Chronic venous insufficiencyin workers with a standing profession

(R.M.A. Krijnen)

Academisch proefschrift ter verkrijging van de graad van doctor aan de Vrije Universiteit te Amsterdam op gezag van de rector magnificus prof. dr. T. Sminia in het openbaar te verdedigen ten overstaan van de promotiecommissie van de faculteit der geneeskunde op vrijdag 11 juni 19999 om 15.45 uur in het hoofdgebouw van de universiteit De Boelelaan 1105.

Chronic venous insufficiency (CVI) is a burden to many workers, especially to those with a standing profession. Preventive measures are seldom taken. A quasiran domized parallelgroup trial was performed in 114 male workers with CVI and a standing profession. For 3 months, class II compression stockings or rubber floor matswere used vs controls. Outcome measures were diurnal volume changes (legswelling) and complaints of the lower legs. With the stockings, a significant decrease in complaints was found, as well as a significant decrease in legswelling. Rubber mats were often not suitable for hygienic and safety reasons.The decrease in complaints in the group using rubber mats was less pronounced, and leg swelling did not differ from that of the control group. Compressionstockings appeared to be superior to rubber mats with regard to applicability, diminishing subjective complaints, and decrease of diurnal leg swelling.

Background: Chronic venous insufficiency (CVI) in the occupational population is often poorly recognized. The dimensions of this problem have never been thoroughly investigated in the Netherlands.

Objective: To study the epidemiology and risk factors of CVI in males witha standing position at work. To develop a simple diagnostic instrument for screening an (occupational) population for CVI.

Methods: 387 male workers with a standing profession were examined by means of a questionnaire, physical examination, Doppler ultrasound investigation, light reflection rheography and optical leg volume measurements.

Results: CVI was present in 29% of the subjects and correlated with age, weight and duration of standing work. Complaints of the legs were reported by 81% of the individuals with CVI but also by 63% of the persons without CVI. The questionnaire had a predictive value of 80% in detecting CVI.

Conclusion: CVI was a major problem because of the quantity (29%) and the accompanying complaints. Neither the questionnaire nor other investigative measures proved to be as efficient in diagnosing CVI as physical examination in combination with Doppler ultrasound investigation.

Paperback, 136 pag.

Uitg. Krijnen, 1999

ISBN 9090126910

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