Association between occupational exposure and Dupuytren’s contracture using a job-exposure matrix and self-reported exposure in the CONSTANCES cohort
Résumé
BACKGROUND - Although several studies highlighted an association between occupational exposure and Dupuytren’s contracture (DC), they were often limited by the highly selected population. We aimed to study this association using a job-exposure matrix (JEM) and self-reported exposure in a large cohort. METHODS - From CONSTANCES, a French population-based prospective cohort, we retrieved sex, age, social position, alcohol and tobacco intake and diabetes. Lifetime exposures were assessed using JEM Constances, for participants whose work history was available, and using self-reported exposures. Surgery for DC was collected from the French Health Administrative database. Multivariate logistic regression models adjusted on confounders were built to assess association between surgery for DC and occupational exposures. RESULTS - Among the 23,795 subjects with available work history, 98 underwent surgery for DC. Adjusted odds ratio (aOR) was of 2.08 (1.03-4.2) for exposure to vibration and/or screwing for subjects <60 years old. Among the 81,801 participants with selfreported data, 367 underwent surgery for DC. aOR for exposure to arduous work and/ or carrying heavy loads was of 2.01 (1.32-3.04) for subjects <60 years old. CONCLUSIONS - Some work exposures are associated with DC when adjusting on confounders, mainly for younger subjects. Monitoring exposed workers is important to prevent possible future functional limitations.