Association between occupational exposure and Dupuytren's contracture using a job-exposure matrix and self-reported exposure in the CONSTANCES cohort

Marc Fadel (1, 2) , Annette Leclerc (2, 3) , Bradley Evanoff (4) , Ann-Marie Dale (4) , Laure Ngabirano (5, 6) , Yves Roquelaure (5, 7) , Alexis Descatha (5, 6, 2)

1 HUPO - Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest
2 VIMA - Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique
3 CONSTANCES - Cohortes épidémiologiques en population
4 WUSTL - Washington University in Saint Louis
5 Irset - Institut de recherche en santé, environnement et travail
6 EHESP - École des Hautes Études en Santé Publique [EHESP]
7 EHESP-Irset - EHESP-Irset

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/tobacco intake and diabetes. Lifetime exposures were assessed by two different methods: with the biomechanical JEM “JEM Constances”, we assessed exposure to vibration and/or forearm rotation for participants whose work history was available, and from a self-administered questionnaire, we retrieved self-reported exposure to arduous work and/or carrying heavy loads. Surgery for DC was collected from the French Health Administrative database from 2009 to 2016. Multivariate logistic regression models adjusted for confounders were built to assess association between surgery for DC and occupational exposures. Results: Work history was retrieved for 23,795 subjects among whom 98 underwent surgery for DC. Adjusted odds ratio (aOR) was of 2.08 (1.03-4.2) for being ever exposed to vibration and/or forearm rotation for subjects <60 years and of 1.20 (0.69-2.08) for subjects 60 years. Data for self-reported exposure were available for 81,801 participants among whom 367 underwent surgery for DC. aOR for being exposed more than 20 years to arduous work and/or carrying heavy loads was of 2.01 (1.32-3.04) for subjects <60 years and of 1.04 (0.7-1.54) for subjects ≥60. Conclusions: Manual work is associated with surgery for DC among younger subjects. Monitoring exposed workers is important to prevent future functional limitations.

Mots clés: occupational; dupuytren’s contracture; job-exposure matrix; epidemiology

Domaines: Sciences du Vivant [q-bio]

Marc Fadel, Annette Leclerc, Bradley Evanoff, Ann-Marie Dale, Laure Ngabirano, et al.. Association between occupational exposure and Dupuytren's contracture using a job-exposure matrix and self-reported exposure in the CONSTANCES cohort. Occupational and Environmental Medicine, 2019, 76 (11), pp.845-848. ⟨10.1136/oemed-2019-105912⟩. ⟨hal-02280781⟩