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Varicose Veins

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Incidence of varicose veins in relation to occupation and working hours - A study conducted in tertiary care hospitals of South India.

Incidence of varicose veins in relation to occupation and working hours - A study conducted in tertiary care hospitals of South India.

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Varicose Veins Varicose Veins Presentation Transcript

  • The Incidence of Varicose Veins in Relation to Occupation and Working Hours
    Presented By:
    Mohammad Amir
    Final Year MBBS
    JJM Medical College
    Davangere
  • What are varicose veins?
    A disease of dilated tortuous veins of lower limbs.
    The penalty man is paying for his erect
    posture.
    2
  • How serious is the problem?
    The varicose veins affect 5% of the population and 1% have or have had the venous ulceration.
    At any one time up to 200,00 people in UK have active venous ulceration.
    In Europe, in the year 1952, the disability from varicose vein was more than that from auto mobile accidents.
    Severe chronic venous insufficiency is found in nearly 20% of working men and women.
    The actual magnitude of problem is suspected to be more since it is a slowly progressing disease and sometimes symptom free in earlier stages.
    3
  • What are the factors responsible?
    The following factors can either cause or precipitate the disease.
    • Primary valvular weakness.
    • Occupations of prolonged standing
    • Age
    • Parity
    • Immobilization following a surgery
    • Low fiber diet
    4
  • How to identify the disease?
    Aching in veins which
    increases towards the end
    of the day.
    Ankle swelling
    Itching
    Bleeding
    Superficial thrombophlebitis
    Eczema
    Lipodermatosclerosis
    Ulceration
    5
    Lipodermatosclerosis in a cotton mill worker who participated in the study
    A typical venous ulcer
  • Study Design & Setting
    • Retrospective cohort study, on 58 patients who were diagnosed with varicose veins and admitted in Bapuji Hospital and CG Hospital Davangere during January 2009 to April 2010.
    • Exclusion criteria: Patients with insufficient data and non-specific occupational history were excluded.
    6
  • Results
    7
    Table- 1
    Table-2
  • Occupation and the disease
    70.69% cases involved in mainly standing occupations while only 29.31% patients belonged to mainly sitting occupations.
    8
  • Sex and the disease
    The male: female ratio among the varicose vein patients was found to be 4:1
    9
  • The duration of work and age incidence
    On an average, the patients who got the disease had worked standing or walking for 9.33 hours/day.
    The maximum incidence was seen in the age group of 30-39 years with as many as 17 cases out of 58 cases studied.
    10
  • Discussion
    The average working time in present study was found to be 9.33 hours/day which led to the development or precipitation of inherent tendency to varicose veins.
    Dr. Rajmohan Nambiar in Singapore also noted that 67% of varicose veins patients had involved in professions of prolonged standing.
    In the year 1998, Shida Tsutomu from Japan observed that over 85% patients had engaged in prolonged standing occupations with average working time of 10.4 hours/day.
    11
  • Men or women? Who are affected more?
    The male versus female incidence in present study was found to be 4:1 which is, though contradictory to general belief but expected considering the following facts –
    • Low awareness
    • Under reporting
    • Little concern about the disease till it is symptom free
    • Females being less active in standing occupation.
    12
  • Conclusions
    There is a definite co relation between varicose veins and standing occupations, and taking care of the factors responsible for the disease will go a long way in increasing the productivity and efficiency of workers.
    People who work more than 9.33 hours per day standing or walking are more likely to develop the disease.
    The maximum patients belonged to the age group of 30-39 years, which is the most active and productive period of life.
    13
  • Recommendations
    Job rotation
    Pre placement examination
    Health education
    Elastic stockings
    Periodic health check-ups
    14
  • Acknowledgement
    • Thank are due to Dr. H.R Chandrashekhar The Principal, JJMMC, Dr. Prakash M.G. Professor of Surgery, Dr. Vijay Kumar B. Professor of Community Medicine, Dr. P.S. Balu Associate Professor of Community Medicine, and Dr. Ajay K.T. Assistant Professor of Physiology, JJM medical college Davangere, for providing me this opportunity, encouragement and critical review of the manuscript.
    • To my friends Manish, Shakkir and Ravishu for their help and support throughout the project.
    15
  • References
    Bauer G. A plea for the chronic ulcer patient AngiologyVol. 1 No.2.1950:229
    Curwen I.H.M., Scott B.O. Ann. phys. Med. 1952; 1: 17
    Kewine Burnand.Beiley& Love’s short practice of surgery.25th edition.UK.Hodder Arnold.2008:925
    Niren Angle & John J. Berger. Varicose veins:Chronic venous insufficiency. Vascular surgery:a comprehensive review. 6th edition WB Saunders. US.1996:826
    American college of phlebology. Phlebology: The Treatment of Leg Veins. http://mimit.org/html/American_College_of_Phlebology_Brochure.htm (accessed on 07/06/2010)
    Greenfield.Lazor J.Venous and lymphatic disorders. Schwartz principles of surgery. US. Mc Graw HillInc. 1994:1003-1007
    Nambiar.Rajmohan. The Incidence of Varicose veins in Singapore. Singapore medical journal. Vol.9 No.3:167-169(1968)
    16
  • 17
    Questions?