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Published in: Hernia 5/2020

Open Access 01-10-2020 | Inguinal Hernia | Review

Work-relatedness of inguinal hernia: a systematic review including meta-analysis and GRADE

Authors: P. P. F. M. Kuijer, D. Hondebrink, C. T. J. Hulshof, H. F. Van der Molen

Published in: Hernia | Issue 5/2020

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Abstract

Purpose

Clinicians need to know whether inguinal hernia (IH) can be attributed to work to answer questions regarding prevention and medical causation. This review describes whether work-related risk factors are associated with IH.

Methods

A systematic review was performed in Medline via PubMed until February 3rd, 2020. Inclusion criteria were that IH was diagnosed by a clinician, and workers exposed to work-related risk factors were compared to workers less exposed or not at all. A quality assessment and a meta-analysis using Cochrane’s RevMan 5.3 were performed, including GRADE for quality of evidence.

Results

The search resulted in 540 references. Fourteen studies fulfilled the inclusion criteria, of which three were included in a meta-analysis, all three being of high quality, including 621 workers diagnosed with IH. The meta-analysis revealed significant associations with physically demanding work (OR 2.30, 95% CI 1.56–3.40). Two prospective studies, including 382 and 22,926 cases revealed associations that this was true for male workers with a lateral IH that reported standing or walking for more than six hours per workday (OR 1.45, 95% CI 1.12–1.88) or lifting cumulative loads of more than 4000 kg per workday (OR 1.32, 95% CI 1.27–1.38). The level of certainty for the latter two work-related risk factors was moderate and high according to GRADE.

Conclusion

Lateral IH among males is associated with work-related risk factors depending on the level of exposure to the time standing/walking per workday, or the amount of load lifted per workday.
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Literature
1.
go back to reference The HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22:1–165CrossRef The HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22:1–165CrossRef
2.
go back to reference Svendsen SW, Frost P, Vad MV, Andersen JH (2013) Risk and prognosis of inguinal hernia in relation to occupational mechanical exposures—a systematic review of the epidemiologic evidence. Scand J Work Environ Health 39(1):5–26CrossRef Svendsen SW, Frost P, Vad MV, Andersen JH (2013) Risk and prognosis of inguinal hernia in relation to occupational mechanical exposures—a systematic review of the epidemiologic evidence. Scand J Work Environ Health 39(1):5–26CrossRef
3.
go back to reference Vad MV, Frost P, Bay-Nielsen M, Svendsen SW (2012) Impact of occupational mechanical exposures on risk of lateral and medial inguinal hernia requiring surgical repair. Occup Environ Med 69(11):802–809CrossRef Vad MV, Frost P, Bay-Nielsen M, Svendsen SW (2012) Impact of occupational mechanical exposures on risk of lateral and medial inguinal hernia requiring surgical repair. Occup Environ Med 69(11):802–809CrossRef
4.
go back to reference Carbonell JF, Sanchez JL, Peris RT, Ivorra JC, Del Baño MJ, Sanchez CS, Arraez JI, Greus PC (1993) Risk factors associated with inguinal hernias: a case control study. Eur J Surg 159(9):481–486PubMed Carbonell JF, Sanchez JL, Peris RT, Ivorra JC, Del Baño MJ, Sanchez CS, Arraez JI, Greus PC (1993) Risk factors associated with inguinal hernias: a case control study. Eur J Surg 159(9):481–486PubMed
5.
go back to reference Vad MV, Frost P, Svendsen SW (2015) Occupational mechanical exposures and reoperation after first-time inguinal hernia repair: a prognosis study in a male cohort. Hernia 19(6):893–900CrossRef Vad MV, Frost P, Svendsen SW (2015) Occupational mechanical exposures and reoperation after first-time inguinal hernia repair: a prognosis study in a male cohort. Hernia 19(6):893–900CrossRef
6.
go back to reference Vad MV, Frost P, Rosenberg J, Andersen JH, Svendsen SW (2017) Inguinal hernia repair among men in relation to occupational mechanical exposures and lifestyle factors: a longitudinal study. Occup Environ Med 74(11):769–775CrossRef Vad MV, Frost P, Rosenberg J, Andersen JH, Svendsen SW (2017) Inguinal hernia repair among men in relation to occupational mechanical exposures and lifestyle factors: a longitudinal study. Occup Environ Med 74(11):769–775CrossRef
7.
go back to reference Boschman JS, Brand T, Frings-Dresen MH, van der Molen HF (2017) Improving the assessment of occupational diseases by occupational physicians. Occup Med (Lond) 67(1):13–19CrossRef Boschman JS, Brand T, Frings-Dresen MH, van der Molen HF (2017) Improving the assessment of occupational diseases by occupational physicians. Occup Med (Lond) 67(1):13–19CrossRef
8.
go back to reference Verbeek J (2012) When work is related to disease, what establishes evidence for a causal relation? Saf Health Work 3(2):110–116CrossRef Verbeek J (2012) When work is related to disease, what establishes evidence for a causal relation? Saf Health Work 3(2):110–116CrossRef
9.
go back to reference Van der Beek AJ, Dennerlein JT, Huysmans MA, Mathiassen SE, Burdorf A, van Mechelen W, van Dieën JH, Frings-Dresen MH, Holtermann A, Janwantanakul P, van der Molen HF, Rempel D, Straker L, Walker-Bone K, Coenen P (2017) A research framework for the development and implementation of interventions preventing work-related musculoskeletal disorders. Scand J Work Environ Health 43(6):526–539PubMed Van der Beek AJ, Dennerlein JT, Huysmans MA, Mathiassen SE, Burdorf A, van Mechelen W, van Dieën JH, Frings-Dresen MH, Holtermann A, Janwantanakul P, van der Molen HF, Rempel D, Straker L, Walker-Bone K, Coenen P (2017) A research framework for the development and implementation of interventions preventing work-related musculoskeletal disorders. Scand J Work Environ Health 43(6):526–539PubMed
10.
go back to reference Yung M, Dale AM, Kapellusch J, Bao S, Harris-Adamson C, Meyers AR, Hegmann KT, Rempel D, Evanoff BA (2019) Modeling the effect of the 2018 revised ACGIH® hand activity threshold limit value® (TLV) at reducing risk for carpal tunnel syndrome. J Occup Environ Hyg 30:1–6 Yung M, Dale AM, Kapellusch J, Bao S, Harris-Adamson C, Meyers AR, Hegmann KT, Rempel D, Evanoff BA (2019) Modeling the effect of the 2018 revised ACGIH® hand activity threshold limit value® (TLV) at reducing risk for carpal tunnel syndrome. J Occup Environ Hyg 30:1–6
11.
go back to reference Descatha A, Albo F, Leclerc A, Carton M, Godeau D, Roquelaure Y, Petit A (2016) Lateral epicondylitis and physical exposure at work? A review of prospective studies and meta-analysis. Arthritis Care Res (Hoboken) 68:1681–1687CrossRef Descatha A, Albo F, Leclerc A, Carton M, Godeau D, Roquelaure Y, Petit A (2016) Lateral epicondylitis and physical exposure at work? A review of prospective studies and meta-analysis. Arthritis Care Res (Hoboken) 68:1681–1687CrossRef
12.
go back to reference Van der Molen HF, Foresti C, Daams JG, Frings-Dresen MHW, Kuijer PPFM (2017) Work-related risk factors for specific shoulder disorders: a systematic review and meta-analysis. Occup Environ Med 74(10):745–755CrossRef Van der Molen HF, Foresti C, Daams JG, Frings-Dresen MHW, Kuijer PPFM (2017) Work-related risk factors for specific shoulder disorders: a systematic review and meta-analysis. Occup Environ Med 74(10):745–755CrossRef
13.
go back to reference Seidler A, Lüben L, Hegewald J, Bolm-Audorff U, Bergmann A, Liebers F, Ramdohr C, Romero Starke K, Freiberg A, Unverzagt S (2018) Dose-response relationship between cumulative physical workload and osteoarthritis of the hip—a meta-analysis applying an external reference population for exposure assignment. BMC Musculoskelet Disord 19(1):182CrossRef Seidler A, Lüben L, Hegewald J, Bolm-Audorff U, Bergmann A, Liebers F, Ramdohr C, Romero Starke K, Freiberg A, Unverzagt S (2018) Dose-response relationship between cumulative physical workload and osteoarthritis of the hip—a meta-analysis applying an external reference population for exposure assignment. BMC Musculoskelet Disord 19(1):182CrossRef
14.
go back to reference Verbeek J, Mischke C, Robinson R, Ijaz S, Kuijer P, Kievit A, Ojajärvi A, Neuvonen K (2017) Occupational exposure to knee loading and the risk of osteoarthritis of the knee: a systematic review and a dose-response meta-analysis. Saf Health Work 8(2):130–142CrossRef Verbeek J, Mischke C, Robinson R, Ijaz S, Kuijer P, Kievit A, Ojajärvi A, Neuvonen K (2017) Occupational exposure to knee loading and the risk of osteoarthritis of the knee: a systematic review and a dose-response meta-analysis. Saf Health Work 8(2):130–142CrossRef
15.
go back to reference Kuijer PPFM, Verbeek JH, Seidler A, Ellegast R, Hulshof CTJ, Frings-Dresen MHW, Van der Molen HF (2018) Work-relatedness of lumbosacral radiculopathy syndrome: Review and dose-response meta-analysis. Neurology 91(12):558–564CrossRef Kuijer PPFM, Verbeek JH, Seidler A, Ellegast R, Hulshof CTJ, Frings-Dresen MHW, Van der Molen HF (2018) Work-relatedness of lumbosacral radiculopathy syndrome: Review and dose-response meta-analysis. Neurology 91(12):558–564CrossRef
16.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535CrossRef Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535CrossRef
17.
go back to reference Huguet A, Hayden JA, Stinson J, McGrath PJ, Chambers CT, Tougas ME, Wozney L (2013) Judging the quality of evidence in reviews of prognostic factor research: adapting the GRADE framework. Syst Rev 2:71CrossRef Huguet A, Hayden JA, Stinson J, McGrath PJ, Chambers CT, Tougas ME, Wozney L (2013) Judging the quality of evidence in reviews of prognostic factor research: adapting the GRADE framework. Syst Rev 2:71CrossRef
18.
go back to reference Kang SK, Burnett CA, Freund E, Sestito J (1999) Hernia: is it a work-related condition? Am J Ind Med 36(6):638–644CrossRef Kang SK, Burnett CA, Freund E, Sestito J (1999) Hernia: is it a work-related condition? Am J Ind Med 36(6):638–644CrossRef
19.
go back to reference Lau H, Fang C, Yuen WK, Patil NG (2007) Risk factors for inguinal hernia in adult males: a case-control study. Surgery 141(2):262–266CrossRef Lau H, Fang C, Yuen WK, Patil NG (2007) Risk factors for inguinal hernia in adult males: a case-control study. Surgery 141(2):262–266CrossRef
20.
go back to reference Liem MS, van der Graaf Y, Zwart RC, Geurts I, van Vroonhoven TJ (1997) Risk factors for inguinal hernia in women: a case-control study. The Coala Trial group. Am J Epidemiol 146(9):721–726CrossRef Liem MS, van der Graaf Y, Zwart RC, Geurts I, van Vroonhoven TJ (1997) Risk factors for inguinal hernia in women: a case-control study. The Coala Trial group. Am J Epidemiol 146(9):721–726CrossRef
21.
go back to reference Ruhl CE, Everhart JE (2007) Risk factors for inguinal hernia among adults in the US population. Am J Epidemiol 165(10):1154–1161CrossRef Ruhl CE, Everhart JE (2007) Risk factors for inguinal hernia among adults in the US population. Am J Epidemiol 165(10):1154–1161CrossRef
22.
go back to reference Ashindoitiang JA, Ibrahim NA, Akinlolu OO (2012) Risk factors for inguinal hernia in adult male Nigerians: a case control study. Int J Surg 10(7):364–367CrossRef Ashindoitiang JA, Ibrahim NA, Akinlolu OO (2012) Risk factors for inguinal hernia in adult male Nigerians: a case control study. Int J Surg 10(7):364–367CrossRef
23.
go back to reference Flich J, Alfonso JL, Delgado F, Prado MJ, Cortina P (1992) Inguinal hernia and certain risk factors. Eur J Epidemiol 8(2):277–282CrossRef Flich J, Alfonso JL, Delgado F, Prado MJ, Cortina P (1992) Inguinal hernia and certain risk factors. Eur J Epidemiol 8(2):277–282CrossRef
24.
go back to reference Pathak S, Poston GJ (2006) It is highly unlikely that the development of an abdominal wall hernia can be attributable to a single strenuous event. Ann R Coll Surg Engl 88(2):168–171CrossRef Pathak S, Poston GJ (2006) It is highly unlikely that the development of an abdominal wall hernia can be attributable to a single strenuous event. Ann R Coll Surg Engl 88(2):168–171CrossRef
25.
go back to reference Smith GD, Crosby DL, Lewis PA (1996) Inguinal hernia and a single strenuous event. Ann R Coll Surg Engl 78(4):367–368PubMedPubMedCentral Smith GD, Crosby DL, Lewis PA (1996) Inguinal hernia and a single strenuous event. Ann R Coll Surg Engl 78(4):367–368PubMedPubMedCentral
26.
go back to reference Dickerman RD, Smith A, Stevens QE (2004) Umbilical and bilateral inguinal hernias in a veteran powerlifter: is it a pressure-overload syndrome? Clin J Sport Med 14(2):95–96 (discussion 97)CrossRef Dickerman RD, Smith A, Stevens QE (2004) Umbilical and bilateral inguinal hernias in a veteran powerlifter: is it a pressure-overload syndrome? Clin J Sport Med 14(2):95–96 (discussion 97)CrossRef
27.
go back to reference Snyder QC, Kearney PJ (2002) High +Gz induced acute inguinal herniation in an F-16 aircrew member: case report and review. Aviat Space Environ Med 73(1):68–72PubMed Snyder QC, Kearney PJ (2002) High +Gz induced acute inguinal herniation in an F-16 aircrew member: case report and review. Aviat Space Environ Med 73(1):68–72PubMed
28.
go back to reference Sanjay P, Woodward A (2007) Single strenuous event: does it predispose to inguinal herniation? Hernia 11(6):493–496CrossRef Sanjay P, Woodward A (2007) Single strenuous event: does it predispose to inguinal herniation? Hernia 11(6):493–496CrossRef
30.
go back to reference Van der Beek AJ, Frings-Dresen MH (1998) Assessment of mechanical exposure in ergonomic epidemiology. Occup Environ Med 55(5):291–299CrossRef Van der Beek AJ, Frings-Dresen MH (1998) Assessment of mechanical exposure in ergonomic epidemiology. Occup Environ Med 55(5):291–299CrossRef
Metadata
Title
Work-relatedness of inguinal hernia: a systematic review including meta-analysis and GRADE
Authors
P. P. F. M. Kuijer
D. Hondebrink
C. T. J. Hulshof
H. F. Van der Molen
Publication date
01-10-2020
Publisher
Springer Paris
Keyword
Inguinal Hernia
Published in
Hernia / Issue 5/2020
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-020-02236-0

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