Dupuytren's Disease and exposure to vibration: Systematic review and Meta-analysis - 20/04/20

Doi : 10.1016/j.jbspin.2020.02.001

Sylvain Mathieu ^a,⁎ , Geraldine Naughton ^b, Alexis Descatha ^c,^d, Martin Soubrier ^a, Frédéric Dutheil ^e
^a Service de Rhumatologie, CHU Clermont-Ferrand, Université Clermont Auvergne, France
^b Department of Educational Studies, Macquarie University, Sydney, New South Wales, Australia, and the Department of Health and Medical Sciences, Swinburne University of Technology, Melbourne, Australia
^c Université Angers, UMR_S1085, CHU Angers, Université Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Angers, France
^d UVSQ, U1168 (VIMA: Aging and chronic diseases, Epidemiological and public health approaches), UMS 011 (Population-based Epidemiologic Cohorts Unit), Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, Villejuif, France
^e CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Occupational and Preventive Medicine, WittyFit, Université Clermont Auvergne, Clermont-Ferrand, France

^⁎Corresponding author.

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Abstract

Introduction

Dupuytren's Disease (DD) occurs frequently in the entire population. Several risk factors are well known, including diabetes, alcohol, and age. In this meta-analysis, we assessed the role of occupational vibration exposure in the risk of DD, an issue currently under debate.

Methods

We searched PubMed, Google Scholar, and the Cochrane Library to find references up to June 2019. DD prevalence was calculated using meta-proportion analysis. Differences in characteristics between DD patients and controls were expressed as standardized mean differences using the inverse of variance method or percentages using also meta-proportion analysis. We performed meta-regression analyses to assess the effects of alcohol, smoking, age, and sex on the DD incidence for the patients with DD that were exposed to vibrations.

Results

We included 9 studies, comprising a total of 60,570 patients, including 1,804 DD patients. Prevalence of DD was 9.8% (95%CI: 5.9–14.4%). Compared with controls, patients with DD were older, more diabetic, more smokers and with a higher consumption of alcohol. Meta-analysis of the nine longitudinal studies comparing DD occurrence between patients exposed to vibration (626 of 6825) or not (1220 of 52,502) revealed a significantly increased DD incidence among patients with vibration exposure compared with controls (OR=2.87; 95%CI: 1.41–5.84). In metaregression we found no significant influence of all parameters on DD.

Conclusion

Age and environmental factors had no effect on DD prevalence among patients exposed to vibrations, despite a 10% prevalence in this group. Using vibration tools at work should be recognized as an important risk factor of developing DD.

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Keywords : Dupuytren disease, Work, Vibration exposure, Meta-analysis