Chronic Venous Disease in Healthcare Workers: A Systematic Review
Olumide Ijishakin *
FIU Herbert Wertheim College of Medicine, USA.
Jyothsna Goranti
Texas Tech University Health Sciences Center, USA.
Oluwatobi Atiba
Capella University School of Nursing and Health Sciences, USA.
Olabisi Basirat Akinsanya
Richmond Gabriel University School of Medicine, Saint Vincent and the Grenadines.
Onyinyechi Chinyere Kalagbor
Richmond Gabriel University School of Medicine, Saint Vincent and the Grenadines.
Tuoyo Stephen Fregene
College of Health Sciences University of Port Harcourt Teaching Hospital, Nigeria.
Nahid Ahmed Abdelhadi
Al-Zaiem Al-Azhari University, Sudan.
Danish Ahmed Munir
Cooper Medical School of Rowan University, USA.
Adetola Mowo-wale
Obafemi Awolowo College of Health Sciences/Olabisi Onabanjo University, Nigeria.
Kelechi Adannaya Iwuji
University of Belgrade, Faculty of Medicine, Serbia.
Ibiai Stephanie Lolomari
The American University of Barbados, Barbados.
Uzoamaka Amara Ogbu
Enugu State University of Science and Technology College of Medicine, Nigeria.
Ebube Onyedika Molokwu
Windsor University School of Medicine, St. Kitts, Saint Kitts and Nevis.
Ovonomor Peace Aggreh
Obafemi Awolowo College of Health Sciences/Olabisi Onabanjo University, Nigeria.
Sami Ahmed Ishag Salih
University of Kordofan, Sudan.
Jovita Echere
University of Texas Health Science Center at Houston, Texas, USA.
*Author to whom correspondence should be addressed.
Abstract
Background: Chronic Venous Disease (CVD) encompasses a spectrum of clinical manifestations stemming from venous system dysfunction in the limbs, resulting in symptoms like leg discomfort, swelling, and varicose veins. The global prevalence of CVD varies, with an international survey in 2020 reporting a 22% prevalence rate. CVD's impact extends beyond physical symptoms to psychological well-being, self-esteem, and productivity, posing significant challenges in management and incurring substantial healthcare costs. The condition's prevalence and impact among healthcare workers, particularly those in roles requiring prolonged standing, are notably high yet underexplored.
Methods: This review employed a systematic approach, including studies with healthcare workers diagnosed with CVD, exploring various interventions, therapies, or management strategies. The search covered major databases such as PubMed, Embase, and the Cochrane Library, with no restrictions on language or publication date, and was finalized on March 20, 2024. Study selection and data extraction were meticulously conducted, focusing on outcomes relevant to CVD management among healthcare workers.
Results: From 821 identified studies, 59 duplicates were removed, and 762 titles/abstracts were screened. After excluding 695 records, 67 full-text articles were reviewed, of which 9 met inclusion criteria, representing 54,618 healthcare workers from seven countries. Varicose vein (VV) prevalence among healthcare workers ranged from 16.2% to 46%, while chronic venous insufficiency was reported in up to 69.1% of participants. The largest study (n=51,406) found VVs in 37.0% of Chinese nurses, alongside high rates of insomnia (71.8%) and musculoskeletal disorders (40.9%). In Nepal, 46% of nurses had Doppler-confirmed VVs, with each additional hour of standing per day increasing VV risk (OR=27.4, 95% CI: 4.09-180.8, p<0.001). Significant risk factors across studies included female sex, prolonged standing, nursing roles, age ≥25, and work in high-risk departments (e.g., ICU/OR). For example, Egyptian nurses working in ICUs had markedly increased odds of VVs (AOR=16.2, 95% CI: 3.9–67.4). In a U.S. cohort, 82.1% had venous reflux, and 14.1% were at high risk for DVT based on Caprini scores.
Conclusion: The systematic review underscores the high prevalence of CVD among healthcare workers, driven largely by occupational factors. It calls for enhanced awareness, preventive measures, and management strategies to address the condition effectively within this critical workforce segment. Future research should delve into targeted interventions and the development of comprehensive management frameworks to alleviate the burden of CVD among healthcare professionals.
Keywords: Chronic venous disease, healthcare workers, occupational health, venous insufficiency, management strategies, preventive measures