Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 6  |  Issue : 2  |  Page : 107-109

Risk assessment of varicose veins among the traffic police of Kathmandu Metropolitan City, Nepal


1 Department of Surgery, Dhulikhel Hospital, Dhulikhel, Nepal
2 Department of Nursing, Dhulikhel Hospital, Dhulikhel, Nepal

Date of Web Publication6-Jun-2019

Correspondence Address:
Dr. Robin Man Karmacharya
Department of Surgery, Dhulikhel Hospital, Dhulikhel
Nepal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijves.ijves_67_18

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  Abstract 


Introduction: Varicose veins are swollen, tortuous, and sometimes painful veins that are filled with an abnormal collection of blood. Varicose veins are known to be common among professionals such as teachers, traffic police, nurses, shopkeepers, and bus conductors, who have to stand for a long time daily. Other risk factors include age, obesity, pregnancy, smoking, and family history. If left untreated, it can lead to several complications such as ulcers, bleeding, and thromboembolism. Objective: The objective was to assess the risk of varicose veins among traffic police officers of Kathmandu Metropolitan City. Methods: An analytical cross-sectional study was conducted. Data were collected by interview technique and observation method which consisted of self-constructed semi-structured questionnaire for sociodemographic data, descriptive rating scales for symptoms, and observational checklist for signs of varicose veins. Nonprobability convenient sampling technique was used. Results: Out of 200 respondents, 24 (12%) were at risk of varicose veins, out of which 22 were male and the rest were female. Conclusion: The results of the study suggest that overall risk of varicose vein is 12%, with males accounting for 12.3% and females for 9.5%. In the study, the risk of varicose veins is statistically significantly associated with the family history of varicose vein and smoking.

Keywords: Risk, traffic police, varicose vein


How to cite this article:
Karmacharya RM, Prajapati L, Rai S. Risk assessment of varicose veins among the traffic police of Kathmandu Metropolitan City, Nepal. Indian J Vasc Endovasc Surg 2019;6:107-9

How to cite this URL:
Karmacharya RM, Prajapati L, Rai S. Risk assessment of varicose veins among the traffic police of Kathmandu Metropolitan City, Nepal. Indian J Vasc Endovasc Surg [serial online] 2019 [cited 2019 Nov 21];6:107-9. Available from: http://www.indjvascsurg.org/text.asp?2019/6/2/107/259653




  Introduction Top


Varicose veins are abnormally dilated, tortuous, superficial veins caused by incompetent venous valves. Most commonly, this condition occurs in the lower extremities, the saphenous veins.[1] The condition is most common in professionals such as teachers, traffic police, bus conductors, salespeople, nurses, and construction workers whose occupation require prolonged standing.[1] Other risk factors include aging, overweight, pregnancy, smoking, and family history.[2] The valves in deep and superficial veins get damaged because of prolonged standing. Once the valve is damaged, there is a reversal of blood flow from deep to superficial vein.[3] The health hazards get more severe when the duration of exposure increases.[2]

A growing number of traffic police officers are suffering from varicose veins as their job requires prolonged standing. Physical stress is more common among the traffic squad and if neglected it could lead to acute problems.[4] The personnel also pursue a near-sedentary type of work as they only stand at one place for long hours or just walk a few meters, only when necessity arises. These factors such as prolonged standing and restricted mobility in terms of work demand pose a health hazard. Hence, varicose veins are one of the most common occupational problems among traffic police.[2]


  Methods Top


An analytical cross-sectional study was done at Metropolitan Traffic Police Division, Ram Shah Path, Kathmandu, Nepal. Data of duration of work as traffic police, hours of standing per day, symptoms and findings of varicose veins, and family history were taken.

Operational definition of risk of varicose veins was participants having at least one sign out of ten signs (veins are tender to touch, dilated tortuous vein/prominent veins, elevated temperature on palpation of veins, ulcers, skin scars [spontaneous], eczema, ankle swelling, paler areas over healed ulcer, pigmentation [purple/blue], varicosities [small spider-like veins]) or reporting of at least one symptom always or three symptoms sometimes out of 11 (leg pain worsening during work, burning or itching sensation in legs, leg or ankle swelling, heavy feeling in legs, skin discoloration in legs, scars [spontaneous], pain not relieved though medication is taken, itching around one or more veins, skin eczema, tingling sensation in legs, and nocturnal cramps).

Statistical Package for the Social Sciences version 20.0, SPSS Inc., IBM Corporation, Chicago was used for descriptive as well as inferential statistics. Data were analyzed by using descriptive statistical methods such as frequency and percentage. For inferential statistics, Pearson's Chi-square test and Fisher's exact test were used to test the association between independent and dependent variables. Ethical clearance for the study was duly taken from the Institutional Review Committee.


  Results Top


A total of 200 traffic police officers participated in the study. [Table 1] summarizes the distribution of sociodemographic characteristics, work-related details, and risk factors for varicose vein.
Table 1: Distribution of sociodemographic characteristics, work-related details, and risk factors for varicose vein (n=200)

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Notably, 60% of the responders belonged to the age group of 20–29 years. Male responders were the majority with 89.5%. Daily standing hour was > 6 h in 78.5% of respondents. None of the responders had a past history of varicose veins. [Table 2] summarizes the distribution of symptoms of varicose vein.
Table 2: Distribution of symptoms of varicose vein based on sample characteristics (n=200)

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Of the different symptoms, the highest percentage of patients had occasional tingling sensation in legs (43.5%) followed by nocturnal cramps (32%) and leg pain (29%).

[Table 3] summarizes the distribution of signs of varicose veins.
Table 3: Distribution of signs of varicose veins (n=200)

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Based on the operational definition of risks of varicose vein, 24 participants (12%) belonged to this group. Of this, 22 were male participants (11% of total) and 2 were female participants (1% of total).


  Discussion Top


In our study, 60% of participants belonged to the age group of 20–29 years, comparatively younger age. In relation to gender, 89.5% of the responders were male. In a study of traffic personnel's occupational hazard at Brahmapur City, India, the participants constituted 89.6% of males, similar to our study.[5] Majority of the participants had work experience of <5 years. Daily standing hour was >6 h in 78.5% of respondents. Preobesity or obesity was noted in 42.5% of participants. In relation to symptoms, the highest percentage of participants had occasional tingling sensation in the legs (43.5%) followed by nocturnal cramps (32%) and leg pain (29%). The most common signs were dilated tortuous veins (present in 5.5% of participants) and varicosities (present in 3% of participants).

Operational definition of varicose vein in our study was presence of at least one sign or presence of at least one symptom always or presence of three symptoms sometimes. Of the different symptoms, the highest percentage of patients had occasional tingling sensation in the legs (43.5%) followed by nocturnal cramps (32%) and leg pain (29%). The most common signs were dilated tortuous veins (present in 5.5% of participants) and varicosities (present in 3% of participants).

In our study, the overall risk of varicose vein among traffic police officers was 12% with 12.3% risk in males and 9.5% risk in females. Similar finding was noted in a study done in Ahmedabad, Gujarat, India, where the risk of varicose vein was 13% over the age of 45 among 100 participants.[6] In a study done at Bengaluru, India, 11% of traffic police were found to have varicose vein, similar to our study.[7] In a study done at Taiwan, 24.2% of hairdressers had varicose vein, an occupation which too requires prolonged standing like traffic police.[8]

Regarding the work experience, in the current study, the risk was more among those respondents who have been involved in their job between 3 and 5 years, i.e., 18% which is consistent with the finding of the study conducted in Gujarat, India.[9]

It has been shown in the present study that the risk was 12.7% among those who stand for >6 h and 9.3% for those who need <6 h of standing. It is supported by the similar finding of the study conducted in Rajiv Gandhi Institute of Medicine, in which out of fifty patients studied, all exhibited the definite history of prolonged standing.[10]


  Conclusion Top


Traffic police officers are at a significant risk of developing varicose vein due to the fact that they need to stand for prolonged time in their work. Varicose vein, with no doubt, is a form of occupational health hazard and measures should be taken to decrease this problem.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Beebe-Dimmer JL, Pfeifer JR, Engle JS, Schottenfeld D. The epidemiology of chronic venous insufficiency and varicose veins. Ann Epidemiol 2005;15:175-84.  Back to cited text no. 1
    
2.
Annigeri SS. Effectiveness of a Self-Instructional Module (SIM) on Knowledge Regarding Prevention of Varicose Vein among Traffic Police at Selected Stations at Bellary. M. Sc. [Dissertation]. Bangalore: Rajiv Gandhi University of Health Sciences; 2010.  Back to cited text no. 2
    
3.
Abraham SK. Assessment of Knowledge and Practices of Traffic Policemen Regarding Prevention of Varicose Vein in Selected Traffic Police Station Bangalore. M. Sc. [Dissertation]. Bangalore: Rajiv Gandhi University of Health Sciences; 2007.  Back to cited text no. 3
    
4.
Paul BM. Effectiveness of a Self-Instructional Module (SIM) on Knowledge Regarding Prevention of Varicose Vein among Traffic Police at Selected Stations at Bellary. M. Sc. [Dissertation]. Bangalore: Rajiv Gandhi University of Health Sciences; 2010.  Back to cited text no. 4
    
5.
Satapathy D, Behera T, Tripathy R. Health status of traffic police personnel in Brahmapur city. Indian J Community Med 2009;34:71-2.  Back to cited text no. 5
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6.
Patel PG, Jani YK, Bala DV. Study of the morbidity pattern in traffic police in Ahmedabad city. Global J Res Anal 2014;3:106-7.  Back to cited text no. 6
    
7.
Radhakrishna V, Rajagopal Y, Sunilkumar SR, Khazi S, Vishwakarma V, Haran A. Health status of traffic police personnel: A cross-sectional study. J Med Sci Clin Res 2016;4:15075-9.  Back to cited text no. 7
    
8.
Chen CL, Guo HR. Varicose veins in hairdressers and associated risk factors: A cross-sectional study. BMC Public Health 2014;14:885.  Back to cited text no. 8
    
9.
Prajapati P, Modi K, Rahul K, Shah A. A study related to effects of job experience on health of traffic police personnel of Ahmedabad city, Gujarat. Int J Interdiscip Multidiscip Stud 2015;2:127-33.  Back to cited text no. 9
    
10.
Vani K, Reddy DP. Clinical study and management of lower limb varicose veins. IJAR 2015;3:1778-84.  Back to cited text no. 10
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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