Chronic Venous Disease in Healthcare Workers: A Systematic Review

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.