INCIDENCE RATES OF SURGICALLY TREATED RHEGMATOGENOUS RETINAL DETACHMENT IN MANUAL WORKERS, NON-MANUAL WORKERS AND HOUSEWIVES OF TUSCANY, ITALY

Introduction. Candidate risk factors for idiopathic rhegmatogenous retinal detachment (RRD) include heavy manual handling (requiring Valsalva’s maneuver) and high body mass index (BMI). Objectives.We assessed incidence rates of surgically-treated idiopathic RRD in the general population and among manual workers, non-manual workers and housewives. Methods. In Italy, both public and private hospitals are obliged to issue codified discharge records (even after day-treatment) for archival in patients’ regions of residence; Tuscan hospitals additionally provide employment information, allowing classification of patients as manual workers, non-manual workers or full-time housewives.We retrieved all Italian discharge records bearing a principal diagnosis corresponding to idiopathic RRD (ICD-9 code 361.0-361.07, 361.9) coupled with retinal surgery (DRG code 36) for any resident of Tuscany or Emilia-Romagna (1997-2008) aged 25-59 years. we restricted the study population to subjects.We extracted population data from the 2001 census. We calculated agestandardized admission rates (per 100,000 person-years) based on the WHO Standard European Population. Results. After eliminating repeat admissions, we identified 1,380 eligible cases (795men). Amongmen,manual workers experienced a 1.9-fold higher age-standardized rate than non-manual workers (17.8 [95%CI: 16.3-19.4] vs. 9.2 [8.0-10.4]). Among women, agestandardized rates were ~2-fold higher among both manual workers (11.1 [9.6-12.6]) and housewives (10.8 [9.2-12.4]) than in nonmanual workers (5.6 [4.5-6.6]). Conclusions. This study suggests that manual workers are more often affected by idiopathic RRD than non-manual workers. The findings accord with the hypothesis that heavy manual handling and high BMI have a causal role.