The Relationship between Work Activities and Duration of Symptoms with the Severity of Inguinal Hernia: A Cross-Sectional Study at in Waled Cirebon Hospital, Indonesia
DOI:
https://doi.org/10.35898/ghmj-931372Keywords:
Inguinal hernia, Work activity, Physical activity, Symptom duration, Hernia incarcerationAbstract
Background: Inguinal hernia repair is one of the most commonly performed surgical procedures worldwide, and inguinal hernia is frequently treated at Waled Regional General Hospital, Cirebon. Heavy physical work may raise intra-abdominal pressure, and delayed treatment may allow a hernia to progress to irreducibility or incarceration. However, whether these two factors are related to the clinical severity of the hernia at presentation has rarely been examined in Indonesia.
Aims: To analyse the association of work activity and of symptom duration with the severity of inguinal hernia among patients treated at Waled Regional General Hospital, Cirebon, in 2020–2025, and to describe how severity is distributed across work-activity and symptom-duration groups.
Methods: This analytical observational study used a cross-sectional design based on the medical records of 88 adult inpatients who underwent surgery for primary inguinal hernia, selected by consecutive sampling. Work activity (light–moderate vs heavy), symptom duration (acute <6 months, subacute 6–12 months, chronic >12 months) and severity (reducible, irreducible, incarcerated, strangulated) were extracted from the records. Associations were assessed with cross-tabulation, chi-square tests, Spearman's rank correlation and ordinal logistic regression including both exposures.
Results: Of the 88 patients, 63.6% had light–moderate and 36.4% heavy work; 46.6% had reducible, 34.1% irreducible and 19.3% incarcerated hernias, and none had strangulation. Work activity showed a weak but statistically significant inverse association with severity (r = −0.234; p = 0.028): reducible hernias were more frequent among heavy than light–moderate workers (62.5% vs 37.5%), whereas irreducible (25.0% vs 39.3%) and incarcerated hernias (12.5% vs 23.2%) were less frequent. This association persisted after adjustment for symptom duration (adjusted OR for a more severe category 0.38; 95% CI 0.16–0.90; p = 0.027). Symptom duration was not significantly associated with severity (r = −0.018; p = 0.871); incarceration occurred in 24.1%, 19.4% and 13.0% of the acute, subacute and chronic groups, respectively.
Conclusion: Work activity showed a weak but statistically significant association with hernia severity, with heavy workers more often presenting with reducible hernias, whereas symptom duration was not significantly associated with severity. Because of the cross-sectional design and the lack of adjustment for age and sex, which may have confounded the observed inverse association, these findings indicate associations only and do not establish causality.
Downloads
References
Abrahamson, J. (1998). Etiology and pathophysiology of primary and recurrent groin hernia formation. Surgical Clinics of North America, 78(6), 953–972. https://doi.org/10.1016/S0039-6109(05)70364-9
Aritiah, M. A. R., Fariztia, A. I., Azmi, N. A., Haq, A. M. A. F., Ragad, P., Rizaldi, M. H., Salsabilah, M. S., & Sari, L. S. (2024). Inguinal hernia: Literature review. Jurnal Biologi Tropis, 24(1b), 258–263. https://doi.org/10.29303/jbt.v24i1b.7889
Burcharth, J., Pedersen, M. S., Bisgaard, T., Pedersen, C. B., & Rosenberg, J. (2017). Etiology of inguinal hernias: A comprehensive review. Frontiers in Surgery, 4, Article 52. https://doi.org/10.3389/fsurg.2017.00052
Fitzgibbons, R. J., Jr., Giobbie-Hurder, A., Gibbs, J. O., Dunlop, D. D., Reda, D. J., McCarthy, M., Jr., Neumayer, L. A., Barkun, J. S. T., Hoehn, J. L., Murphy, J. T., Sarosi, G. A., Jr., Syme, W. C., Thompson, J. S., Wang, J., & Jonasson, O. (2006). Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: A randomized clinical trial. JAMA, 295(3), 285–292. https://doi.org/10.1001/jama.295.3.285
Gallegos, N. C., Dawson, J., Jarvis, M., & Hobsley, M. (1991). Risk of strangulation in groin hernias. British Journal of Surgery, 78(10), 1171–1173. https://doi.org/10.1002/bjs.1800781007
Hair, A., Paterson, C., Wright, D., Baxter, J. N., & O'Dwyer, P. J. (2001). What effect does the duration of an inguinal hernia have on patient symptoms? Journal of the American College of Surgeons, 193(2), 125–129. https://doi.org/10.1016/S1072-7515(01)00983-8
Handayani, F., & Hardichal, R. (2016). Faktor-faktor yang berhubungan dengan kejadian hernia inguinal di ruang perawatan bedah RSUD Prof. Dr. Hi. Aloei Saboe Kota Gorontalo. Zaitun (Jurnal Ilmu Kesehatan), 4(1), 1–6. https://doi.org/10.31314/zijk.v4i1.1236
Kuijer, P. P. F. M., Hondebrink, D., Hulshof, C. T. J., et al. (2020). Work-relatedness of inguinal hernia: A systematic review including meta-analysis and GRADE. Hernia, 24(5), 943–950. https://doi.org/10.1007/s10029-020-02236-0
Kulah, B., Duzgun, A. P., Moran, M., Kulacoglu, I. H., Ozmen, M. M., & Coskun, F. (2001). Emergency hernia repairs in elderly patients. American Journal of Surgery, 182(5), 455–459. https://doi.org/10.1016/S0002-9610(01)00765-6
Ma, Q., Jing, W., Liu, X., Liu, J., Liu, M., & Chen, J. (2023). The global, regional, and national burden and its trends of inguinal, femoral, and abdominal hernia from 1990 to 2019: Findings from the 2019 Global Burden of Disease Study—A cross-sectional study. International Journal of Surgery, 109(3), 333–342. https://doi.org/10.1097/JS9.0000000000000217
Mitura, K., Śmietański, M., Kozieł, S., Garnysz, K., & Michałek, I. (2018). Factors influencing inguinal hernia symptoms and preoperative evaluation of symptoms by patients: Results of a prospective study including 1647 patients. Hernia, 22(4), 585–591. https://doi.org/10.1007/s10029-018-1774-4
Primatesta, P., & Goldacre, M. J. (1996). Inguinal hernia repair: Incidence of elective and emergency surgery, readmission and mortality. International Journal of Epidemiology, 25(4), 835–839. https://doi.org/10.1093/ije/25.4.835
Putri, N. A., Agistany, N. F. F., Akhyar, R. B. F., Chauna, S., Annisa, W. N., & Haikal, Z. (2023). Inguinal hernia: Diagnosis and management. Jurnal Biologi Tropis, 23(4b), 96–103. https://doi.org/10.29303/jbt.v23i4b.5721
Ramadani, V. S., Ladala, E. W., & Ulfah, M. (2025). Hubungan pekerjaan dan usia dengan angka kejadian hernia inguinalis di RSUD Waled Cirebon periode Januari 2022–Desember 2023. EduInovasi: Journal of Basic Educational Studies, 5(3), 1246–1257. https://doi.org/10.47467/edu.v5i3.9867
Yuniar, R., & Dewi, P. (2008). Aktifitas fisik dan penggunaan energi pekerja laki-laki dengan jenis pekerjaan berbeda. Gizi Indonesia, 31(2), 98–106. https://doi.org/10.36457/gizindo.v31i2.60
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 Laila Hanum Mutmainah, dr. Evan Wahyudy Ladala, Sp.B, dr. Mohamad Irwan Dharmansyah, M.Biomed
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
GHMJ (Global Health Management Journal) conforms fully to The Budapest Open Access Initiative (BOAI) and DOAJ Open Access Definition. Authors, readers, and reviewers are free to Share ” copy and redistribute the material in any medium or format, and Adapt ” remix, transform, and build upon the material. Author(s) retain unrestricted copyrights and publishing rights of their work. The licensor cannot revoke these freedoms as long as you follow the license terms. Learn the details at the License policy.
How to Cite
