BACKGROUND: The etiology of Dupuytren's disease is unknown, and the role of occupational exposure is still debated. Our objective was to study the association between occupational exposures, personal risk factors and Dupuytren's disease. METHODS: In this cross-sectional survey, nine occupational physicians performed clinical examinations, focused on Dupuytren's disease, of 2,406 French male civil servants employed at the Equipment Ministry in 1998 and interviewed them about medical history, leisure manual exposure and occupational biomechanical exposure to vibrations and manual work. A cumulative occupational exposure score was defined, with three levels of exposure. RESULTS: Dupuytren's disease was diagnosed in 212 men (8.8%). The occupational exposure score was significantly higher in this group of cases than in the rest of the sample (377 (SD280) vs. 223 (SD250), respectively; P < 0.0001). Occupational exposure was associated with Dupuytren's disease (adjusted Odds Ratio = 2.20 [1.39-3.45] for the intermediate and 3.10 [1.99-4.84] for the high exposure groups), with adjustment for age, leisure physical activities, alcohol consumption (> or =5 servings per day), history of diabetes, epilepsy, hand trauma, and familial history of Dupuytren's disease. CONCLUSION: Manual work exposure was associated with Dupuytren's disease after adjustment for personal risk factors. Longitudinal studies are needed to confirm these results.