In a case-control study 317 male patients with Dupuytren's contracture between 30 and 80 years old were compared with 372 population controls (177 of whom were recruited by random digit dialling). Cases were recruited from two surgery clinics and two practices in Frankfurt/Main. The test persons were questioned about all occupational activities (with at least one year's duration); exposure to vibration, lifting and carrying; work with tools; consumption-related factors (smoking, alcohol, body mass index); and the diagnosis of diabetes, epilepsy, or hypertension. Odds ratios (OR) were calculated using logistic regression analysis, adjusting for age, region, duration of diabetes, and alcohol consumption. Elevated odds ratios were found for working 10 years or more as forestry workers; lowered odds ratios were found for working 10 years or more as packers/labourers or as metal workers. The odds ratio for alcohol consumption was 1.9 (95 % confidence interval Cl 1.3-2.7) for 8-13 glasses of alcohol per week (as opposed to < = 7 glasses), 2.1 (95 % Cl 1.3-3.5) for 14-21 glasses, and 2.8 (95 % Cl 1.4-5.6) for more than 21 glasses per week. Smoking was not significantly associated with Dupuytren's contracture. The negative relationship between a body mass index > 26 and Dupuytren's contracture was of borderline significance (OR = 0.7, 95 % Cl 0.5-1.0). Subjects suffering from diabetes for 10 years or more (OR = 5.1, 95 % Cl 1.4-19.0) and subjects suffering from hypertension for 10 years or more (OR = 2.4, 95 % Cl 1.3-4.7) had an elevated risk of Dupuytren's contracture. These results suggest that the reduction of alcohol consumption, possibly also an efficient anti-hypertension therapy may help prevent Dupuytren's contracture. The potential etiological role of occupational factors remains unclear.