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d'Errico A, Fontana D, Filippi M. Incidence of knee and hip joint replacement associated with cumulative exposure to physical factors at work. Am J Ind Med 2024; 67:657-666. [PMID: 38752439 DOI: 10.1002/ajim.23615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/30/2024] [Accepted: 05/03/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Knee osteoarthritis (OA) has been quite consistently associated with high physical workload and specific physical factors at work, while for hip OA, fewer studies are available, which still indicate possible associations with heavy lifting and physical workload. The objective of the study was to assess the association between exposure to workplace physical factors and incidence of knee and hip arthroplasty, as markers of severe OA in these joints. METHODS The study population was composed of employees 25-60 years who participated in the Turin 2011 census. For each job held since 1995, exposure to physical factors was assigned to individuals in the cohort through a Job-Exposure Matrix constructed from the Italian O*NET database. Using Poisson regression models, the incidence of knee and hip arthroplasty for OA, identified through hospitalizations from 2012 to 2018, was examined in relation to cumulative exposure to 7 different physical hazards and a composite indicator of physical workload constructed from 17 physical factors (Ergo-Index). RESULTS The risk of knee OA was significantly increased in the highest cumulative exposure quartile of physical workload (incidence rate ratio = 1.98, 95% confidence interval: 1.24-3.16) and of all single hazards examined, compared to the lowest quartile, with significant trends in risk with increasing exposure. In contrast, no association was found with hip OA, whose relative risks were close to or below one in all higher-exposure quartiles of physical workload and of each single hazard. CONCLUSIONS Our results indicate that exposure to physical hazards at work increases the likelihood of developing knee OA, but not hip OA.
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Affiliation(s)
| | - Dario Fontana
- Epidemiology Department, ASL TO3, Grugliasco (TO), Italy
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Makani A, Shirazi-Adl SA, Ghezelbash F. Computational biomechanics of human knee joint in stair ascent: Muscle-ligament-contact forces and comparison with level walking. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3646. [PMID: 36054682 DOI: 10.1002/cnm.3646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/28/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
About a third of knee joint disorders originate from the patellofemoral (PF) site that makes stair ascent a difficult activity for patients. A detailed finite element model of the knee joint is coupled to a lower extremity musculoskeletal model to simulate the stance phase of stair ascent. It is driven by the mean of measurements on the hip-knee-ankle moments-angles as well as ground reaction forces reported in healthy individuals. Predicted muscle activities compare well to the recorded electromyography data. Peak forces in quadriceps (3.87 BW, body weight, at 20% instance in our 607 N subject), medial hamstrings (0.77 BW at 20%), and gastrocnemii (1.21 BW at 80%) are estimated. Due to much greater flexion angles-moments in the first half of stance, large PF contact forces (peak of 3.1 BW at 20% stance) and stresses (peak of 4.83 MPa at 20% stance) are estimated that exceed their peaks in level walking by fourfold and twofold, respectively. Compared with level walking, ACL forces diminish in the first half of stance but substantially increase later in the second half (peak of 0.76 BW at 75% stance). Under nearly similar contact forces at 20% of stance, the contact stress on the tibiofemoral (TF) medial plateau reaches a peak (9.68 MPa) twice that on the PF joint suggesting the vulnerability of both joints. Compared with walking, stair ascent increases peak ACL force and both peak TF and PF contact stresses. Reductions in the knee flexion moment and/or angle appear as a viable strategy to mitigate internal loads and pain.
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Affiliation(s)
- Amirhossein Makani
- Department of Mechanical Engineering, Polytechnique Montréal, Montreal, Québec, Canada
| | - Saeed A Shirazi-Adl
- Department of Mechanical Engineering, Polytechnique Montréal, Montreal, Québec, Canada
| | - Farshid Ghezelbash
- Department of Mechanical Engineering, Polytechnique Montréal, Montreal, Québec, Canada
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Jin X, Dong Y, Wang F, Jiang P, Zhang Z, He L, Forsman M, Yang L. Prevalence and associated factors of lower extremity musculoskeletal disorders among manufacturing workers: a cross-sectional study in China. BMJ Open 2022; 12:e054969. [PMID: 35110322 PMCID: PMC8811580 DOI: 10.1136/bmjopen-2021-054969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To survey the prevalence of lower extremity musculoskeletal disorders (MSDs) among Chinese manufacturing workers, and to identify the associated factors. DESIGN Observational study with cross-sectional design. SETTING A self-administered questionnaire survey was conducted in four manufacturing factories in China. PARTICIPANTS 7908 manufacturing workers were included in this study after excluding non-conforming personnel. OUTCOME MEASURES Individual and work-related information, and MSDs in the whole leg and knee region were measured by the anonymous self-administered questionnaire. Individual and work-related factors associated with MSDs and their effects were identified through multivariate logistic regression. RESULTS Of all respondents, 3241 (41.0%) reported having had lower extremity MSDs in the recent 12 months, and for the knees, ankles/feet and hips/thighs were 29.5%, 23.9% and 16.7%, respectively. After confounder-adjusted single-factor analysis, 22 variables (of 24) were significantly related to the disorders. Factors like always kneeling/squatting for long periods, always standing for long periods and often lifting in an uncomfortable position were shown to have higher risks, with ORs of 2.77 (95% CI: 2.33 to 3.30), 2.30 (1.96 to 2.69) and 2.25 (2.04 to 2.47). Comparable results were found on knee disorders. The final model included 15 variables of demography, biomechanics and work organisation. The following factors showed increased risks of lower extremity MSDs: being female, being older, longer working years, higher body mass index (BMI), keeping the same posture for a long time, awkward position, shift work and monotonous work. Whereas having enough breaks reduced the risk. CONCLUSION The prevalence of lower extremity MSDs among Chinese manufacturing workers is high. The most commonly affected body regions were the knees and ankles/feet. Multiple factors were found associated with lower extremity MSDs including age, BMI, work experience, work organisations, physical ergonomics exposures, etc.
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Affiliation(s)
- Xu Jin
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
| | - Yidan Dong
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
| | - Fujiang Wang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
| | - Ping Jiang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
| | - Zhongbin Zhang
- National Center of Occupational Safety and Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Lihua He
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
| | - Mikael Forsman
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
- Division of Ergonomics, KTH Royal Institute of Technology School of Biotechnology, Stockholm, Sweden
| | - Liyun Yang
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
- Division of Ergonomics, KTH Royal Institute of Technology School of Biotechnology, Stockholm, Sweden
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Hendriksen PF, Korshøj M, Skotte J, Holtermann A. Detection of kneeling and squatting during work using wireless triaxial accelerometers. ERGONOMICS 2020; 63:607-617. [PMID: 32100646 DOI: 10.1080/00140139.2020.1734668] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
Occupational kneeling and squatting are well-documented risk factors for knee disorders. A method using 3 wireless accelerometers to detect and discriminate kneeling and squatting during work were developed based on data from a semi-standardised laboratory protocol. The method was tested for validity under free-living working conditions. The developed method showed high sensitivity (88-99%) and specificity (98-99%) for detection of kneeling and squatting during the semi-standardised laboratory conditions. During free-living working conditions, kneeling showed very high sensitivity (94%) and specificity (99%), while squatting results were non-conclusive due to limited duration of squatting during the free-living working conditions. This method shows great promise for long-term technical measurement of kneeling and squatting during normal working conditions using wireless accelerometers. The method opens up possibilities for using technical measurements to provide valid exposure assessments and intervention evaluations of kneeling and squatting, as well as increased feasibility for technical measurements in large cohort studies. Practitioner summary: Quantification of kneeling and squatting during work is important for prevention, but limited by either imprecise or costly methods. This study developed and validated an inexpensive wireless accelerometer-based measurement method that can be used by practitioners and researchers for long-term measurements of kneeling and squatting during free-living working conditions.
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Affiliation(s)
| | - Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jørgen Skotte
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Gold JE, Kurowski A, Gore RJ, Punnett L. Knee pain in nursing home workers after implementation of a safe resident handling program. Am J Ind Med 2018; 61:849-860. [PMID: 30156000 PMCID: PMC6430608 DOI: 10.1002/ajim.22902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Approximately 25-30% of nursing personnel experience knee pain (KP). We sought to identify physical and psychosocial work exposures, and personal factors related to prevalent, incident, and persistent KP 5-8 years after safe resident handing program (SRHP) implementation in nursing homes. METHODS Health and exposure information was obtained from worker surveys 5-6 years ("F5") and 7-8 years ("F6") post-SRHP implementation. Prevalent KP correlates were examined at F5; persistent and incident KP predictors were analyzed at F6, utilizing robust Poisson multivariable regression. RESULTS F5 KP prevalence (19.7%) was associated with combined physical exposures, and with either high job strain or low social support, in separate models. Two-year persistent KP was similarly associated with these psychosocial exposures. Being overweight was associated with KP in all analyses. CONCLUSIONS The SRHP program did not eliminate knee physical loading, which should be reduced to prevent nursing home worker KP. Workplace psychosocial exposures (high job strain, low social support) also appeared germane.
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Affiliation(s)
- Judith E. Gold
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden
- Gold Standard Research Consulting, Bryn Mawr, Pennsylvania
| | - Alicia Kurowski
- Center for the Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Rebecca J. Gore
- Center for the Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Lowell, Massachusetts
| | - ProCare Research Team
- Center for the Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Laura Punnett
- Center for the Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Lowell, Massachusetts
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Thetkathuek A, Meepradit P, Sa-Ngiamsak T. A Cross-sectional Study of Musculoskeletal Symptoms and Risk Factors in Cambodian Fruit Farm Workers in Eastern Region, Thailand. Saf Health Work 2017; 9:192-202. [PMID: 29928534 PMCID: PMC6005961 DOI: 10.1016/j.shaw.2017.06.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 06/20/2017] [Accepted: 06/21/2017] [Indexed: 11/30/2022] Open
Abstract
Background Work-related musculoskeletal disorders are accumulative disorders that are most frequently found in agricultural farmers. The purpose of this study was to investigate factors that affect symptoms resulting from work-related musculoskeletal disorders among Cambodian farm workers working in fruit plantations in the eastern region of Thailand. Methods The Nordic Musculoskeletal Questionnaire, Rapid Upper Limb Assessment, and Hazard Zone Jobs Checklist techniques were used to interview 861 farmers who participated in the study. Results The data showed that men who had been working for >10 years were more at risk of neck pain than those working for <1 year with adjusted odds ratio (aOR) 1.66, 95% confidence interval (CI) (1.90, 14.5). Among women those who had been working for >10 years experienced lower back pain with aOR 8.13, 95% CI (1.04, 63.74), compared with those who had been working for <1 year. Men whose tasks required raising the arms above shoulder height had a risk factor contributing to neck pain of aOR 1.68, 95% CI (1.08, 2.61) when compared with those who did not work with this posture, and women had aOR 1.82, 95% CI (1.07, 3.12) when compared with those who did not work with this posture. Conclusion Based on the results of this study, it is recommended that work-related health conditions are monitored in migrant plantation workers to reduce the risks of musculoskeletal disorders.
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Affiliation(s)
- Anamai Thetkathuek
- Department of Industrial Hygiene and Safety, Faculty of Public Health, Burapha University, Chonburi 20131, Thailand
| | - Parvena Meepradit
- Department of Industrial Hygiene and Safety, Faculty of Public Health, Burapha University, Chonburi 20131, Thailand
| | - Teerayut Sa-Ngiamsak
- Department of Industrial Hygiene and Safety, Faculty of Public Health, Burapha University, Chonburi 20131, Thailand
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Thetkathuek A, Meepradit P. Work-related musculoskeletal disorders among workers in an MDF furniture factory in eastern Thailand. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2016; 24:207-217. [DOI: 10.1080/10803548.2016.1257765] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Anamai Thetkathuek
- Department of Industrial Hygiene and Safety, Burapha University, Thailand
| | - Parvena Meepradit
- Department of Industrial Hygiene and Safety, Burapha University, Thailand
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Leclerc A, Chastang JF, Taiba R, Pascal P, Cyr D, Plouvier S, Descatha A. Musculoskeletal pain at various anatomical sites and socioeconomic position: Results of a national survey. Rev Epidemiol Sante Publique 2016; 64:331-339. [PMID: 27789068 DOI: 10.1016/j.respe.2016.04.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 02/09/2016] [Accepted: 04/12/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Prevalence of musculoskeletal pain according to sites of pain and associated factors in the community has not been thoroughly documented. The association between pain and socioeconomic position has been studied by several authors, but without details in most studies regarding sites of pain, whereas the relations with social position could differ according to the site of pain. The objective of this study was to explore these differences in the community in France. METHODS The national Health and Occupational History survey was conducted in France in 2006 in subjects aged 20-74 years. Self-assessment of pain at various sites in the previous year was recorded. Five sites were considered here: back, neck, shoulder, upper limb, and lower limb. After a description of prevalence according to gender and age, the associations with socioeconomic position at the beginning of the subjects' working life, in seven categories, were studied with logistic models adjusted for age. The analyses were limited to those aged 30-74 years and were conducted separately for men and women. RESULTS Of the 5520 males and 6643 females studied, prevalence was the highest for back pain (35% for males, 37% for females). Pain was globally more frequent for women. For all sites of pain an increase with age was significant for women. This was not observed in men for back pain (highest prevalence in the 40- to 49-year-old age group) or neck pain. Overall, prevalence of pain was the lowest for professionals (reference category in the analyses). For males, the first occupation as a farmer or blue-collar worker was associated with an increased prevalence for most sites of pain, with odds ratios close to 2. For females, prevalence was increased for more socioeconomic categories, as compared to professionals. Among the five sites, neck pain was an exception: for both men and women, no association was observed between neck pain and socioeconomic position. CONCLUSION Although exploratory, these results are consistent with the available knowledge on occupational and personal risk factors for pain, which differ according to the site of pain. Other studies are needed to better understand the causal mechanisms underlying the associations observed.
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Affiliation(s)
- A Leclerc
- Inserm, UMS 011 « cohortes épidémiologiques en population », 94807 Villejuif, France; Inserm, UMR 1168, 94807 Villejuif, France; Université Versailles St-Quentin, 78000 Versailles, France.
| | - J-F Chastang
- Pierre-Louis Institute of Epidemiology and Public Health, Inserm UMR 1136, department of social epidemiology, 75013 Paris, France; Sorbonne Universités, UMPC Université Paris 06, 75005 Paris, France
| | - R Taiba
- Inserm, UMS 011 « cohortes épidémiologiques en population », 94807 Villejuif, France
| | - P Pascal
- Inserm, UMS 011 « cohortes épidémiologiques en population », 94807 Villejuif, France
| | - D Cyr
- Inserm, UMS 011 « cohortes épidémiologiques en population », 94807 Villejuif, France
| | - S Plouvier
- Inserm, UMS 011 « cohortes épidémiologiques en population », 94807 Villejuif, France
| | - A Descatha
- Inserm, UMS 011 « cohortes épidémiologiques en population », 94807 Villejuif, France; Inserm, UMR 1168, 94807 Villejuif, France; Université Versailles St-Quentin, 78000 Versailles, France; AP-HP, hôpitaux universitaires de Paris Île-de-France Ouest, unité de pathologie professionnelle/samu92, site de Poincaré, 92380 Garches, France
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