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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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Unverzagt S, Bolm-Audorff U, Frese T, Hechtl J, Liebers F, Moser K, Seidler A, Weyer J, Bergmann A. Influence of physically demanding occupations on the development of osteoarthritis of the hip: a systematic review. J Occup Med Toxicol 2022; 17:18. [PMID: 36002875 PMCID: PMC9400208 DOI: 10.1186/s12995-022-00358-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 07/20/2022] [Indexed: 11/12/2022] Open
Abstract
Background Hip osteoarthritis (HOA) is a disabling disease affecting around 33 million people worldwide. People of working age and the elderly are at increased risk of developing HOA and the disease is associated with high costs at individual and societal levels due to sick leaves, job loss, total hip replacements and disability pension. This systematic review evaluated the influence of physically demanding occupations on the development of HOA in men. Methods Cohort studies, case–control studies and cross-sectional studies with publications in English or German, which assessed the association between exposure to physically demanding occupations and development of HOA, were searched in electronic databases (Medline, Embase, HSE-Line, Cochrane Library) and conference abstracts from 1990 until May 2020. We assessed the methodological quality of selected studies, interpreted all relative effect estimators as relative risks (RRs) and meta-analytically reviewed the effects of occupations with high physical workloads. All steps are based on a study protocol published in PROSPERO (CRD42015016894). Results Seven cohort studies and six case–control studies were included. An elevated risk to develop HOA was shown for six physically demanding occupational groups. Working in agriculture including fishery and forestry and food production doubles the risk of HOA. Construction, metal working and sales as well as exposure to whole body vibration while driving vehicles increases the risk by roughly 50 to 60%. Unskilled or basic level workers, who were frequently exposed to repetitive heavy manual work, had nearly a doubled risk (RR 1.89 95%CI: 1.29 to 2.77) compared to workers with lower exposure. Conclusions Existing studies state an association between various occupations with high physical workload and an increased risk of developing HOA. High Physical workloads include including lifting and carrying heavy loads, demanding postures, repetitive activities, long standing and running, as well as exposure to body vibrations. Occupational prevention and early detection as well as individual health promotion strategies should place their focus on reducing the impact of high physical strain at work sites. Supplementary Information The online version contains supplementary material available at 10.1186/s12995-022-00358-y.
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Affiliation(s)
- Susanne Unverzagt
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany.
| | - Ulrich Bolm-Audorff
- Department for Occupational Safety and the Environment, Regional Authority Darmstadt, Wilhelminenstraße 1 - 3, 64283, Darmstadt, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
| | - Julia Hechtl
- Department of Occupational Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 20, 06112, Halle (Saale), Germany
| | - Falk Liebers
- Division 3 Work and Health, Unit 3.1 Prevention of Work-related Diseases, Federal Institute for Occupational Safety and Health (BAuA), Friedrich-Henkel-Weg 1-25, 44149, Dortmund, Germany
| | - Konstantin Moser
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
| | - Andreas Seidler
- Institute and Polyclinic for Occupational and Social Medicine, Technical University of Dresden, Faculty of Medicine, Löscherstraße 18, 01309, Dresden, Germany
| | - Johannes Weyer
- Department of Occupational Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 20, 06112, Halle (Saale), Germany
| | - Annekatrin Bergmann
- Department of Occupational Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 20, 06112, Halle (Saale), Germany
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Andrasfay T, Raymo N, Goldman N, Pebley AR. Physical work conditions and disparities in later life functioning: Potential pathways. SSM Popul Health 2021; 16:100990. [PMID: 34917747 PMCID: PMC8666356 DOI: 10.1016/j.ssmph.2021.100990] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/19/2021] [Accepted: 11/30/2021] [Indexed: 11/24/2022] Open
Abstract
Research in the US on the social determinants of reduced physical functioning at older ages has typically not considered physical work conditions as contributors to disparities. We briefly describe a model of occupational stratification and segregation, review and synthesize the occupational health literature, and outline the physiological pathways through which physical work exposures may be tied to long-term declines in physical functioning. The literature suggests that posture, force, vibration, and repetition are the primary occupational risk factors implicated in the development of musculoskeletal disorders, through either acute injuries or longer-term wear and tear. Personal risk factors and environmental and structural work characteristics can modify this association. In the long-term, these musculoskeletal disorders can become chronic and ultimately lead to functional limitations and disabilities that interfere with one's quality of life and ability to remain independent. We then use data on occupational characteristics from the Occupational Information Network (O*NET) linked to the 2019 American Community Survey (ACS) to examine disparities among sociodemographic groups in exposure to these risk factors. Occupations with high levels of these physical demands are not limited to those traditionally thought of as manual or blue-collar jobs and include many positions in the service sector. We document a steep education gradient with less educated workers experiencing far greater physical demands at work than more educated workers. There are pronounced racial and ethnic differences in these exposures with Hispanic, Black, and Native American workers experiencing higher risks than White and Asian workers. Occupations with high exposures to these physical risk factors provide lower compensation and are less likely to provide employer-sponsored health insurance, making it more difficult for workers to address injuries or conditions that arise from their jobs. In sum, we argue that physical work exposures are likely an important pathway through which disparities in physical functioning arise.
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Affiliation(s)
- Theresa Andrasfay
- Leonard Davis School of Gerontology, University of Southern California, USA
| | - Nina Raymo
- University of North Carolina Geriatrics Clinic, MedServe, AmeriCorps, USA
| | - Noreen Goldman
- Office of Population Research, Princeton School of Public and International Affairs, Princeton University, USA
| | - Anne R. Pebley
- California Center for Population Research, Fielding School of Public Health, University of California Los Angeles, USA
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Hulshof CTJ, Pega F, Neupane S, Colosio C, Daams JG, Kc P, Kuijer PPFM, Mandic-Rajcevic S, Masci F, van der Molen HF, Nygård CH, Oakman J, Proper KI, Frings-Dresen MHW. The effect of occupational exposure to ergonomic risk factors on osteoarthritis of hip or knee and selected other musculoskeletal diseases: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2021; 150:106349. [PMID: 33546919 DOI: 10.1016/j.envint.2020.106349] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 12/04/2020] [Accepted: 12/16/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic data suggests that occupational exposure to ergonomic risk factors may cause selected other musculoskeletal diseases, other than back or neck pain (MSD) or osteoarthritis of hip or knee (OA). In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of disability-adjusted life years from MSD or OA that are attributable to occupational exposure to ergonomic risk factors, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the effect of occupational exposure to ergonomic risk factors (force exertion, demanding posture, repetitiveness, hand-arm vibration, lifting, kneeling and/or squatting, and climbing) on MSD and OA (two outcomes: prevalence and incidence). DATA SOURCES We developed and published a protocol, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic academic databases for potentially relevant records from published and unpublished studies, including the International Trials Register, Ovid Medline, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of occupational exposure to ergonomic risk factors (any exposure to force exertion, demanding posture, repetitiveness, hand-arm vibration, lifting, kneeling and/or squatting, and climbing ≥ 2 h/day) compared with no or low exposure to the theoretical minimum risk exposure level (<2 h/day) on the prevalence or incidence of MSD or OA. STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. Missing data were requested from principal study authors. We combined odds ratios using random-effect meta-analysis. Two or more review authors assessed the risk of bias and the quality of evidence, using Navigation Guide tools adapted to this project. RESULTS In total eight studies (4 cohort studies and 4 case control studies) met the inclusion criteria, comprising a total of 2,378,729 participants (1,157,943 females and 1,220,786 males) in 6 countries in 3 WHO regions (Europe, Eastern Mediterranean and Western Pacific). The exposure was measured using self-reports in most studies and with a job exposure matrix in one study and outcome was generally assessed with physician diagnostic records or administrative health data. Across included studies, risk of bias was generally moderate. Compared with no or low exposure (<2 h per day), any occupational exposure to ergonomic risk factors increased the risk of acquiring MSD (odds ratio (OR) 1.76, 95% confidence interval [CI] 1.14 to 2.72, 4 studies, 2,376,592 participants, I2 70%); and increased the risk of acquiring OA of knee or hip (OR 2.20, 95% CI 1.42 to 3.40, 3 studies, 1,354 participants, I2 13%); Subgroup analysis for MSD found evidence for differences by sex, but indicated a difference in study type, where OR was higher among study participants in a case control study compared to study participants in cohort studies. CONCLUSIONS Overall, for both outcomes, the main body of evidence was assessed as being of low quality. Occupational exposure to ergonomic risk factors increased the risk of acquiring MSD and of acquiring OA of knee or hip. We judged the body of human evidence on the relationship between exposure to occupational ergonomic factors and MSD as "limited evidence of harmfulness" and the relationship between exposure to occupational ergonomic factors and OA also as "limited evidence of harmfulness". These relative risks might perhaps be suitable as input data for WHO/ILO modelling of work-related burden of disease and injury. Protocol identifier: https://doi.org/10.1016/j.envint.2018.09.053 PROSPERO registration number: CRD42018102631.
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Affiliation(s)
- Carel T J Hulshof
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Subas Neupane
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Joost G Daams
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Prakash Kc
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Paul P F M Kuijer
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Federica Masci
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Clas-Håkan Nygård
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Jodi Oakman
- Centre for Ergonomics and Human Factors, School of Psychology and Public Health, LaTrobe University, Melbourne, Australia.
| | - Karin I Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Amsterdam, the Netherlands.
| | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
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Hulshof CTJ, Pega F, Neupane S, van der Molen HF, Colosio C, Daams JG, Descatha A, Kc P, Kuijer PPFM, Mandic-Rajcevic S, Masci F, Morgan RL, Nygård CH, Oakman J, Proper KI, Solovieva S, Frings-Dresen MHW. The prevalence of occupational exposure to ergonomic risk factors: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2021; 146:106157. [PMID: 33395953 DOI: 10.1016/j.envint.2020.106157] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic and human data suggests that occupational exposure to ergonomic (or physical) risk factors may cause osteoarthritis and other musculoskeletal diseases (excluding rheumatoid arthritis, gout, and back and neck pain). In this paper, we present a systematic review and meta-analysis of the prevalence of occupational exposure to physical ergonomic risk factors for estimating the number of disability-adjusted life years from these diseases that are attributable to exposure to this risk factor, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the prevalence of occupational exposure to ergonomic risk factors for osteoarthritis and other musculoskeletal diseases. DATA SOURCES We searched electronic bibliographic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. The exposure was defined as any occupational exposure to one or more of: force exertion, demanding posture, repetitive movement, hand-arm vibration, kneeling or squatting, lifting, and/or climbing. We included all study types with an estimate of the prevalence of occupational exposure to ergonomic risk factors. STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. We combined prevalence estimates using random-effect meta-analysis. Two or more review authors assessed the risk of bias and the quality of evidence, using the ROB-SPEO tool and QoE-SPEO approach developed specifically for the WHO/ILO Joint Estimates. RESULTS Five studies (three cross-sectional studies and two cohort studies) met the inclusion criteria, comprising 150,895 participants (81,613 females) in 36 countries in two WHO regions (Africa, Europe). The exposure was generally assessed with questionnaire data about self-reported exposure. Estimates of the prevalence of occupational exposure to ergonomic risk factors are presented for all five included studies, disaggregated by country, sex, 5-year age group, industrial sector or occupational group where feasible. The pooled prevalence of any occupational exposure to ergonomic risk factors was 0.76 (95% confidence interval 0.69 to 0.84, 3 studies, 148,433 participants, 35 countries in the WHO Europe region, I2 100%, low quality of evidence). Subgroup analyses found no statistically significant differences in exposure by sex but differences by age group, occupation and country. No evidence was found for publication bias. We assessed this body evidence to be of low quality, based on serious concerns for risk of bias due to exposure assessment only being based on self-report and for indirectness due to evidence from two WHO regions only. CONCLUSIONS Our systematic review and meta-analysis found that occupational exposure to ergonomic risk factors is highly prevalent. The current body of evidence is, however, limited, especially by risk of bias and indirectness. Producing estimates for the burden of disease attributable to occupational exposure to ergonomic risk factors appears evidence-based, and the pooled effect estimates presented in this systematic review may perhaps be used as input data for the WHO/ILO Joint Estimates. Protocol identifier:https://doi.org/10.1016/j.envint.2018.09.053. PROSPERO registration number: CRD42018102631.
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Affiliation(s)
- Carel T J Hulshof
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Subas Neupane
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Joost G Daams
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Alexis Descatha
- AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Inserm Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), Villejuif, France; Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Angers, France.
| | - Prakash Kc
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Paul P F M Kuijer
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Federica Masci
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada.
| | - Clas-Håkan Nygård
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Jodi Oakman
- Centre for Ergonomics and Human Factors, School of Psychology and Public Health, LaTrobe University, Melbourne, Australia.
| | - Karin I Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | | | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
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Li J, Sommerich CM, Chipps E, Lavender SA, Stasny EA. A framework for studying risk factors for lower extremity musculoskeletal discomfort in nurses. ERGONOMICS 2020; 63:1535-1550. [PMID: 32781904 DOI: 10.1080/00140139.2020.1807615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 07/23/2020] [Indexed: 06/11/2023]
Abstract
Lower extremity musculoskeletal discomfort (MSD) is prevalent, but understudied, in nurses. A comprehensive, theoretical, aetiological model of lower extremity work-related MSD in hospital in-patient staff nurses was developed through a review of the literature to provide a framework for aetiological and intervention research. The framework informed the design of a survey of 502 hospital staff nurses. Symptom prevalence ranged from 32% in hip/thigh to 59% in ankle/foot regions. Logistic regression modelling using survey data showed that different work and personal factors were associated with discomfort in different regions of the lower extremity. Individual factors (e.g. older age, higher BMI or having any foot condition), physical factors (e.g. higher frequency of patient handling), psychosocial factors (e.g. lower job satisfaction) were associated with discomfort in one or more parts of the lower extremity. Future research should target these factors for intervention, to attempt to reduce occurrence of lower extremity discomfort in nurses. Practitioner Summary: Practitioners may find useful the illustrated, theoretical aetiological model of factors that could influence the prevalence of lower extremity discomfort in nurses. The model could guide conversations with nurses and observational analyses of nursing work. The model and survey results may provide ideas for intervention exploration. Abbreviations: MSD: musculoskeletal discomfort; BMI: body mass index; MSK: musculoskeletal; ICU: intensive care unit; NLERF: nurses' lower extremity MSD risk factor; NASA-TLX: NASA-task load index.
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Affiliation(s)
- Jing Li
- Department of Integrated Systems Engineering, College of Engineering, The Ohio State University, Columbus, OH, USA
| | - Carolyn M Sommerich
- Department of Integrated Systems Engineering, College of Engineering, The Ohio State University, Columbus, OH, USA
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Esther Chipps
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Steven A Lavender
- Department of Integrated Systems Engineering, College of Engineering, The Ohio State University, Columbus, OH, USA
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Elizabeth A Stasny
- Department of Statistics, College of Arts and Sciences, The Ohio State University, Columbus, OH, USA
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7
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Strizhakov LA, Guliaev SV, Babanov SA, Moiseev SV. [Osteoarthrosis in the clinic of internal and occupational diseases: differential diagnostic aspects]. TERAPEVT ARKH 2020; 92:89-92. [PMID: 33346500 DOI: 10.26442/00403660.2020.06.000620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Indexed: 11/22/2022]
Abstract
Osteoarthritis is a common pathology, which indicates the great medical and social significance of this disease. The article discusses the issues of pathogenesis, risk factors and diagnosis of professional and professionally caused osteoarthritis: the age of onset of the disease, the specifics of work, the localization of joint damage. Differential diagnosis issues are discussed.
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Affiliation(s)
- L A Strizhakov
- Sechenov First Moscow State Medical University (Sechenov University)
| | - S V Guliaev
- Sechenov First Moscow State Medical University (Sechenov University)
| | | | - S V Moiseev
- Sechenov First Moscow State Medical University (Sechenov University)
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8
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Canetti EFD, Schram B, Orr RM, Knapik J, Pope R. Risk factors for development of lower limb osteoarthritis in physically demanding occupations: A systematic review and meta-analysis. APPLIED ERGONOMICS 2020; 86:103097. [PMID: 32342888 DOI: 10.1016/j.apergo.2020.103097] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 02/05/2020] [Accepted: 03/06/2020] [Indexed: 06/11/2023]
Abstract
This systematic review and meta-analysis identified and critically reviewed the findings of recent studies (last 15 years) examining relationships between specific physically demanding occupations or occupational tasks and development of lower limb osteoarthritis (OA). Twenty-eight studies with 266,227 cases of lower limb OA were included. Occupational tasks contributing to OA included farming, floor laying, and brick laying. Activities significantly contributing to the risk of knee OA were lifting heavy loads (>10 kg/week) (odds ratio [OR] = 1.52, 95% confidence interval [95%CI] 1.29-1.79), squatting/kneeling (OR = 1.69, 95%CI 1.15-2.49), standing (>2 h/daily) (OR = 1.22 95%CI 1.02-1.46) and walking (OR = 1.40 95%CI 1.14-1.73). Lifting contributed significantly to the risk of hip OA (OR = 1.35, 95%CI 1.16-1.57). The effects of occupational exposures appear to be magnified by previous injury and BMI >25 kg/m2. Since specific occupational activities increase OA risk, ergonomist should encourage the use of existing tools, or oversee the design of new tools that may decrease exposure to such activities.
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Affiliation(s)
- Elisa F D Canetti
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Ben Schram
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Robin M Orr
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Joseph Knapik
- Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Rodney Pope
- Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia; School of Community Health, Charles Sturt University, Elizabeth Mitchell Dr, Thurgoona, NSW, 2640, Australia.
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Schram B, Orr R, Pope R, Canetti E, Knapik J. Risk factors for development of lower limb osteoarthritis in physically demanding occupations: A narrative umbrella review. J Occup Health 2019; 62:e12103. [PMID: 31828895 PMCID: PMC6970406 DOI: 10.1002/1348-9585.12103] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 01/08/2023] Open
Abstract
Objectives Osteoarthritis (OA) is a common disorder which affects the joints. As relationships between occupational factors and lower limb OA have been widely studied in systematic reviews, the aim of this umbrella review was to synthesize their key findings in the risk factors for development of lower limb OA. Methods A systematic search was conducted using the databases PUBMED, Cumulative Index of Nursing and Allied Health Literature, and Elton B Stevens Company to identify reviews examining associations between lower limb OA and occupational tasks. These reviews were rated for their methodological quality before key data were extracted and synthesized. Results Sixteen reviews were found, seven pertained to the knee, four to the hip, two to a variety of joints, and three to both the hip and knee. One was deemed to be of high methodological quality, one of critically low methodological quality, and the others of moderate methodological quality. The reviews found moderate to good evidence for heavy occupational lifting to be associated with an increased risk of OA at the knee and the hip. Kneeling, squatting, and climbing, previous injuries to joints, being overweight and obese were also predictive of lower limb OA. Conclusion Occupations which involve heavy physical workloads increase the risk of developing lower limb OA. Heavy lifting, squatting, knee bending, kneeling, and climbing may all increase the risk of developing OA in both the knees and hips. Efforts to reduce exposure to these tasks, reducing joint injuries, optimizing bodyweight may reduce the risks of lower limb OA for occupations which are physically demanding.
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Affiliation(s)
- Ben Schram
- Tactical Research Unit, Bond University, Robina, QLD, Australia
| | - Robin Orr
- Tactical Research Unit, Bond University, Robina, QLD, Australia
| | - Rodney Pope
- Tactical Research Unit, Bond University, Robina, QLD, Australia.,School of Community Health, Charles Sturt University, Albury, NSW, Australia
| | - Elisa Canetti
- Tactical Research Unit, Bond University, Robina, QLD, Australia
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10
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Breloff SP, Dutta A, Sinsel EW, Carey RE, Warren CM, Dai F, Ning S, Wu JZ. Are knee savers and knee pads a viable intervention to reduce lower extremity musculoskeletal disorder risk in residential roofers? INTERNATIONAL JOURNAL OF INDUSTRIAL ERGONOMICS 2019; 74:10.1016/j.ergon.2019.102868. [PMID: 32327865 PMCID: PMC7179875 DOI: 10.1016/j.ergon.2019.102868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
One factor commonly associated with musculoskeletal disorder risk is extreme postures. To lessen this risk, individuals must be in an as neutral posture as possible while working. We analyzed how the inclusion of different combinations of two interventions-knee pads and knee savers-can alter lower extremity kinematics during deep or near full flexion kneeling occurs while on different sloped surfaces. Nine male subjects were requested to keep a typical resting posture while kneeling on sloped roofing simulator. We observed that the introduction of a wearable third party device considerably altered lower extremity full flexion kneeling kinematics compared to level deep kneeling. This study provided a sound base for the use of third party devices to reduce musculoskeletal disorder risk on a sloped surface, however further testing with other musculoskeletal disorder risk factors is needed prior to conclusive recommendation.
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Affiliation(s)
- Scott P. Breloff
- National Institute for Occupational Safety & Health, Centers for Disease Control and Prevention, 1095 Willowdale Rd., Morgantown, WV 26505
| | - Amrita Dutta
- West Virginia University, Department of Civil & Environmental Engineering, Morgantown, WV 26506
| | - Erik W. Sinsel
- National Institute for Occupational Safety & Health, Centers for Disease Control and Prevention, 1095 Willowdale Rd., Morgantown, WV 26505
| | - Robert E. Carey
- National Institute for Occupational Safety & Health, Centers for Disease Control and Prevention, 1095 Willowdale Rd., Morgantown, WV 26505
| | - Christopher M. Warren
- National Institute for Occupational Safety & Health, Centers for Disease Control and Prevention, 1095 Willowdale Rd., Morgantown, WV 26505
| | - Fei Dai
- West Virginia University, Department of Civil & Environmental Engineering, Morgantown, WV 26506
| | - Shawn Ning
- West Virginia University, Department of Industrial and Management Systems Engineering, Morgantown, WV 26506
| | - John Z. Wu
- National Institute for Occupational Safety & Health, Centers for Disease Control and Prevention, 1095 Willowdale Rd., Morgantown, WV 26505
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11
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Rice D, McNair P, Huysmans E, Letzen J, Finan P. Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis. J Clin Med 2019; 8:jcm8111769. [PMID: 31652929 PMCID: PMC6912819 DOI: 10.3390/jcm8111769] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 09/30/2019] [Indexed: 02/06/2023] Open
Abstract
Osteoarthritis (OA) is a leading cause of chronic pain and disability in older adults, which most commonly affects the joints of the knee, hip, and hand. To date, there are no established disease modifying interventions that can halt or reverse OA progression. Therefore, treatment is focused on alleviating pain and maintaining or improving physical and psychological function. Rehabilitation is widely recommended as first-line treatment for OA as, in many cases, it is safer and more effective than the best-established pharmacological interventions. In this article, we describe the presentation of OA pain and give an overview of its peripheral and central mechanisms. We then provide a state-of-the-art review of rehabilitation for OA pain—including self-management programs, exercise, weight loss, cognitive behavioral therapy, adjunct therapies, and the use of aids and devices. Next, we explore several promising directions for clinical practice, including novel education strategies to target unhelpful illness and treatment beliefs, methods to enhance the efficacy of exercise interventions, and innovative, brain-directed treatments. Finally, we discuss potential future research in areas, such as treatment adherence and personalized rehabilitation for OA pain.
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Affiliation(s)
- David Rice
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland 1142, New Zealand.
- Waitemata Pain Service, Department of Anaesthesiology and Perioperative Medicine, Waitemata District Health Board, Auckland 1142, New Zealand.
| | - Peter McNair
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland 1142, New Zealand.
| | - Eva Huysmans
- Pain in Motion International Research Group.
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussel, Belgium.
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090 Brussels, Belgium.
- I-CHER, Interuniversity Center for Health Economics Research, 1090 Brussels, Belgium.
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium.
| | - Janelle Letzen
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, MD 21287, USA.
| | - Patrick Finan
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, MD 21287, USA.
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12
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Ishimoto Y, Cooper C, Ntani G, Yamada H, Hashizume H, Nagata K, Muraki S, Tanaka S, Yoshimura N, Yoshida M, Walker‐Bone K. Factory and construction work is associated with an increased risk of severe lumbar spinal stenosis on MRI: A case control analysis within the wakayama spine study. Am J Ind Med 2019; 62:430-438. [PMID: 30762243 PMCID: PMC6499731 DOI: 10.1002/ajim.22957] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2018] [Indexed: 12/04/2022]
Abstract
BACKGROUND To explore the association of MRI-diagnosed severe lumbar spinal stenosis with occupation. METHODS Occupational data were collected by questionnaire and all participants underwent spine MRI scans using the same protocol. Central lumbar spinal stenosis (LSS) was graded qualitatively. Those with severe LSS (>two-thirds narrowing) were compared with the controls with lesser degrees of stenosis or no stenosis. RESULTS Data were available for 722 subjects, mean age 70.1 years. 239 (33%) cases with severe LSS were identified. Factory/construction workers had an almost four-fold increased risk of severe LSS after adjustment for age, sex, smoking, and walking speed amongst those aged <75 years (OR 3.97, 95%CI 1.46-10.85). Severe LSS was also associated with squatting ≥1 h/day (OR 1.76, 95%CI 1.01-3.07) but this association became non-significant after adjustment. CONCLUSION Further research is needed but this study adds more evidence that occupational factors are associated with an increased risk and/or severity of degenerative disease of the lumbar spine.
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Affiliation(s)
- Yuyu Ishimoto
- MRC Lifecourse Epidemiology UnitSouthampton General HospitalSouthamptonHampshireUnited Kingdom
- Orthopedic surgeryWakayama Medical UniversityWakayama cityWakayama prefectureJapan
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology UnitSouthampton General HospitalSouthamptonHampshireUnited Kingdom
- Arthritis Research UK/MRC Centre for Musculoskeletal Work and HealthSouthampton General HospitalSouthamptonHampshireUnited Kingdom
| | - Georgia Ntani
- MRC Lifecourse Epidemiology UnitSouthampton General HospitalSouthamptonHampshireUnited Kingdom
- Arthritis Research UK/MRC Centre for Musculoskeletal Work and HealthSouthampton General HospitalSouthamptonHampshireUnited Kingdom
| | - Hiroshi Yamada
- Orthopedic surgeryWakayama Medical UniversityWakayama cityWakayama prefectureJapan
| | - Hiroshi Hashizume
- Orthopedic surgeryWakayama Medical UniversityWakayama cityWakayama prefectureJapan
| | - Keiji Nagata
- Orthopedic surgeryWakayama Medical UniversityWakayama cityWakayama prefectureJapan
| | - Shigeyuki Muraki
- Faculty of MedicineDepartment of Preventive Medicine for Locomotive Organ Disorders22nd Century Medical & Research CenterUniversity of TokyoTokyoJapan
| | - Sakae Tanaka
- Department of Orthopedic SurgerySensory and Motor System MedicineGraduate School of MedicineUniversity of TokyoTokyoJapan
| | - Noriko Yoshimura
- Department of Joint Disease Research22nd Century Medical and Research CenterUniversity of TokyoTokyoJapan
| | - Munehito Yoshida
- Orthopedic surgeryWakayama Medical UniversityWakayama cityWakayama prefectureJapan
| | - Karen Walker‐Bone
- MRC Lifecourse Epidemiology UnitSouthampton General HospitalSouthamptonHampshireUnited Kingdom
- Arthritis Research UK/MRC Centre for Musculoskeletal Work and HealthSouthampton General HospitalSouthamptonHampshireUnited Kingdom
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13
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Hulshof CTJ, Colosio C, Daams JG, Ivanov ID, Prakash KC, Kuijer PPFM, Leppink N, Mandic-Rajcevic S, Masci F, van der Molen HF, Neupane S, Nygård CH, Oakman J, Pega F, Proper K, Prüss-Üstün AM, Ujita Y, Frings-Dresen MHW. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to occupational ergonomic risk factors and of the effect of exposure to occupational ergonomic risk factors on osteoarthritis of hip or knee and selected other musculoskeletal diseases. ENVIRONMENT INTERNATIONAL 2019; 125:554-566. [PMID: 30583853 PMCID: PMC7794864 DOI: 10.1016/j.envint.2018.09.053] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of disability-adjusted life years from osteoarthritis of hip or knee, and selected other musculoskeletal diseases respectively, attributable to exposure to occupational ergonomic risk factors to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on exposure to occupational ergonomic risk factors (Systematic Review 1) and systematically review and meta-analyze estimates of the effect of exposure to occupational ergonomic risk factors on osteoarthritis of the hip or knee, and selected other musculoskeletal diseases respectively (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science and CISDOC. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference lists of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. The included occupational ergonomic risk factors will be any exposure to one or more of: force exertion; demanding posture; repetitiveness; hand-arm vibration; lifting; kneeling and/or squatting; and climbing. Included outcomes will be (i) osteoarthritis and (ii) other musculoskeletal diseases (i.e., one or more of: rotator cuff syndrome; bicipital tendinitis; calcific tendinitis; shoulder impingement; bursitis shoulder; epicondylitis medialis; epicondylitis lateralis; bursitis elbow; bursitis hip; chondromalacia patellae; meniscus disorders; and/or bursitis knee). For Systematic Review 1, we will include quantitative prevalence studies of any exposure to occupational ergonomic risk factors stratified by country, gender, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control-studies and other non-randomized intervention studies with an estimate of the relative effect of any exposure with occupational ergonomic risk factors on the prevalence or incidence of osteoarthritis and/or selected musculoskeletal diseases, compared with the theoretical minimum risk exposure level (i.e., no exposure). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42018102631.
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Affiliation(s)
- Carel T J Hulshof
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Joost G Daams
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - K C Prakash
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | - Paul P F M Kuijer
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Frederica Masci
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Henk F van der Molen
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Subas Neupane
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | - Clas-Håkan Nygård
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | | | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Karin Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Amsterdam, Netherlands.
| | - Annette M Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
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14
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Sirén M, Viikari-Juntura E, Arokoski J, Solovieva S. Work participation and working life expectancy after a disabling shoulder lesion. Occup Environ Med 2019; 76:363-369. [PMID: 30928906 PMCID: PMC6585271 DOI: 10.1136/oemed-2018-105647] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 02/11/2019] [Accepted: 02/25/2019] [Indexed: 11/26/2022]
Abstract
Objective To examine the impact of a disabling non-traumatic shoulder lesion on work participation and working life expectancy. Methods From a 70% random sample of the Finnish population, we selected 30–59-year-old wage earners with prolonged sickness absence due to a shoulder lesion (n=7644). We followed the persons from 2006 to 2014 and calculated the proportion of time a person spent in different work participation statuses. The associations of potential determinants with a preterm exit from paid employment were tested using Cox regression. Years expected to be spent in different work participation statuses were estimated applying the Sullivan method for healthy life expectancy. Results During 9 years of follow-up time spent at work was reduced from 77.7% to 46.7%, and 15.8% of the persons were granted disability retirement, mostly due to shoulder and other musculoskeletal diseases. Compared with the general population persons with a disabling shoulder disease are expected to lose from 1.8 to 8.1 years of working life, depending on their age. Age, gender, education, duration of initial sickness absence due to the shoulder lesion, not being able to return to work sustainably and participation in vocational rehabilitation predicted preterm exit from work. Heavy lifting increased the risk of preterm exit marginally. Conclusions Working life expectancy is markedly reduced in persons with a disabling shoulder lesion, mainly because of disability retirement due to musculoskeletal problems. Clinicians should consider interventions targeted at improving musculoskeletal functioning and necessary work modifications before shoulder problems become chronic or the persons develop disabling comorbid musculoskeletal conditions.
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Affiliation(s)
- Maria Sirén
- Finnish Institute of Occupational Health, Helsinki, Finland.,Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland
| | | | - Jari Arokoski
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
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15
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Becker SK. Evaluating elbow osteoarthritis within the prehistoric Tiwanaku state using generalized estimating equations (GEE). AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 169:186-196. [PMID: 30821354 DOI: 10.1002/ajpa.23806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 01/26/2019] [Accepted: 02/08/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Studies of osteoarthritis (OA) in human skeletal remains can come with scalar problems. If OA measurement is noted as present or absent in one joint, like the elbow, results may not identify specific articular pathology data and the sample size may be insufficient to address research questions. If calculated on a per data point basis (i.e., each articular surface within a joint), results may prove too data heavy to comprehensively understand arthritic changes, or one individual with multiple positive scores may skew results and violate the data independence required for statistical tests. The objective of this article is to show that the statistical methodology Generalized Estimating Equations (GEE) can solve scalar issues in bioarchaeological studies. MATERIALS AND METHODS Using GEE, a population-averaged statistical model, 1,195 adults from the core and one colony of the prehistoric Tiwanaku state (AD 500-1,100) were evaluated bilaterally for OA on the seven articular surfaces of the elbow joint. RESULTS GEE linked the articular surfaces within each individual specimen, permitting the largest possible unbiased dataset, and showed significant differences between core and colony Tiwanaku peoples in the overall elbow joint, while also pinpointing specific articular surfaces with OA. Data groupings by sex and age at death also demonstrated significant variation. A pattern of elbow rotation noted for core Tiwanaku people may indicate a specific pattern of movement. DISCUSSION GEE is effective and should be encouraged in bioarchaeological studies as a way to address scalar issues and to retain all pathology information.
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Affiliation(s)
- Sara K Becker
- Department of Anthropology, University of California, Riverside, Riverside, California
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16
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Bergmann A, Bolm-Audorff U, Krone D, Seidler A, Liebers F, Haerting J, Freiberg A, Unverzagt S. Occupational Strain as a Risk for Hip Osteoarthritis. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 114:581-588. [PMID: 28927496 DOI: 10.3238/arztebl.2017.0581] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 11/29/2016] [Accepted: 06/12/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Multiple epidemiological studies have revealed an association between occupational physical strain and the risk of developing hip osteoarthritis. METHODS To determine the association between the lifting and carrying of heavy loads or other physically demanding work and the risk of hip osteoarthritis (HOA) or total hip replacement (THR), we systematically searched the literature for primary studies on the effects of exposure to physical strain and meta-analytically reviewed the results that were amenable to comparisons across studies. We separately assessed studies that had hip pain as an endpoint. RESULTS 5 cohort studies and 18 case-control studies were found suitable for inclusion. The lifting of heavy loads increases the risk of HOA or THR: exposure doubles the risk in men (relative risk [RR] 2.09, 95% confidence interval [1.4; 3.1]) and increases it by roughly 40% in women (RR 1.41 [1.0; 1.9]). Physically demanding work consisting of a combination of activities of various kinds (dealing with heavy loads, heavy manual work, or prolonged walking and standing) increases the risk by roughly 150% in men (RR 2.46 [1.3; 4.8]) and 40% in women (RR 1.38 [0.9; 2.2]). Hip pain was also reported more commonly in the exposed groups. CONCLUSION The studies are moderately to highly heterogeneous. An association exists between years of lifting heavy loads or other kinds of physical strain on the job and the risk of developing osteoarthritis of the hip. The greater the exposure, the greater the risk. The evidence base for risk assessment in women is currently inadequate.
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Affiliation(s)
- Annekatrin Bergmann
- Martin Luther University Halle-Wittenberg, Faculty of Medicine, Department of Occupational Medicine; Martin Luther University Halle-Wittenberg, Faculty of Medicine, Institute for Medical Epidemiology, Biometrics and Informatics; Regional Authority Darmstadt, Department for Occupational Safety and the Environment; Technical University of Dresden, Faculty of Medicine, Institute and Polyclinic for Occupational and Social Medicine; Federal Institute for Occupational Safety and Health (BAuA), Berlin
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17
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Johansson H, Hongslo Vala C, Odén A, Lorentzon M, McCloskey E, Kanis JA, Harvey NC, Ohlsson C, Stefan Lohmander L, Kärrholm J, Mellström D. Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers. Osteoporos Int 2018; 29:741-749. [PMID: 29327294 PMCID: PMC5884415 DOI: 10.1007/s00198-017-4355-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/17/2017] [Indexed: 01/12/2023]
Abstract
We aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty. INTRODUCTION The risks of hip fracture and hip arthroplasty are influenced by factors including socioeconomic status, education, urbanization, latitude of residence, and physical activity. Farming is an occupation encompassing rural living and high level of physical activity. Therefore, we aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. METHODS We studied the risk of hip fracture, and hip arthroplasty due to primary osteoarthritis, in all men and women aged 35 years or more in Sweden between 1987 and 2002. Documented occupations were available in 3.5 million individuals, of whom 97,136 were farmers. The effects of age, sex, income, education, location of residence, and occupation on risk of hip fracture or hip arthroplasty were examined using a modification of Poisson regression. RESULTS A total of 4027 farmers and 93,109 individuals with other occupations sustained a hip fracture, while 5349 farmers and 63,473 others underwent a hip arthroplasty. Risk of hip fracture was higher with greater age, lower income, lower education, higher latitude, and urban area for all men and women. Compared to all other occupations, male farmers had a 20% lower age-adjusted risk of hip fracture (hazard ratio (HR) 0.80, 95%CI 0.77-0.84), an effect that was not seen in female farmers (HR 0.96, 95% CI 0.91-1.01). Both male and female farmers had a higher age-adjusted risk for hip arthroplasty. CONCLUSIONS Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.
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Affiliation(s)
- H Johansson
- Institute for Health and Ageing, Catholic University of Australia, Melbourne, Australia.
- Centre for Bone and Arthritis Research, Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden.
| | - C Hongslo Vala
- Centre for Bone and Arthritis Research, Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Odén
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - M Lorentzon
- Centre for Bone and Arthritis Research, Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
| | - E McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - J A Kanis
- Institute for Health and Ageing, Catholic University of Australia, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK
| | - C Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - L Stefan Lohmander
- Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Orthopedics, Sweden
| | - J Kärrholm
- Department of Orthopedics, Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - D Mellström
- Centre for Bone and Arthritis Research, Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
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18
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Kolber MJ, Hanney WJ, Cheatham SW, Salamh PA. Risk Factors for Hip Osteoarthritis: Insight for the Strength and Conditioning Professional. Strength Cond J 2017. [DOI: 10.1519/ssc.0000000000000222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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19
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Taylor-Gjevre RM, Trask C, King N, Koehncke N. Prevalence and occupational impact of arthritis in Saskatchewan farmers. J Agromedicine 2016; 20:205-16. [PMID: 25906279 DOI: 10.1080/1059924x.2015.1009666] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Agricultural workers have physically demanding occupations. In this study of Saskatchewan farmers, the authors examined (1) self-reported prevalence of physician-diagnosed rheumatoid arthritis and osteoarthritis; and (2) the impact of these chronic arthridities on engagement in physical tasks related to farming. This study was conducted through a cross-sectional analysis of baseline data from the Saskatchewan Farm Injury Cohort Study in which 2,473 adult residents upon 1,216 farms participated. Collected survey data included demographic and health information; regional musculoskeletal symptoms for each participant assessed via the Standard Nordic Questionnaire; and engagement in various specific physical tasks or activities associated with mixed farming practices. Of the 2,473 respondents, 13% reported chronic arthritic diagnoses (10% osteoarthritis, 4% rheumatoid arthritis, with 1% from each category overlapping with both forms of arthritis). Participants reporting arthritis were more likely to also report disabling musculoskeletal symptoms involving their shoulders, elbows, hands, lower back, hips, knees, and ankles. Farmers with arthritis reported less participation in all physical farming activities studied, including various machinery operations, herd maintenance and veterinary activities, overhead work, shoveling/pitchfork work, and lifting/carrying. When adjusted for age, gender, and comorbidities, operation of combines and shoveling/pitchfork work continued to be significantly less engaged in by farmers with arthritis. The overall prevalence of arthritis was consistent with general population prevalence, although the category of rheumatoid arthritis was overrepresented. Farmers with arthritis were significantly less likely to participate in combine operation and shoveling/pitchfork chores compared with their counterparts without arthritis.
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Affiliation(s)
- Regina M Taylor-Gjevre
- a Division of Rheumatology, Department of Medicine , College of Medicine, University of Saskatchewan , Saskatoon , Saskatchewan , Canada
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Abstract
Osteoarthritis (OA) is the most common joint disorder, is associated with an increasing socioeconomic impact owing to the ageing population and mainly affects the diarthrodial joints. Primary OA results from a combination of risk factors, with increasing age and obesity being the most prominent. The concept of the pathophysiology is still evolving, from being viewed as cartilage-limited to a multifactorial disease that affects the whole joint. An intricate relationship between local and systemic factors modulates its clinical and structural presentations, leading to a common final pathway of joint destruction. Pharmacological treatments are mostly related to relief of symptoms and there is no disease-modifying OA drug (that is, treatment that will reduce symptoms in addition to slowing or stopping the disease progression) yet approved by the regulatory agencies. Identifying phenotypes of patients will enable the detection of the disease in its early stages as well as distinguish individuals who are at higher risk of progression, which in turn could be used to guide clinical decision making and allow more effective and specific therapeutic interventions to be designed. This Primer is an update on the progress made in the field of OA epidemiology, quality of life, pathophysiological mechanisms, diagnosis, screening, prevention and disease management.
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Ross JA, Shipp EM, Trueblood AB, Bhattacharya A. Ergonomics and Beyond: Understanding How Chemical and Heat Exposures and Physical Exertions at Work Affect Functional Ability, Injury, and Long-Term Health. HUMAN FACTORS 2016; 58:777-795. [PMID: 27125533 PMCID: PMC6894162 DOI: 10.1177/0018720816645457] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 03/12/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To honor Tom Waters's work on emerging occupational health issues, we review the literature on physical along with chemical exposures and their impact on functional outcomes. BACKGROUND Many occupations present the opportunity for exposure to multiple hazardous exposures, including both physical and chemical factors. However, little is known about how these different factors affect functional ability and injury. The goal of this review is to examine the relationships between these exposures, impairment of the neuromuscular and musculoskeletal systems, functional outcomes, and health problems with a focus on acute injury. METHOD Literature was identified using online databases, including PubMed, Ovid Medline, and Google Scholar. References from included articles were searched for additional relevant articles. RESULTS This review documented the limited existing literature that discussed cognitive impairment and functional disorders via neurotoxicity for physical exposures (heat and repetitive loading) and chemical exposures (pesticides, volatile organic compounds [VOCs], and heavy metals). CONCLUSION This review supports that workers are exposed to physical and chemical exposures that are associated with negative health effects, including functional impairment and injury. Innovation in exposure assessment with respect to quantifying the joint exposure to these different exposures is especially needed for developing risk assessment models and, ultimately, preventive measures. APPLICATION Along with physical exposures, chemical exposures need to be considered, alone and in combination, in assessing functional ability and occupationally related injuries.
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Affiliation(s)
- Jennifer A Ross
- Texas A&M University, College StationUniversity of Cincinnati, Ohio
| | - Eva M Shipp
- Texas A&M University, College StationUniversity of Cincinnati, Ohio
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Skousgaard SG, Hjelmborg J, Skytthe A, Brandt LPA, Möller S, Overgaard S. Probability and heritability estimates on primary osteoarthritis of the hip leading to total hip arthroplasty: a nationwide population based follow-up study in Danish twins. Arthritis Res Ther 2015; 17:336. [PMID: 26589897 PMCID: PMC4654897 DOI: 10.1186/s13075-015-0854-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/05/2015] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Primary hip osteoarthritis, radiographic as well as symptomatic, is highly associated with increasing age in both genders. However, little is known about the mechanisms behind this, in particular if this increase is caused by genetic factors. This study examined the risk and heritability of primary osteoarthritis of the hip leading to a total hip arthroplasty, and if this heritability increased with increasing age. METHODS In a nationwide population-based follow-up study 118,788 twins from the Danish Twin Register and 90,007 individuals from the Danish Hip Arthroplasty Register for the period 1995 to 2010 were examined. Our main outcomes were the cumulative incidence, proband-wise concordance and heritability on age, within-pair correlations in monozygotic and dizygotic twin pairs, and the genetic and environmental influence estimated in models taking into account that individuals may not have had a total hip arthroplasty at the time of follow-up. RESULTS There were 94,063 twins eligible for analyses, comprising 835 cases of 36 concordant and 763 discordant twin pairs. The probability increased particularly from 50 years of age. After sex and age adjustment a significant additive genetic component of 47% (12:79), a shared environmental component of 21% (2:76) and a unique environment component of 32% (21:41) accounted for the variation in population liability to total hip arthroplasty. The sex-adjusted proband-wise concordance and heritability on age indicated an increasing age-associated genetic influence onwards from 60 years of age. CONCLUSION The cumulative incidence in primary hip osteoarthritis leading to total hip arthroplasty increases in particular after the age of 50 years in both genders. Family factors of genes and shared environment are highly significant and account for 68% of the variation in the population liability to total hip arthroplasty; however, the genetic influence increases significantly from 60 years of age onwards.
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Affiliation(s)
- Søren Glud Skousgaard
- Department of Occupational and Environmental Medicine, Odense University Hospital, 5000, Odense C, Denmark. .,Department of Orthopaedic Surgery and Traumatology & Orthopaedic Research Unit, Odense University Hospital, 5000, Odense C, Denmark. .,Institute of Clinical Research, University of Southern Denmark, 5000, Odense C, Denmark.
| | - Jacob Hjelmborg
- Department of Epidemiology, Biostatistics, and Biodemography, The Danish Twin Registry, Department of Public Health, University of Southern Denmark, 5000, Odense C, Denmark.
| | - Axel Skytthe
- Department of Epidemiology, Biostatistics, and Biodemography, The Danish Twin Registry, Department of Public Health, University of Southern Denmark, 5000, Odense C, Denmark.
| | - Lars Peter Andreas Brandt
- Department of Occupational and Environmental Medicine, Odense University Hospital, 5000, Odense C, Denmark. .,Institute of Clinical Research, University of Southern Denmark, 5000, Odense C, Denmark.
| | - Sören Möller
- Department of Epidemiology, Biostatistics, and Biodemography, The Danish Twin Registry, Department of Public Health, University of Southern Denmark, 5000, Odense C, Denmark.
| | - Søren Overgaard
- Department of Orthopaedic Surgery and Traumatology & Orthopaedic Research Unit, Odense University Hospital, 5000, Odense C, Denmark. .,Institute of Clinical Research, University of Southern Denmark, 5000, Odense C, Denmark.
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Rubak TS, Svendsen SW, Søballe K, Frost P. Total hip replacement due to primary osteoarthritis in relation to cumulative occupational exposures and lifestyle factors: a nationwide nested case-control study. Arthritis Care Res (Hoboken) 2015; 66:1496-505. [PMID: 24664794 DOI: 10.1002/acr.22326] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 03/18/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the risk of total hip replacement (THR) due to primary osteoarthritis in relation to cumulative occupational mechanical exposures and lifestyle factors. METHODS Using register information, we identified first-time THR cases within the Danish working population in 2005-2006. For each case, 2 age- and sex-matched controls were drawn. Persons within 2,500 randomly selected case-control sets received a questionnaire about job history, weight at age 25 years, present weight and height, smoking, and sports activities at age 25 years. The job history was combined with a job exposure matrix. Cumulative exposure estimates were expressed according to the pack-year concept of smoking (e.g., cumulative lifting was expressed as ton-years). We used conditional logistic regression for statistical analyses. RESULTS In total, 1,776 case-control sets (71%) were available for analysis. The adjusted odds ratio (OR) for exposure to ≥20 ton-years was 1.35 (95% confidence interval [95% CI] 1.05-1.74) for men and 1.00 (95% CI 0.73-1.41) for women. Standing/walking and whole body vibration showed no associations. The adjusted OR for body mass index (BMI) ≥30 kg/m(2) at age 25 years was 2.44 (95% CI 1.38-4.32) for men and 5.12 (95% CI 2.30-11.39) for women. The corresponding adjusted ORs for an increase in BMI of ≥10 kg/m(2) since age 25 years were 2.16 (95% CI 1.25-3.70) and 2.46 (95% CI 1.47-4.13). Sports participation showed weak positive associations, while pack-years of smoking showed no associations. CONCLUSION The results indicated a modest increase in risk of THR in relation to cumulative lifting among men and an increased risk in relation to a high BMI at age 25 years and to a gain in BMI in both sexes.
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Teichtahl AJ, Smith S, Wang Y, Wluka AE, O'Sullivan R, Giles GG, Cicuttini FM. Occupational risk factors for hip osteoarthritis are associated with early hip structural abnormalities: a 3.0 T magnetic resonance imaging study of community-based adults. Arthritis Res Ther 2015; 17:19. [PMID: 25627648 PMCID: PMC4342869 DOI: 10.1186/s13075-015-0535-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 01/21/2015] [Indexed: 11/13/2022] Open
Abstract
Introduction Occupational exposure to heavy lifting and stair climbing are associated with radiographic hip osteoarthritis (OA). This study examined whether these activities are associated with early structural hip joint changes in a community-based population. Methods In total, 198 community-based people with no history of hip disease, including OA, had 3.0 T-magnetic resonance imaging (MRI) to assess hip cartilage volume, defects and bone marrow lesions (BMLs). Recall of occupational exposure to heavy lifting and stair climbing aged 18 to 30 years and in the previous 10 years were collected. A persistence score was defined as exposure at neither time point (0), at one time point (1) or at both time points (2). Results Exposure to heavy lifting when aged 18 to 30 years was associated with BMLs of the central superolateral femoroacetabular region (odds ratio (OR) 3.9, 95% confidence interval (CI) 1.6 to 9.8, P <0.01), with persistence score associated with cartilage defects in the central superolateral region of the femoral head (OR 1.6, 95% CI 1.0 to 2.5, P = 0.04). Exposure to stair climbing aged 18 to 30 years and persistence score were associated with an increased risk of cartilage defects in the central superolateral femoral head and BMLs in the central superolateral and posterior femoroacetabular regions (OR range 2.1 to 3.2, all P ≤0.03). Conclusions Occupational exposure to heavy lifting and stair climbing are associated with hip structural abnormalities. If confirmed by longitudinal data, such associations may explain how occupational activities affect the hip joint and may identify new targets for the prevention of hip OA.
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Affiliation(s)
- Andrew J Teichtahl
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia. .,Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Sam Smith
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Richard O'Sullivan
- MRI Department, Healthcare Imaging Services, Epworth Hospital, 89 Bridge Road, Richmond, VIC, 3121, Australia. .,Department of Medicine, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Graham G Giles
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia. .,Cancer Epidemiology Centre, Cancer Council Victoria, 89 Bridge Road, Melbourne, VIC, 3004, Australia. .,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia.
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
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Rubak TS, Svendsen SW, Andersen JH, Haahr JPL, Kryger A, Jensen LD, Frost P. An expert-based job exposure matrix for large scale epidemiologic studies of primary hip and knee osteoarthritis: the Lower Body JEM. BMC Musculoskelet Disord 2014; 15:204. [PMID: 24927760 PMCID: PMC4067499 DOI: 10.1186/1471-2474-15-204] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 06/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND When conducting large scale epidemiologic studies, it is a challenge to obtain quantitative exposure estimates, which do not rely on self-report where estimates may be influenced by symptoms and knowledge of disease status. In this study we developed a job exposure matrix (JEM) for use in population studies of the work-relatedness of hip and knee osteoarthritis. METHODS Based on all 2227 occupational titles in the Danish version of the International Standard Classification of Occupations (D-ISCO 88), we constructed 121 job groups comprising occupational titles with expected homogeneous exposure patterns in addition to a minimally exposed job group, which was not included in the JEM. The job groups were allocated the mean value of five experts' ratings of daily duration (hours/day) of standing/walking, kneeling/squatting, and whole-body vibration as well as total load lifted (kg/day), and frequency of lifting loads weighing ≥20 kg (times/day). Weighted kappa statistics were used to evaluate inter-rater agreement on rankings of the job groups for four of these exposures (whole-body vibration could not be evaluated due to few exposed job groups). Two external experts checked the face validity of the rankings of the mean values. RESULTS A JEM was constructed and English ISCO codes were provided where possible. The experts' ratings showed fair to moderate agreement with respect to rankings of the job groups (mean weighted kappa values between 0.36 and 0.49). The external experts agreed on 586 of the 605 rankings. CONCLUSION The Lower Body JEM based on experts' ratings was established. Experts agreed on rankings of the job groups, and rankings based on mean values were in accordance with the opinion of external experts.
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Affiliation(s)
- Tine Steen Rubak
- Department of Occupational Medicine, Slagelse Hospital, Ingemannsvej 18, 4200 Slagelse, Denmark.
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Punnett L. Musculoskeletal disorders and occupational exposures: How should we judge the evidence concerning the causal association? Scand J Public Health 2014; 42:49-58. [DOI: 10.1177/1403494813517324] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Musculoskeletal disorders (MSDs) affecting the back, upper and lower extremities are widespread in the general population, implying a variety of causal factors. Multiple causes are not mutually exclusive, and a high background rate does not preclude associations with specific factors that are uncommon in the general population. MSDs have well-documented associations with occupational ergonomic stressors such as repetitive motion, heavy lifting, non-neutral postures, and vibration. Organizational features of the work environment, such as time pressure and low decision latitude, may also play a role, at least by potentiating the effects of physical loading. Numerous systematic reviews have mostly concurred with these overall findings. Nevertheless, some continue to debate whether MSDs are sometimes work-related, even for those performing jobs with repetitive and routinized tasks, heavy lifting, and/or pronounced postural strain. This article discusses (1) some epidemiologic features of MSDs that underlie that debate; and (2) the question of what should appropriately be considered a gold standard for scientific evidence on an etiological question such as the health effects of a non-voluntary exposure, such as an occupational or environmental agent. In particular, randomized clinical trials have little relevance for determining the health effects of non-therapeutic risk factors.
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Affiliation(s)
- Laura Punnett
- Department of Work Environment, University of Massachusetts Lowell, USA
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Xu H, He ML, Xiao ZM, Cao Y. Hip resurfacing versus traditional total hip arthroplasty for osteoarthritis and other non-traumatic diseases of the hip. Cochrane Database Syst Rev 2013. [DOI: 10.1002/14651858.cd010851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Hua Xu
- Guangxi Medical University; Center for Education Evaluation and Faculty Development; 22 Shuangyong Road Nanning Guangxi China 530021
| | - Mao Lin He
- 1st Affiliated Hospital of Guangxi Medical University; Division of Spinal Surgery; 22 Shuangyong Road Nanning Guangxi China 530021
| | - Zeng Ming Xiao
- 1st Affiliated Hospital of Guangxi Medical University; Division of Spinal Surgery; 22 Shuangyong Road Nanning Guangxi China 530021
| | - Yunfei Cao
- First Affiliated Hospital, Guangxi Medical University; Center of Evidence Based Medicine; Taoyuan Road Nanning Guangxi China 530001
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Bern SH, Brauer C, Møller KL, Koblauch H, Thygesen LC, Simonsen EB, Alkjær T, Bonde JP, Mikkelsen S. Baggage handler seniority and musculoskeletal symptoms: is heavy lifting in awkward positions associated with the risk of pain? BMJ Open 2013; 3:e004055. [PMID: 24293209 PMCID: PMC3845067 DOI: 10.1136/bmjopen-2013-004055] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Heavy lifting is associated with musculoskeletal disorders but it is unclear whether it is related to acute reversible effects or to chronic effects from cumulated exposure. The aim of this study was to examine whether musculoskeletal symptoms in Danish airport baggage handlers were associated with their seniority as baggage handler, indicating chronic effects from cumulated workload. METHODS We established a group of baggage handlers employed at Copenhagen Airport during the period 1983-2012 (n=3092) and a reference group of men in other unskilled occupations with less heavy work (n=2478). Data regarding work history, lifestyle and musculoskeletal symptoms were collected using a self-administered questionnaire (response rate 70.1% among baggage handlers and 68.8% among the reference group). RESULTS The ORs of self-reported musculoskeletal symptoms during the last 12 months in the neck/upper back, lower back, shoulders, elbows, wrists, hips and knees were significantly higher in baggage handlers than in the reference group. These differences were explained by significant linear effects of baggage handler seniority for six anatomical regions. Adjustment for age, body mass index, smoking and leisure-time physical activity did not change these results. The findings were stable over age strata and among present and former baggage handlers. CONCLUSIONS The risk of musculoskeletal symptoms in six anatomical regions increased with increasing seniority as a baggage handler. This is consistent with the assumption that cumulated heavy lifting may cause chronic or long-lasting musculoskeletal symptoms. However, we cannot exclude that other factors related to baggage handler seniority may explain some of the associations.
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Affiliation(s)
- Stine Hvid Bern
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Charlotte Brauer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | | | - Henrik Koblauch
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Erik Bruun Simonsen
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Tine Alkjær
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Sigurd Mikkelsen
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
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Kaptein SA, Backman CL, Badley EM, Lacaille D, Beaton DE, Hofstetter C, Gignac MAM. Choosing where to put your energy: a qualitative analysis of the role of physical activity in the lives of working adults with arthritis. Arthritis Care Res (Hoboken) 2013; 65:1070-6. [PMID: 23335584 DOI: 10.1002/acr.21957] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 01/08/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Research points to many potential benefits of physical activity (PA) for those with arthritis. However, PA has not typically been examined within the context of other life roles. This study examined the perceptions of PA among individuals managing arthritis in addition to employment and other role demands. METHODS Eight focus groups were conducted with 24 women and 16 men (age range 29-72 years) who were currently or recently employed (within 2 years) and had osteoarthritis or inflammatory arthritis. Participants were recruited from community newspaper advertisements, rheumatology clinics, and arthritis groups. Discussions were audiotaped and transcribed. Transcripts were analyzed using qualitative content analysis. RESULTS All groups discussed the impact of arthritis on a range of PAs. Overall, participants discussed PA as positively influencing their health and well-being. Yet, several overarching themes highlighted the complexity of PA, including 1) PA as a potential cause of arthritis; 2) the reciprocal impact of arthritis on PA and PA on arthritis; 3) physical and psychological benefits and harms of PA, such as difficulty making PA decisions when living in pain or when faced with episodic symptoms; 4) perceived choices about engagement in PA (e.g., role overload); and 5) social support. CONCLUSION The relationships among work, health, and other roles were complex. Competing demands, pain, energy, episodic symptoms, support, and decisions to disclose one's illness at work influenced PA. Changes to PA not only affected physical health but also people's self-identity. PA interventions may be improved by taking into account the demands of multiple life roles.
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Clyde CT, Goyal N, Matar WY, Witmer D, Restrepo C, Hozack WJ. Workers' Compensation patients after total joint arthroplasty: do they return to work? J Arthroplasty 2013; 28:883-7. [PMID: 23583541 DOI: 10.1016/j.arth.2013.01.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 12/07/2012] [Accepted: 01/29/2013] [Indexed: 02/01/2023] Open
Abstract
Clinicians identify patients receiving Workers' Compensation (WC) as unlikely to fully benefit from total joint arthroplasty (TJA), with possibly decreased ability to return to work. We completed follow-up for 164 patients undergoing 177 arthroplasties while receiving WC between 2000 and 2009. Inquiry was made regarding work status, nature of work, and return to work time frame. Patients undergoing primary versus revision TJA returned to work 70.2% versus 43.9%, respectively (p=0.002). The mean time frame for return to work following primary TJA was 16.4 weeks. Manual laborers versus sedentary workers returned to work 67.1% versus 84.8%, respectively (p=0.05). As this group is limited by the strenuous nature of their employment, clinicians should be aware that receiving WC may modestly impact return to work following arthroplasty.
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Affiliation(s)
- Corey T Clyde
- The Rothman Institute of Orthopaedic at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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31
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Duda GN, Eniwumide JO, Sittinger M. Constraints to Articular Cartilage Regeneration. Regen Med 2013. [DOI: 10.1007/978-94-007-5690-8_41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Suri P, Morgenroth DC, Hunter DJ. Epidemiology of osteoarthritis and associated comorbidities. PM R 2012; 4:S10-9. [PMID: 22632687 DOI: 10.1016/j.pmrj.2012.01.007] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 01/19/2012] [Indexed: 12/14/2022]
Abstract
Osteoarthritis (OA) is the most common cause of walking-related disability among older adults in the United States, and the prevalence and incidence of OA are increasing rapidly. Systemic and local risk factors for knee OA have been identified, and obesity and joint injury appear to be the strongest risk factors that are both modifiable and have the potential for substantial impact on a population level. The risk factors for functional decline and disability in persons with symptomatic OA have been examined in relatively few studies. The course of functional decline in persons with symptomatic OA on a population level is generally one of stable to slowly deteriorating function, but on an individual level, many patients maintain function or improve during the first 3 years of follow-up. Obesity stands out as one of few modifiable risk factors of OA that also is a potentially modifiable predictor of functional decline. Physical activity also appears to have a substantial protective impact on future OA-related disability. Further epidemiologic studies and randomized controlled trials are needed to prioritize prevention through targeting these modifiable risk factors for OA and related disability.
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Affiliation(s)
- Pradeep Suri
- Division of PM&R, VA Boston Healthcare System-JP Campus, 150 S Huntington Ave, Boston, MA 02130, USA.
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Juhakoski R, Malmivaara A, Lakka TA, Tenhonen S, Hannila ML, Arokoski JPA. Determinants of pain and functioning in hip osteoarthritis - a two-year prospective study. Clin Rehabil 2012; 27:281-7. [PMID: 22843354 DOI: 10.1177/0269215512453060] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify predictors of pain and disability in hip osteoarthritis. DESIGN A prospective analysis of determinants of pain and functioning in hip osteoarthritis. STUDY SETTING Rehabilitation clinic in a central hospital. PATIENTS A total of 118 men and women aged 55-80 years who had radiologically diagnosed hip osteoarthritis and associated clinical symptoms and participated in a randomized controlled trial. MAIN MEASURES The self-reported disease-specific pain and physical function were assessed using the pain and functioning subscales of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index. The self-reported generic physical and mental functioning were assessed by using the Finnish-validated SF-36-item Health Survey RAND-36 subscales for function and physical and mental component summary scores. Outcome measures were recorded at 0, 3, 6, 12, 18 and 24 months. RESULTS Multivariate linear mixed model analyses revealed that lower disease-specific pain score and better functioning (WOMAC) were predicted by higher educational level (9.61 (3.15 to 16.07); 9.07 (2.05 to 16.09)), supervised exercise training (-10.13 (-17.87 to -2.39); -11.58 (-19.40 to -3.77)), habitual conditioning physical activity (-0.48 (-0.96 to -0.01); -0.39 (-0.84 to 0.05)), absence of comorbidities (-6.30 (-12.35 to -0.24); -7.87 (-14.45 to -1.30)) and absence of additional knee osteoarthritis (-7.62 (-13.87 to -1.36); -8.02 (-14.81 to -1.23)), respectively. The same factors, except for the comorbidities, also predicted general physical functioning score (RAND-36). CONCLUSIONS Higher education, absence of knee osteoarthritis and comorbidities, supervised exercise training and habitual conditioning physical activity predicted a lower presence of pain and better functional status in patients with hip osteoarthritis.
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Affiliation(s)
- Riikka Juhakoski
- Department of Physical and Rehabilitation Medicine, Mikkeli Central Hospital, Mikkeli, Finland.
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34
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Epidemiological evidence for work load as a risk factor for osteoarthritis of the hip: a systematic review. PLoS One 2012; 7:e31521. [PMID: 22348095 PMCID: PMC3279372 DOI: 10.1371/journal.pone.0031521] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 01/09/2012] [Indexed: 11/21/2022] Open
Abstract
Objective Osteoarthritis of the hip (OA) is a common degenerative disorder of the joint cartilage that presents a major public health problem worldwide. While intrinsic risk factors (e.g, body mass and morphology) have been identified, external risk factors are not well understood. In this systematic review, the evidence for workload as a risk factor for hip OA is summarized and used to derive recommendations for prevention and further research. Methods Epidemiological studies on workload or occupation and osteoarthritis of the hip were identified through database and bibliography searches. Using pre-defined quality criteria, 30 studies were selected for critical evaluation; six of these provided quantitative exposure data. Results Study results were too heterogeneous to develop pooled risk estimates by specific work activities. The weight of evidence favors a graded association between long-term exposure to heavy lifting and risk of hip OA. Long-term exposure to standing at work might also increase the risk of hip OA. Conclusions It is not possible to estimate a quantitative dose-response relationship between workload and hip OA using existing data, but there is enough evidence available to identify job-related heavy lifting and standing as hazards, and thus to begin developing recommendations for preventing hip OA by limiting the amount and duration of these activities. Future research to identify specific risk factors for work-related hip OA should focus on implementing rigorous study methods with quantitative exposure measures and objective diagnostic criteria.
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Lee CG. Work-related musculoskeletal disorders in Korean farmers. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2012. [DOI: 10.5124/jkma.2012.55.11.1054] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Chul Gab Lee
- Department of Occupational and Environmental Medicine, Chosun University School of Medicine, Gwangju, Korea
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Fransen M, Bridgett L, March L, Hoy D, Penserga E, Brooks P. The epidemiology of osteoarthritis in Asia. Int J Rheum Dis 2011; 14:113-21. [PMID: 21518309 DOI: 10.1111/j.1756-185x.2011.01608.x] [Citation(s) in RCA: 200] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Worldwide, osteoarthritis (OA) is estimated to be the fourth leading cause of disability. Most of this disability burden is attributable to the involvement of the hips or the knees. OA is strongly associated with ageing and the Asian region is ageing rapidly. Further, OA has been associated with heavy physical occupational activity, a required livelihood for many people living in rural communities in developing countries. Unfortunately, joint replacement surgery, an effective intervention for people with severe OA involving the hips or knees, is inaccessible to most people in these regions. On the other hand, obesity, another major risk factor, may be less prevalent, although it is on the increase. Determining region-specific OA prevalence and risk factor profiles will provide important information for planning future cost-effective preventive strategies and health care services. An update of what is currently known about the prevalence of hip and knee OA from population-based studies conducted in the Asian region is presented in this review. Many of the recent studies have conducted comparisons between urban and rural areas and poor and affluent communities. The results of Asian-based studies evaluating risk factors from population-based cohorts or case-control studies, and the current evidence on OA morbidity burden in Asia is also outlined.
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Affiliation(s)
- Marlene Fransen
- Faculty of Health Sciences, School of Medicine, University of Sydney, Sydney, New South Wales School of Population Health, University of Queensland, Brisbane, Queensland, Australia
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BIELEMAN HENDRIKJ, BIERMA-ZEINSTRA SITAM, OOSTERVELD FRITSG, RENEMAN MICHIELF, VERHAGEN ARIANNEP, GROOTHOFF JOHANW. The Effect of Osteoarthritis of the Hip or Knee on Work Participation. J Rheumatol 2011; 38:1835-43. [DOI: 10.3899/jrheum.101210] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In our systematic literature search, we included studies involving patients with hip or knee osteoarthritis (OA) and outcome measures of work participation. Methodological quality was assessed using 11 criteria; a qualitative data analysis was performed. Fifty-three full-text articles were selected out of 1861 abstracts; finally, data were extracted from 14 articles. Design, populations, definitions, and measurements in the studies showed large variations; work outcomes were often only secondary objectives. The outcomes were summarized as showing a mild negative effect of OA on work participation. Many patients had paid work and managed to stay at work despite limitations. However, research on the effect of OA on work participation is scarce and the methodological quality is often insufficient. The longitudinal course of work participation in individuals with OA has not been described completely.
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38
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Rohrer JE, Merry SP, Thacher TD, Summers MR, Alpern JD, Contino RW. Self-assessed disability and self-rated health among rural villagers in Peru: a brief report. J Rural Health 2011; 26:294-8. [PMID: 20633098 DOI: 10.1111/j.1748-0361.2010.00293.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT Risks for poor self-rated overall health in rural areas of developing nations have not been thoroughly investigated. PURPOSE The objective of this study was to assess potential risk factors for poor self-rated health among rural villagers in Peru. METHODS A door-to-door survey of villagers residing in the Pampas Grande region in Peru, which is in the Andes Mountains, yielded complete data for 337 adults. FINDINGS Adjusting for age and gender using multiple logistic regression analysis revealed that having self-reported disabilities was inversely and independently related to good self-rated health (OR 0.48 [95% CI, 0.26-0.88]). Joint pain also was related to self-rated health (OR 0.23 [95% CI, 0.13-0.41]). CONCLUSIONS Increasing access to affordable, effective analgesics may reduce this disparity. Health agencies should consider these actions as possible planning priorities for the region.
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Affiliation(s)
- James E Rohrer
- Department of Family Medicine, Mayo Clinic-Rochester, Rochester, Minnesota 55905, USA.
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39
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Hip and knee pain: Role of occupational factors. Best Pract Res Clin Rheumatol 2011; 25:81-101. [DOI: 10.1016/j.berh.2011.01.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/24/2010] [Accepted: 01/25/2011] [Indexed: 11/19/2022]
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40
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Constraints to Articular Cartilage Regeneration. Regen Med 2011. [DOI: 10.1007/978-90-481-9075-1_37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Franklin J, Ingvarsson T, Englund M, Lohmander S. Association between occupation and knee and hip replacement due to osteoarthritis: a case-control study. Arthritis Res Ther 2010; 12:R102. [PMID: 20497530 PMCID: PMC2911890 DOI: 10.1186/ar3033] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2010] [Revised: 05/10/2010] [Accepted: 05/24/2010] [Indexed: 11/16/2022] Open
Abstract
Introduction The objective of this study was to examine the association between occupation and osteoarthritis (OA) leading to total knee (TKR) or hip (THR) joint replacement. Methods The following is the case-control study design. All patients still living in Iceland who had had a TKR or THR due to OA as of the end of 2002 were invited to participate. First degree relatives of participating patients served as controls. N = 1,408 cases (832 women) and n = 1,082 controls (592 women), 60 years or older and who had adequately answered a questionnaire were analyzed. Occupations were classified according to international standards. Inheritance of occupations was calculated by using the Icelandic Genealogy Database. Results The age adjusted odds ratio (OR) for male farmers getting a TKR due to OA was 5.1 (95% confidence interval (CI) 2.1 to 12.4) and for a male farmer getting a THR due to OA the OR was 3.6 (95% CI 2.1 to 6.2). The OR for a fisherman getting a TKR was 3.3 (95% CI 1.3 to 8.4). No other occupations showed increased risk for men. For women there was no increased risk for any occupation. Farming and fishing were also the occupations that showed the greatest degree of inheritance. Conclusions These results support an association in males between occupations with heavy physical load and both TKR and THR for OA.
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Affiliation(s)
- Jonas Franklin
- Department of Orthopedics, University Hospital, Eyrarlandsvegi, Akureyri, IS-600, Iceland.
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Kuijer PPFM, de Beer MJPM, Houdijk JHP, Frings-Dresen MHW. Beneficial and limiting factors affecting return to work after total knee and hip arthroplasty: a systematic review. JOURNAL OF OCCUPATIONAL REHABILITATION 2009; 19:375-81. [PMID: 19693656 PMCID: PMC2775121 DOI: 10.1007/s10926-009-9192-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Accepted: 07/02/2009] [Indexed: 05/28/2023]
Abstract
INTRODUCTION A large number of patients undergoing total knee (TKA) and hip (THA) arthroplasties are of working age at the time these procedures are performed. The objective of this study was to systematically review literature on the beneficial and limiting factors affecting return to work in patients undergoing TKA or THA. METHOD Pubmed and Embase were systematically searched to find studies that described factors that influence return to work (RTW) after surgery. The following inclusion criteria had to be met: (1) inclusion of patients with primary or revision TKA or THA; (2) description of return to work after surgery or employment status; and (3) description of a beneficial or restricting factor affecting return to work. RESULTS Only three studies were found that fulfilled the three inclusion criteria. Three factors were discussed: (1) the mini-posterior approach compared to the two-incision approach; (2) patient movement restrictions after surgery compared to no restrictions; and (3) patient discharge based on guidelines compared to discharge without guidelines. CONCLUSIONS This systematic review revealed that knowledge is sparse regarding beneficial or limiting factors affecting return to work after TKA or THA. Despite that, the results suggests that the two-incision approach is beneficial, patient movement restrictions are limiting, and patient discharge guidelines have no effect on the time patients take to RTW.
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Affiliation(s)
- P P F M Kuijer
- Coronel Institute of Occupational Health, People and Work Outpatient Clinic, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands.
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Recnik G, Vengust R, Kralj-Iglič V, Vogrin M, Krajnc Z, Kramberger S. Association between Sub-Clinical Acetabular Dysplasia and a Younger Age at Hip Arthroplasty in Idiopathic Osteoarthritis. J Int Med Res 2009; 37:1620-1625. [DOI: 10.1177/147323000903700541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
This retrospective study was designed to investigate whether sub-clinical acetabular dysplasia, defined by a reduced centre-edge angle of Wiberg, was associated with a younger age at hip arthroplasty in patients with idiopathic osteoarthritis (OA). Fifty-four patients with 69 performed arthroplasties and no previous referral for hip dysplasia were selected from a list of consecutive recipients of hip endoprostheses due to idiopathic OA. The centre-edge angle was measured from standard pelvic radiographs taken a mean of 5.1 years prior to the endoprosthesis operation when there were minimal signs of hip OA. The age at which hip arthroplasty was carried out was compared between those patients with low (20° − 35°) and those with high (≥ 35°) centre-edge angles. The mean age at hip arthroplasty was significantly younger in the group with centre-edge angles of 20° − 35° (65.6 years) compared with those with centre-edge angles ≥ 35° (69.2 years). These results suggest that sub-clinical acetabular dysplasia was associated with a younger age at hip arthroplasty in idiopathic OA.
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Affiliation(s)
- G Recnik
- Department of Orthopaedic Surgery, University Hospital Maribor, Maribor, Slovenia
| | - R Vengust
- Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - V Kralj-Iglič
- Laboratory of Clinical Biophysics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - M Vogrin
- Department of Orthopaedic Surgery, University Hospital Maribor, Maribor, Slovenia
| | - Z Krajnc
- Department of Orthopaedic Surgery, University Hospital Maribor, Maribor, Slovenia
| | - S Kramberger
- Department of Orthopaedic Surgery, University Hospital Maribor, Maribor, Slovenia
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Rytter S, Egund N, Jensen LK, Bonde JP. Occupational kneeling and radiographic tibiofemoral and patellofemoral osteoarthritis. J Occup Med Toxicol 2009; 4:19. [PMID: 19594940 PMCID: PMC2726153 DOI: 10.1186/1745-6673-4-19] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Accepted: 07/13/2009] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The objective of our study was to evaluate the association between occupational kneeling and compartment specific radiographic tibiofemoral (TF) and patellofemoral (PF) osteoarthritis (OA). METHODS Questionnaire data and bilateral knee radiographs were obtained in 134 male floor layers and 120 male graphic designers (referents). Weight-bearing radiographs in three views (postero-anterior, lateral and axial) were classified according to joint space narrowing. After the exclusion of subjects with reports of earlier knee injuries the odds ratio (OR) with 95% confidence intervals (CI) of TF and PF OA was computed among floor layers compared to graphic designers in three age groups (</= 49; 50-59; >/= 60 years). Using logistic regression, estimates were adjusted for body mass index and knee-straining sports. In addition, the association between trade seniority and TF OA was assessed in age-adjusted test for trend analyses. RESULTS The prevalence of TF OA was significantly higher among floor layers aged 50-59 years compared to graphic designers (OR = 3.6, 95% CI = 1.1-12.0) while non-significant estimates were found in the young and elderly age groups. Furthermore, the adjusted OR of TF OA increased with trade seniority among floor layers (test for trend, OR = 2.2, 95% CI = 1.0-5.1), but not among graphic designers (OR = 1.2, 95% CI = 0.4-3.5). There were no significant differences regarding PF OA between the two occupational groups. CONCLUSION Results corroborate the existence of a causal relationship between occupational kneeling and radiographic TF OA and suggest a dose-response association with trade seniority. An association between kneeling and PF OA was however doubtful. Apparent discrepancies between findings in different age groups are most likely reflecting selection bias.
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Affiliation(s)
- Søren Rytter
- Department of Orthopaedics, Hospital Unit West, Herning, Denmark.
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Recnik G, Kralj-Iglic V, Iglic A, Antolic V, Kramberger S, Rigler I, Pompe B, Vengust R. The role of obesity, biomechanical constitution of the pelvis and contact joint stress in progression of hip osteoarthritis. Osteoarthritis Cartilage 2009; 17:879-82. [PMID: 19162509 DOI: 10.1016/j.joca.2008.12.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2008] [Revised: 12/01/2008] [Accepted: 12/13/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of our study was to explore whether earlier hip arthroplasty for idiopathic osteoarthritis (OA) might be explained by enlarged contact stress in the hip joint, and to what amount can that be attributed to obesity and biomechanical constitution of the pelvis. METHOD Fifty subjects were selected from a list of consecutive recipients of hip endoprosthesis due to idiopathic OA; standard pelvic radiographs made years prior to surgery were the main selection criteria. For 65 hips resultant hip force and peak contact hip stress normalized to the body weight (R/Wb and p(max)/Wb) were determined from the radiographs with the HIPSTRESS method. Body weight and body mass index (BMI) were obtained with an interview. Regression analysis was used to correlate parameters of obesity (body weight, BMI), biomechanical constitution of the pelvis (R/Wb, p(max)/Wb) and mechanical loading within the hip joint (R, p(max)) with age at hip arthroplasty. RESULTS Younger age at hip arthroplasty was associated with higher body weight (P=0.009), higher peak contact hip stress normalized to the body weight - p(max)/Wb (P=0.019), higher resultant hip force -R (P=0.027) and larger peak contact hip stress - p(max) (P<0.001), but not with BMI (P=0.121) or R/Wb (P=0.614). CONCLUSION Our results suggest that enlarged contact stress (p(max)) plays an important role in rapid progression of hip OA with both obesity (increased body weight) and unfavorable biomechanical constitution of the pelvis (greater p(max)/Wb) contributing.
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Affiliation(s)
- G Recnik
- Department of Orthopedic Surgery, University Hospital Maribor, Maribor, Slovenia.
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