Occupational risk factors for osteoarthritis of the knee: a meta-analysis

McWilliams, Daniel F.; Leeb, Burkhard F.; Muthuri, Stella G.; Doherty, Michael; Zhang, Weiya

doi:10.1016/j.joca.2011.02.016

Cited by 119 publications

(113 citation statements)

References 71 publications

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“…Our study also demonstrated that symptomatic knee OA was more common among persons living in rural areas compared with urban areas in China; this finding was consistent with those of previous studies SYMPTOMATIC KNEE OSTEOARTHRITIS IN CHINA 651 (13,14). Given that residents living in less-developed or rural areas often have limited resources, including fewer clinics, safe options for public transportation, community centers, and safe places to exercise, as well as poorly kept sidewalks and less access to safe streets (28)(29)(30), studies of the impact of symptomatic knee OA on the residents in these communities are urgently needed. We demonstrated an apparent geographic variation in the prevalence of symptomatic knee OA in China.…”

Section: Discussionsupporting

confidence: 91%

The Prevalence of Symptomatic Knee Osteoarthritis in China: Results From the China Health and Retirement Longitudinal Study

Tang

Wang

Zhan

et al. 2016

Arthritis & Rheumatology

343

195

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Objective. To estimate the prevalence of symptomatic knee osteoarthritis (OA) in China.Methods. Using data collected from the China Health and Retirement Longitudinal Study, a populationbased longitudinal survey conducted between 2011 and 2012, we estimated the prevalence of symptomatic knee OA according to sex, age, rural/urban area, socioeconomic status, and geographic region.Results. Among 17,128 individuals (8,367 men and 8,761 women; mean age 59.8 years) included in the analysis, 8.1% had symptomatic knee OA. The prevalence of symptomatic knee OA was higher in women (10.3%) compared with men (5.7%) (adjusted odds ratio [OR] 1.88 [95% confidence interval 1.64-2.17]). The prevalence of symptomatic knee OA increased with age (P for trend <0.01). Symptomatic knee OA was more common in rural areas than in urban areas (OR 1.84 [95% confidence interval 1.46-2.31]). The prevalence of symptomatic knee OA was lower among individuals who had received more years of education and who lived in more developed areas (P for trend <0.01). The North and East regions of China had the lowest prevalence of symptomatic knee OA (5.4% and 5.5%, respectively), followed by the North-East (7.0%), South-Central (7.8%), and North-West (10.8%) regions. The prevalence was highest (13.7%) in subjects living in the South-West region.Conclusion. Symptomatic knee OA in China was prevalent, and the prevalence varied according to sociodemographic, economic, and geographic factors. Epidemiologic studies identifying risk factors that contribute to variation in the prevalence of symptomatic knee OA in China are warranted.Knee osteoarthritis (OA) is the most common joint disorder in elderly individuals (1-4). Knee OA pain is a key symptom of persons seeking medical care and is the leading cause of disability (5-7). To date, the majority of population-based observational studies of knee OA have been conducted in developed countries (8-12), and only a few studies have been conducted in China (13,14). Thus, there is a paucity of data on the prevalence of knee OA and potential risk factors for knee OA in elderly individuals in China.China is a large country, with a population of 1.3 billion. In 2010, 25.3% of the population comprised individuals age 50 years or older (15). Socioeconomic development, environmental factors, lifestyle factors, and health care utilization varied greatly among residents in the different regions of China. Thus, based on these factors, one would expect a large variation in the prevalence of symptomatic knee OA (16,17). To date, data regarding the prevalence of symptomatic OA in this population are lacking. Epidemiologic studies comparing the prevalence of symptomatic knee OA according to sociodemographic factors, economic factors, and geographic areas, using the same research method, would not only provide important and valuable information for health care planners but would also shed light on our understanding of the potential risk factors for symptomatic knee OA.

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Section: Discussionsupporting

confidence: 91%

The Prevalence of Symptomatic Knee Osteoarthritis in China: Results From the China Health and Retirement Longitudinal Study

Tang

Wang

Zhan

et al. 2016

Arthritis & Rheumatology

343

195

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“…6,7 Since we began our study, two other groups have published reviews on this topic. 47,48 Fransen and colleagues, 47 who examined the role of occupational factors in hip and knee pain, reported a significant association between heavy lifting, kneeling or squatting, and symptomatic knee OA. They identified eight new publications on knee OA since the review by Jensen and colleagues, 6 five of which were also included in our review (the other three failed to fit our inclusion criteria for radiographically or MRIconfirmed signs of knee OA).…”

Section: Discussionmentioning

confidence: 99%

“…Although Fransen and colleagues also examined occupational tasks individually, they did not examine the risks separately for men and women. In a second review, McWilliams and colleagues 48 performed a meta-analysis on 51 observational studies to assess the relationships between occupational factors (''heavy work,'' ''kneeling activity,'' elite sports participation, job titles) and knee OA. Their meta-analysis found a statistically significant association between occupational physical loading and knee OA; however, they did not assess the methodological quality of the studies.…”

Section: Discussionmentioning

confidence: 99%

Occupational Physical Loading Tasks and Knee Osteoarthritis: A Review of the Evidence

Ezzat¹,

2014

Physiotherapy Canada

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Purpose: To perform a systematic review with best evidence synthesis examining the literature on the relationship between occupational loading tasks and knee osteoarthritis (OA). Methods: Two databases were searched to identify articles published between 1946 and April, 2011. Eligible studies were those that (1) included adults reporting on their employment history; (2) measured individuals' exposure to work-related activities with heavy loading in the knee joint; and (3) identified presence of knee OA (determined by X-ray), cartilage defects associated with knee OA (identified by magnetic resonance imaging), or joint replacement surgery. Results: A total of 32 articles from 31 studies met the inclusion criteria. We found moderate evidence that combined heavy lifting and kneeling is a risk factor for knee OA, with odds ratios (OR) varying from 1.8 to 7.9, and limited evidence for heavy lifting (OR ¼ 1.4-7.3), kneeling (OR ¼ 1.5-6.9), stair climbing (OR ¼ 1.6-5.1), and occupational groups (OR ¼ 1.4-4.7) as risk factors. When examined by sex, moderate level evidence of knee OA was found in men; however, the evidence in women was limited. Conclusions: Further high-quality prospective studies are warranted to provide further evidence on the role of occupational loading tasks in knee OA, particularly in women.

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“…Palmer concluded that there is reasonably good evidence to connect work activity and knee OA and -more specifically -that this evidence is stronger with regard to squatting / kneeling, lifting and physical workload, somewhat weaker for climbing and somewhat against an important effect caused by standing or walking [2]. McWilliams et al conducted a meta-analysis on the same topic, highlighting that occupational activities such as kneeling, squatting, lifting/carrying, climbing stairs and knee bending/straining, gave positive risks for knee OA [7]. In contrast, the analyses also pointed out that standing work was not a risk factors for knee OA.…”

Section: Discussionmentioning

confidence: 99%

Knee osteoarthritis in a chestnut farmer – Case Report

Mattioli

Graziosi

Curti

et al. 2017

Ann Agric Environ Med.

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Introduction. Several studies have dealt with the issue of professional risk factors and onset of knee osteoarthritis (OA). In particular, occupational epidemiological studies have provided evidence that activities resulting in biomechanical overload may be linked with an increased risk of knee OA -also among farmers. To our knowledge, no cases of knee OA among chestnut farmers have been reported in the literature. Case report. We report the case of a 70-year-old Caucasian male who has worked for more than 50 years on a chestnut farm. In 2007, an X-ray and a MRI, performed after a workplace accident to his left knee, showed the presence of knee OA. His job required a range of repetitive tasks, such as squatting, kneeling, climbing, walking on sloping terrain, assuming uncomfortable postures, and lifting and carrying heavy loads for the great majority of the working day. All the aforementioned tasks are known occupational risk factors for knee OA. Regarding individual risk factors, at the time of the first diagnosis of knee OA, the worker was 64-years-old with a body mass index of 26.5 kg/m 2 . He reported no cases of arthritis among his relatives and no sports playing on his part. In addition, his medical history revealed the presence of two minor lumbar disc herniations and tendinitis of the long head of the biceps. Conclusion. Considering the lack of major individual risk factors for knee OA, it is reasonable to suppose that five decades of exposure to biomechanical overload as a chestnut farmer was a relevant risk factor for the onset of the disease.

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Occupational risk factors for osteoarthritis of the knee: a meta-analysis

Abstract: Some occupational activities increase the risk of knee OA, although the influences of publication bias and heterogeneity are important limitations of this study. Prospective studies would greatly improve the evidence base.

Cited by 119 publications

References 71 publications

The Prevalence of Symptomatic Knee Osteoarthritis in China: Results From the China Health and Retirement Longitudinal Study

The Prevalence of Symptomatic Knee Osteoarthritis in China: Results From the China Health and Retirement Longitudinal Study

Occupational Physical Loading Tasks and Knee Osteoarthritis: A Review of the Evidence

Knee osteoarthritis in a chestnut farmer – Case Report

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