Primary osteoarthritis of hip, knee, and hand in relation to occupational exposure

Abstract

Aim: To identify occupations with excess prevalence of osteoarthritis of the knee, hip, and hand in a nationwide survey and to compare occupations with and without excess prevalence with regard to biomechanical stresses and severity of osteoarthritis. Methods: Patients presenting with osteoarthritis of the knee, hip, or hand were recruited throughout France by their treating physician who collected information on history, including age at onset, occupation, and occupational stresses to joints. Severity was assessed using joint specific functional status questionnaires: Lequesne for the hip and knee and Dreiser for the hand. The distribution of osteoarthritis patients by occupation was compared with the distribution of occupations in all workers in France to obtain prevalence rate ratios. Results: Occupations with the greatest prevalence rate ratio were female cleaners (6.2; 95% CI 4.6 to 8.0), women in the clothing industry (5.0; 95% CI 3.9 to 6.3), male masons and other construction workers (2.9; 95% CI 2.6 to 3.3), and agriculture male and female workers (2.8; 95% CI 2.5 to 3.2). A twofold greater prevalence rate was observed within certain occupations between self-employed and salaried workers. Early onset of osteoarthritis was seen in the more heavy labour jobs with almost 40% of patients reporting their first symptoms before the age of 50. Conclusion: The early onset and severity of osteoarthritis in certain occupations warrants an urgent need for occupation specific studies for the development and evaluation of preventive strategies in this leading cause of disability in Western countries.

Associations of work activities requiring pinch or hand grip or exposure to hand-arm vibration with finger and wrist osteoarthritis: a meta-analysis

“…Among the 19 studies (20 papers) eligible for this review, a majority (18,25,26,(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(45)(46)(47)(48) were cross-sectional, followed by a prospective cohort (44) and a case-control study (24). The sample sizes included >1000 participants (26,(35)(36)(37)41), 500-1000 participants (25,33,38,39,42,43), 100-500 participants (18,24,34,40,(44)(45)(46)48), and <100 participants (47).…”

“…The sample sizes included >1000 participants (26,(35)(36)(37)41), 500-1000 participants (25,33,38,39,42,43), 100-500 participants (18,24,34,40,(44)(45)(46)48), and <100 participants (47). The study populations included only men (39,40,(44)(45)(46)(47)(48), only women (18,(24)(25)38), or both men and women (26,(33)(34)(35)(36)(37)(41)(42)(43). The type of work seems a likely reason for not including both genders in some studies.…”

“…This included six studies addressing the association of finger OA (DIP, PIP, and/or MCP joints) with work activities involving repeated or sustained pinch grip (18, 24-26, 33, 34) and nine studies (ten papers) addressing finger OA and/or wrist OA (intracarpal and/or CMC joints) in relation to work activities involving repeated or sustained hand grip (34)(35)(36)(37)(38)(39)(40)(41)(42)(43). The study of Kellgren & Lawrence (34) was included in both exposure groups as they provided the estimates separately for different occupations.…”

“…In 13 studies (18,25,26,33,34,(38)(39)(40)(44)(45)(46)(47)(48), exposure assignment was based on job titles and subjective recall of exposure provided by questionnaire or interview in 7 studies (24,(35)(36)(37)(41)(42)(43). None of the studies on pinch and hand grip eligible for meta-analysis performed measures of hand/finger movements, applied forces, postures, or repetition.…”

Lifetime trajectory of physical activity according to energy expenditure and joint force

“…Although physical activity is vital for joint health and may protect against osteoarthritis (OA), studies on some high-intensity sports and strenuous occupations have shown a relationship to OA (8,9). However, research on the relationship between hip and knee health and moderate and vigorous physical activities in the general popula-tion has not been consistent.…”