Xia Wang1, Thomas A Perry2, Nigel Arden3, Lingxiao Chen1, Camille M Parsons4, Cyrus Cooper5, Lucy Gates6, David J Hunter1. 1. Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia. 2. Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia, and University of Oxford, Oxford, UK. 3. University of Oxford, Oxford, UK, and Southampton General Hospital, University of Southampton, Southampton, UK. 4. Southampton General Hospital, University of Southampton, Southampton, UK. 5. Southampton General Hospital, National Institute for Health Research Biomedical Research Centre, University of Southampton, and University Hospital Southampton NHS Foundation Trust, Southampton, UK. 6. University of Oxford, Oxford, UK, and University of Southampton, Southampton, UK.
Abstract
OBJECTIVE: To assess the association between occupational exposures and knee osteoarthritis (OA). METHODS: We systematically searched for observational studies that examined the relationship between occupational exposures and knee OA and total knee replacement. Four databases were searched up to October 1, 2019. Two reviewers independently assessed study quality using the Newcastle-Ottawa Scale and evidence quality using the Grading of Recommendations Assessment, Development and Evaluation approach. Subgroup meta-analyses were conducted for important study characteristics and each type of occupational exposure. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated for the meta-analysis using random-effects models. RESULTS: Eighty eligible studies were identified including 25 case-control (n = 20,505 total participants), 36 cross-sectional (n = 139,463 total participants), and 19 cohort studies (n = 16,824,492 total participants). A synthesis of 71 studies suggested increased odds of knee OA (OR 1.52 [95% CI 1.37-1.69]) by combining different physically demanding jobs and occupational activities as compared to sedentary occupations and/or low-exposure groups. Odds of knee OA were greater in males and in industry-based studies and studies assessing lifetime occupational exposures. There were 9 specific job titles that were associated with knee OA, including farmer, builder, metal worker, and floor layer. Occupational lifting, kneeling, climbing, squatting, and standing were all associated with higher odds of knee OA as compared to the odds of knee OA in sedentary workers. CONCLUSION: Strenuous, physically demanding occupations and occupational activities were associated with increased odds of knee OA as supported by moderate-quality evidence. Specifically, agricultural and construction sectors, which typically involve heavy lifting, frequent climbing, prolonged kneeling, squatting, and standing, carried increased odds of knee OA.
OBJECTIVE: To assess the association between occupational exposures and knee osteoarthritis (OA). METHODS: We systematically searched for observational studies that examined the relationship between occupational exposures and knee OA and total knee replacement. Four databases were searched up to October 1, 2019. Two reviewers independently assessed study quality using the Newcastle-Ottawa Scale and evidence quality using the Grading of Recommendations Assessment, Development and Evaluation approach. Subgroup meta-analyses were conducted for important study characteristics and each type of occupational exposure. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated for the meta-analysis using random-effects models. RESULTS: Eighty eligible studies were identified including 25 case-control (n = 20,505 total participants), 36 cross-sectional (n = 139,463 total participants), and 19 cohort studies (n = 16,824,492 total participants). A synthesis of 71 studies suggested increased odds of knee OA (OR 1.52 [95% CI 1.37-1.69]) by combining different physically demanding jobs and occupational activities as compared to sedentary occupations and/or low-exposure groups. Odds of knee OA were greater in males and in industry-based studies and studies assessing lifetime occupational exposures. There were 9 specific job titles that were associated with knee OA, including farmer, builder, metal worker, and floor layer. Occupational lifting, kneeling, climbing, squatting, and standing were all associated with higher odds of knee OA as compared to the odds of knee OA in sedentary workers. CONCLUSION: Strenuous, physically demanding occupations and occupational activities were associated with increased odds of knee OA as supported by moderate-quality evidence. Specifically, agricultural and construction sectors, which typically involve heavy lifting, frequent climbing, prolonged kneeling, squatting, and standing, carried increased odds of knee OA.
Authors: R J Goekoop; M Kloppenburg; H M Kroon; L E V Dirkse; T W J Huizinga; R G J Westendorp; J Gussekloo Journal: Scand J Rheumatol Date: 2010-10-05 Impact factor: 3.641
Authors: Monique A M Gignac; Emma Irvin; Kim Cullen; Dwayne Van Eerd; Dorcas E Beaton; Quenby Mahood; Chris McLeod; Catherine L Backman Journal: Arthritis Care Res (Hoboken) Date: 2020-03 Impact factor: 4.794
Authors: Grace H Lo; Michael J Richard; Timothy E McAlindon; Chantel Park; Michael T Strayhorn; Matthew S Harkey; Lori Lyn Price; Charles B Eaton; Jeffrey B Driban Journal: Occup Environ Med Date: 2022-05-26 Impact factor: 4.948
Authors: Lucy S Gates; Thomas A Perry; Yvonne M Golightly; Amanda E Nelson; Leigh F Callahan; David Felson; Michael Nevitt; Graeme Jones; Cyrus Cooper; Mark E Batt; Maria T Sanchez-Santos; Nigel K Arden Journal: Arthritis Rheumatol Date: 2022-03-10 Impact factor: 15.483
Authors: Niels-Peter Brøchner Nygaard; Gert Frank Thomsen; Jesper Rasmussen; Lars Rauff Skadhauge; Bibi Gram Journal: Int J Environ Res Public Health Date: 2021-11-30 Impact factor: 3.390
Authors: Thomas A Perry; Xia Wang; Lucy Gates; Camille M Parsons; Maria T Sanchez-Santos; Cesar Garriga; Cyrus Cooper; Michael C Nevitt; David J Hunter; Nigel K Arden Journal: Semin Arthritis Rheum Date: 2020-08-08 Impact factor: 5.431