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Journal of Occupational Medicine and Toxicology

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Open Access 01-12-2008 | Research

The role of cumulative physical work load in symptomatic knee osteoarthritis – a case-control study in Germany

Authors: Andreas Seidler, Ulrich Bolm-Audorff, Nasreddin Abolmaali, Gine Elsner, the knee osteoarthritis study-group

Published in: Journal of Occupational Medicine and Toxicology | Issue 1/2008

Abstract

Objectives

To examine the dose-response relationship between cumulative exposure to kneeling and squatting as well as to lifting and carrying of loads and symptomatic knee osteoarthritis (OA) in a population-based case-control study.

Methods

In five orthopedic clinics and five practices we recruited 295 male patients aged 25 to 70 with radiographically confirmed knee osteoarthritis associated with chronic complaints. A total of 327 male control subjects were recruited. Data were gathered in a structured personal interview. To calculate cumulative exposure, the self-reported duration of kneeling and squatting as well as the duration of lifting and carrying of loads were summed up over the entire working life.

Results

The results of our study support a dose-response relationship between kneeling/squatting and symptomatic knee osteoarthritis. For a cumulative exposure to kneeling and squatting > 10.800 hours, the risk of having radiographically confirmed knee osteoarthritis as measured by the odds ratio (adjusted for age, region, weight, jogging/athletics, and lifting or carrying of loads) is 2.4 (95% CI 1.1–5.0) compared to unexposed subjects. Lifting and carrying of loads is significantly associated with knee osteoarthritis independent of kneeling or similar activities.

Conclusion

As the knee osteoarthritis risk is strongly elevated in occupations that involve both kneeling/squatting and heavy lifting/carrying, preventive efforts should particularly focus on these "high-risk occupations".

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Jensen LK: Knee osteoarthritis : Influence of work with heavy lifting, kneeling, climbing stairs or ladders, or combining kneeling/squatting with heavy lifting. Occ Environ Med 2008, 65: 72–89. 10.1136/oem.2007.032466CrossRef

National Board of Industrial Injuries (Arbejdsskadestyrelsen): Administrative Order No. 333 of March 15, on the List of Occupational Diseases Reported on or after January 1, 2005. [http://www.ask.dk/graphics/Dokumenter/English/Guides/Efortegn%20BE333%2015032007.pdf]

Bundesministerium für Gesundheit und Soziale Sicherung: Wissenschaftliche Begründung für die Berufskrankheit „Gonarthrose durch eine Tätigkeit im Knien oder vergleichbarer Kniebelastung mit einer kumulativen Einwirkungsdauer während des Arbeitslebens von mindestens 13.000 Stunden und einer Mindesteinwirkungsdauer von insgesamt einer Stunde pro Schicht". Bundesarbeitsblatt 2005, 46–54.

Kellgren JH: Atlas of standard radiographs of arthritis. Vol II. The epidemiology of chronic rheumatism. Oxford Blackwell Scientific 1963.

Burdorf A, Beek AJ: In musculoskeletal epidemiology are we asking the unanswerable in questionnaires on physical load? [editorial]. Scand J Work Environ Health 1999, 25: 81–83.PubMedCrossRef

Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jörgensen K: Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergonom 1987, 18: 233–237. 10.1016/0003-6870(87)90010-XCrossRef

Statistisches Bundesamt (Ed): Klassifizierung der Berufe–Systematisches und alphabetisches Verzeichnis der Berufsbenennungen–Ausgabe 1992 Stuttgart: Metzler-Poeschl; 1992.

Seidler A, Hornung J, Heiskel H, Börner M, Elsner G: Gonarthrose als Berufskrankheit? Zbl Arbeitsmed 2001, 51: 106–117.

Peat G, McCarney R, Croft P: Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary care. Ann Rheum Dis 2001, 60: 91–97. 10.1136/ard.60.2.91PubMedCentralPubMedCrossRef

10.

Wiktorin C, Selin K, Ekenvall L, Kilbom A, Alfredsson L: Evaluation of perceived and self-reported manual forces exerted in occupational manual materials handling. Appl Ergonom 1996, 27: 231–239. 10.1016/0003-6870(96)00006-3CrossRef

11.

Beek A, Frings-Dresen MHW: Assessment of mechanical exposure in ergonomic epidemiology. Occup Environ Med 1998, 55: 291–299.PubMedCentralPubMedCrossRef

12.

Kumar S: Perception of posture of short duration in the spatial and temporal domains. Appl Ergonom 1993, 24: 345–350. 10.1016/0003-6870(93)90073-ICrossRef

13.

Viikari-Juntura E, Rauas S, Martikainen R, Kuosma E, Riihimäki H, Takala EP, Saarenmaa K: Validity of self-reported physical work load in epidemiologic studies on musculoskeletal disorders. Scand J Work Environ Health 1996, 22: 251–259.PubMedCrossRef

14.

Wiktorin C, Karlqvist L, Winkel J, Stockholm MUSIC I study group: Validity of self-reported exposures to work postures and manual materials handling. Scand J Work Environ Health 1993, 19: 208–214.PubMedCrossRef

15.

Maetzel A, Mäkelä M, Hawker G, Bombardier C: Osteoarthritis of the hip and knee and mechanical occupational exposure – a systematic overview of the evidence. J Rheumatol 1997, 24: 1599–1607.PubMed

16.

Cooper C, Coggon D: Physical activity and knee osteoarthritis. Lancet 1999, 353: 2177–2178. 10.1016/S0140-6736(99)90094-6PubMedCrossRef

17.

Coggon D, Croft P, Kellingray S, Barrett D, McLaren M, Copper C: Occupational physical activities and osteoarthritis of the knee. Arthr Rheum 2000, 43: 1443–1449. Publisher Full Text 10.1002/1529-0131(200007)43:7<1443::AID-ANR5>3.0.CO;2-1CrossRef

18.

Sandmark H, Hogstedt C, Vingard E: Primary osteoarthritis of the knee in men and women as a result of lifelong physical load from work. Scand J Work Environ Health 2000, 26: 20–25.PubMedCrossRef

19.

Jensen LK: Knee-straining work activities, self-reported knee disorders and radiographically determined knee osteoarthritis. Scand J Work Environ Health 2005,31(Suppl 2):68–74.PubMed

20.

D'Souza JC, Werner RA, Keyserling WM, Gillespie B, Rabourn R, Ulin S, Franzblau A: Analysis of the third national health and nutrition examination survey (NHANES III) using expert ratings of job categories. Am J Ind Med 2008, 51: 37–46. 10.1002/ajim.20512PubMedCrossRef

21.

Felson DT, Hannan MT, Naimark A, Berkeley J, Gordon G, Wilson PW, Anderson J: Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham Study. J Rheumatol 1991, 18: 1587–1592.PubMed

22.

Cooper C, McAlindon T, Coggon D, Egger P, Dieppe P: Occupational activity and osteoarthritis of the knee. Ann Rheum Dis 1994, 53: 90–93.PubMedCentralPubMedCrossRef

23.

Thambyah A, Goh JC, De SD: Contact stresses in the knee joint in deep flexion. Med Eng Phys 2005, 27: 329–335. 10.1016/j.medengphy.2004.09.002PubMedCrossRef

Title: The role of cumulative physical work load in symptomatic knee osteoarthritis – a case-control study in Germany
Authors: Andreas Seidler
Ulrich Bolm-Audorff
Nasreddin Abolmaali
Gine Elsner
the knee osteoarthritis study-group
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: Journal of Occupational Medicine and Toxicology / Issue 1/2008
Electronic ISSN: 1745-6673
DOI: https://doi.org/10.1186/1745-6673-3-14

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The role of cumulative physical work load in symptomatic knee osteoarthritis – a case-control study in Germany

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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