Occupational Strain as a Risk for Hip Osteoarthritis

Bergmann, Andreas; Bolm‐Audorff, Ulrich; Krone, Daniel; Seidler, Andreas; Liebers, Falk; Haerting, Johannes; Freiberg, Alice; Unverzagt, Susanne

doi:10.3238/arztebl.2017.0581

Cited by 16 publications

(42 citation statements)

References 39 publications

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“…For all studies (except for the small study of [ 7 ] with only two exposure categories) we assigned the highest exposure category among men at approximately the 90th exposure percentile (range of percentiles of the highest exposure category: 82.1st to 91.2nd; median: 90.2nd percentile). The previous pooled analysis (see [ 2 ]) found that the highest exposure categories of the studies included approximately doubled the risk among men (OR 2.09; 95% CI 1.4–3.1). Therefore, the doubling dose should correspond to approximately the 90th percentile of the cumulative exposure values of the reference population.…”

Section: Resultsmentioning

confidence: 99%

“…This meta-regression analysis was based on our recently published systematic review [ 2 ] on the relationship between physical workload and osteoarthritis of the hip. We first performed an update (until March 31, 2017) of our literature search using the published search strategy.…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, we conducted a first sensitivity analysis, in which we based the estimation of the doubling dose on the 90th percentile of the cumulative exposure values of the reference population. We based this analysis on the meta-analysis by [ 2 ], who found a relative risk of about 2 when pooling the highest categories of the included studies. In a second sensitivity analysis, we included the study conducted by Lau et al [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

“…There is consistent evidence from observational studies of an association between occupational lifting and carrying of heavy loads and the diagnosis of hip osteoarthritis (for the three systematic reviews published after 2010, see [ 9 , 19 ] and [ 2 ]). However, due to the heterogeneity of exposure estimates (differing weights, frequencies and/or duration of manual handling considered in the single studies), a dose-response relationship between cumulative physical workload and hip osteoarthritis (OA) could not be determined so far.…”

Section: Introductionmentioning

confidence: 91%

“…In a recently published systematic review [ 2 ], we pooled the risk estimates for the highest categories of the included studies. For men, based on seven case-control studies [ 3 , 5 – 7 , 10 , 12 , 17 , 26 ], we found a pooled odds ratio (OR) of 2.1 (95% CI 1.4–3.1) for the highest exposure categories combined.…”

Section: Introductionmentioning

confidence: 99%

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Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment

Seidler¹,

Lüben²,

Hegewald³

et al. 2018

BMC Musculoskelet Disord

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BackgroundThere is consistent evidence from observational studies of an association between occupational lifting and carrying of heavy loads and the diagnosis of hip osteoarthritis. However, due to the heterogeneity of exposure estimates considered in single studies, a dose-response relationship between cumulative physical workload and hip osteoarthritis could not be determined so far.MethodsThis study aimed to analyze the dose-response relationship between cumulative physical workload and hip osteoarthritis by replacing the exposure categories of the included studies with cumulative exposure values of an external reference population. Our meta-regression analysis was based on a recently conducted systematic review (Bergmann A, Bolm-Audorff U, Krone D, Seidler A, Liebers F, Haerting J, Freiberg A, Unverzagt S, Dtsch Arztebl Int 114:581–8, 2017). The main analysis of our meta-regression comprised six case-control studies for men and five for women. The population control subjects of a German multicentre case-control study (Seidler A, Bergmann A, Jäger M, Ellegast R, Ditchen D, Elsner G, Grifka J, Haerting J, Hofmann F, Linhardt O, Luttmann A, Michaelis M, Petereit-Haack G, Schumann B, Bolm-Audorff U, BMC Musculoskelet Disord 10:48, 2009) served as the reference population. Based on the sex-specific cumulative exposure percentiles of the reference population, we assigned exposure values to each category of the included studies using three different cumulative exposure parameters. To estimate the doubling dose (the amount of physical workload to double the risk of hip osteoarthritis) on the basis of all available case-control-studies, meta-regression analyses were conducted based on the linear association between exposure values of the reference population and the logarithm of reported odds ratios (ORs) from the included studies.ResultsIn men, the risk to develop hip osteoarthritis was increased by an OR of 1.98 (95% CI 1.20–3.29) per 10,000 tons of weights ≥20 kg handled, 2.08 (95% CI 1.22–3.53) per 10,000 tons handled > 10 times per day and 8.64 (95% CI 1.87–39.91) per 106 operations. These estimations result in doubling dosages of 10,100 tons of weights ≥20 kg handled, 9500 tons ≥20 kg handled > 10 times per day and 321,400 operations of weights ≥20 kg. There was no linear association between manual handling of weights at work and risk to develop hip osteoarthritis in women.ConclusionsUnder specific conditions, the application of an external reference population allows for the derivation of a dose-response relationship despite high exposure heterogeneities in the pooled studies.Electronic supplementary materialThe online version of this article (10.1186/s12891-018-2085-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment

Seidler¹,

Lüben²,

Hegewald³

et al. 2018

BMC Musculoskelet Disord

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Risk factors for development of lower limb osteoarthritis in physically demanding occupations: A narrative umbrella review

Schram

Orr

Pope

et al. 2019

Journal of Occupational Health

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Incidence of knee and hip joint replacement associated with cumulative exposure to physical factors at work

d'Errico,

Fontana,

Filippi

2024

American J Industrial Med

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BackgroundKnee 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.MethodsThe 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).ResultsThe 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.ConclusionsOur results indicate that exposure to physical hazards at work increases the likelihood of developing knee OA, but not hip OA.

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Occupational Strain as a Risk for Hip Osteoarthritis

Cited by 16 publications

References 39 publications

Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment

Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment

Risk factors for development of lower limb osteoarthritis in physically demanding occupations: A narrative umbrella review

Incidence of knee and hip joint replacement associated with cumulative exposure to physical factors at work

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