The Early Detection of Osteoporosis in a Cohort of Healthcare Workers: Is There Room for a Screening Program?

Abstract

Workforce aging is becoming a significant public health problem due to the resulting emergence of age-related diseases, such as osteoporosis. The prevention and early detection of osteoporosis is important to avoid bone fractures and their socio-economic burden. The aim of this study is to evaluate the sustainability of a screening workplace program able to detect workers with osteoporosis. The screening process included a questionnaire-based risk assessment of 1050 healthcare workers followed by measurement of the bone mass density (BMD) with a pulse-echo ultrasound (PEUS) at the proximal tibia in the at-risk subjects. Workers with a BMD value ≤ 0.783 g/cm² were referred to a specialist visit ensuring a diagnosis and the consequent prescriptions. Any possible association between the outcome variable BMD ≤ 0.783 g/cm² and the risk factors was evaluated. The costs were calculated with a full costing method. We identified 60 pathological subjects. We observed increased risks for women, older ages, and menopause (p < 0.01). The yearly cost of our screening program estimated for this study was 8242 euros, and, considering the fragility bone fracture costs, we hypothesize a considerable economic savings, with a possible positive benefits/cost ratio of 2.07. We can say that the margin between the investment and results leads to a preference for this type of screening program. Osteoporosis is an occupational health problem, and a workplace screening program could be a cost-effective intervention.

Managing an ageing healthcare workforce: a systematic literature review

“…Increased risk of osteoporosis, tuberculosis, deaths from COVID-19 have been also associated with older HCWs (Lee et al. , 2021; Rinaldi et al. , 2021; Verma et al.…”

“…This study evaluated the association between physical therapists' (PTs) muscular fitness and Work Ability Index (WAI) in Spain and it showed that PTs aged 50 years or older had lower WAI scores than their younger counterparts. Increased risk of osteoporosis, tuberculosis, deaths from COVID-19 have been also associated with older HCWs (Lee et al, 2021;Rinaldi et al, 2021;Verma et al, 2021). Age-related differences were assessed by Merkus et al (2019) and conclusion was made that the level of occupational physical demands and the higher relative physical strain in older employees require addressing to promote sustainable work participation among an ageing population.…”

Bone density estimation using tissue heat capacity

“…Then, when fractures do occur, they can cause serious mobility impairments (Maffulli & Aicale, 2022). In view of the long asymptomatic period, early detection and prevention are essential for minimizing osteoporosis‐related injuries (Rinaldi et al, 2021).…”

A comparison between IBEX bone health applied to digital radiographs and dual-energy X-ray absorptiometry at the distal-third and ultra-distal regions

“…Increasing primary prevention would be bene cial-not least to the patient whose fracture risk can be substantially mitigated following diagnosis [9]-but also to the healthcare provider through the reduced cost of treatment prior to fracture [10,11]. One method to increase primary prevention is the IBEX Bone Health (IBEX BH) software, which provides a measure of aBMD and T-score at the ultra-distal (UD) and distal-third (TD) regions [12,13] from standard digital radiographs (DRs) of the forearm.…”