VICTORIA, B.C. – Individuals who have physically demanding occupations are at increased risk for osteoarthritis, even in this era of protective measures and equipment, a population-based study has shown.
In this study of a random sample of 88,202 noninstitutionalized U.S. adults, almost one in five reported having physician-diagnosed osteoarthritis (OA), Dr. Chengwei Wang reported in a poster session at the annual meeting of the Canadian Rheumatology Association.
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"Doctors may want to tell patients to use some preventive measures when they work in these occupations other than to just prescribe medications" for musculoskeletal symptoms, said Dr. Chengwei Wang.
After adjustment for age, sex, ethnicity, and obesity, participants in physically demanding jobs such as building maintenance, health care support, and construction had significantly elevated risks of OA relative to their counterparts in computer and mathematical occupations (the group used for comparison because it had the lowest OA rate). The risk was increased to the greatest extent, essentially doubled, for those in military-specific occupations.
The risk of OA was significantly elevated for participants who were in office and administrative support occupations (relative risk, 1.24); sales and related occupations (1.28); building and grounds cleaning and maintenance (1.37); transportation and material moving (1.38); food preparation and serving (1.41); production (1.47); protective services (1.51); construction and extraction (1.51); health care support (1.54); installation, maintenance, and repair (1.54); and military-specific occupations (2.04).
Dr. Chengwei Wang
These findings come from adjusted analyses of data from the U.S. National Health Interview Survey for the years 2005 through 2009 that used participants in computer and mathematical occupations as the reference group. Overall, 19.5% of the sample reported having physician-diagnosed OA.
"Doctors should know that people working in these occupations have a risk factor that plays an important role in developing osteoarthritis," Dr. Wang said in an interview. "I don’t think they need to change occupations. But doctors may want to tell patients to use some preventive measures when they work in these occupations other than to just prescribe medications" for musculoskeletal symptoms, she said.
"We need more-detailed studies to determine what kinds of factors in these occupations play a role in the development of this disease," such as various biomechanical factors, added Dr. Wang, a statistician at Nassau University Medical Center in East Meadow, N.Y. Additionally, the role of duration of exposure requires further investigation.
Such research could eventually help inform the redesign of workplaces and work practices to minimize risk, she said. For example, "occupational therapists and physical medicine and rehabilitation specialists could develop facilities to help protect workers in these occupations further," Dr. Wang suggested.
Dr. Wang said that she and her coauthors had no relevant financial disclosures.