Knee osteoarthritis Influence of work with heavy lifting, kneeling, climbing stairs or ladders, or combining kneeling/squatting with heavy lifting

Lilli Kirkeskov Jensen ^1*

¹ Sygehus Viborg Arbejdsmedicinsk Klinik, Denmark

^* To whom correspondence should be addressed. E-mail: lilli.kirkeskov.jensen{at}sygehusviborg.dk.

Accepted 18 June 2007

Abstract

The purpose of the study was to evaluate the evidence for an association between knee osteoarthritis (kneeOA) and physical work demands. Systematic searches were made and epidemiological studies on knee osteoarthritis and heavy-lifting, kneeling, and climbing stairs were reviewed for the period 1985 to 2007 inclusive. ¬¬The quality of the studies were assessed and an overall evaluation of the degree of evidence of a causal relationship between kneeOA and physical demanding work have been made using specific criteria of the different degrees of evidence of causality. Limitations of the studies include few participants, use of different diagnostic criteria, and a poor description of the exposure. It is concluded that moderate evidence was found for a relationship between kneeling, heavy-lifting and kneeOA. For the combination of kneeling/squatting and heavy-lifting, the association seemed stronger than for kneeling/squatting or heavy-lifting alone, but only few studies were found on this relationship. Therefore the degree of evidence for a causal relationship was considered as moderate. In the studies on the association between kneeOA and climbing stairs or ladders, there was an increased risk for kneeOA, but only few studies were found, and no dose-response relationship has been investigated. The evidence of a causal relationship is therefore considered to be limited.

Keywords: causal relationship, construction workers, knee osteoarthrosis, occupation, physical work demands

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