Incidence of surgically treated osteoarthritis in the hip and knee in male construction workers

bengt Jarvholm ^1*, Carin From ², stefan Lewold ³, Henrik Malchau ⁴ and eva vingard ⁵

¹ Umeå University, Sweden
² University Hospital, Sweden
³ Lunds University, Sweden
⁴ Massachusetts General Hospital, Boston, United States
⁵ Uppsala University, Sweden

^* To whom correspondence should be addressed. E-mail: bengt.jarvholm{at}envmed.umu.se.

Accepted 27 September 2007

Abstract

Objective: Occupational workload has been associated with an increased risk of osteoarthritis. The objective was to further examine the association between work load and occurrence of osteoarthritis and especially study if heavy workload has similar importance as a causative factor for osteoarthritis of the hip and knee. Methods: In a cohort study, we investigated the incidence of surgically treated osteoarthritis in the hip and knee among men employed in the Swedish construction industry (N=204,741). Incident cases were found by linkage with the Swedish hospital discharge register between 1987 and 1998. Incidence rates adjusted for age and BMI were compared between different occupational groups. Results: The incidence rates for osteoarthritis in hip and knee were positively correlated (r=0.62; p=0.01). There was a significantly increased risk of surgically treated osteoarthritis in the knee among floor layers, asphalt workers, sheet-metal workers, rock workers, plumbers, brick layers, wood workers and concrete workers. Even if there was a trend towards increase relative risks for osteoarthritis in the hip in floor layers, asphalt workers, wood workers and concrete workers they were not statistically significant. The relative risk for surgically treated osteoarthritis of the knee was 4.7 (95% CI 1.8-12.3) among floor layers, indicating an attributable fraction for work factors of 79%. Conclusions: This study shows that some work related factors seem to be a risk factors for osteoarthritis both in the knee and hip. However, the risk factors seem to be of greater importance for osteoarthritis in the knee compared to osteoarthritis in the hip. The study indicates that at least 50% of the cases of severe osteoarthritis of the knee can be prevented through decreasing occupational risk factors in some occupational groups.

Keywords: attributable risk, cohort, epidemiology, musculoskeletal, occupation

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