Primary osteoarthritis of hip, knee, and hand in relation to occupational exposure
- M Rossignol1,
- A Leclerc2,
- F A Allaert3,
- S Rozenberg4,
- J P Valat5,
- B Avouac6,
- P Coste7,
- E Litvak8,
- P Hilliquin9
- 1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
- 2INSERM, U88, St-Maurice, France
- 3Medical Information, CHU Dijon, France
- 4Rheumatology, Pitie-Salpetriere Hospital, Paris, France
- 5Faculty of Medicine, Tours University, France
- 6Rheumatology, Henri Mondor Hospital, Créteil, France
- 7Expanscience Laboratories, Courbevoie, France
- 8Département de médecine sociale et préventive, Université de Montréal, Montreal, Canada
- 9Gilles de Corbeil Hospital, Corbeil, France
- Correspondence to: Dr M Rossignol Montreal Department of Public Health, 1301 Sherbrooke Street East, Montreal, Quebec, Canada H2L 1M3;
- Accepted 26 May 2005
Aim: To identify occupations with excess prevalence of osteoarthritis of the knee, hip, and hand in a nationwide survey and to compare occupations with and without excess prevalence with regard to biomechanical stresses and severity of osteoarthritis.
Methods: Patients presenting with osteoarthritis of the knee, hip, or hand were recruited throughout France by their treating physician who collected information on history, including age at onset, occupation, and occupational stresses to joints. Severity was assessed using joint specific functional status questionnaires: Lequesne for the hip and knee and Dreiser for the hand. The distribution of osteoarthritis patients by occupation was compared with the distribution of occupations in all workers in France to obtain prevalence rate ratios.
Results: Occupations with the greatest prevalence rate ratio were female cleaners (6.2; 95% CI 4.6 to 8.0), women in the clothing industry (5.0; 95% CI 3.9 to 6.3), male masons and other construction workers (2.9; 95% CI 2.6 to 3.3), and agriculture male and female workers (2.8; 95% CI 2.5 to 3.2). A twofold greater prevalence rate was observed within certain occupations between self-employed and salaried workers. Early onset of osteoarthritis was seen in the more heavy labour jobs with almost 40% of patients reporting their first symptoms before the age of 50.
Conclusion: The early onset and severity of osteoarthritis in certain occupations warrants an urgent need for occupation specific studies for the development and evaluation of preventive strategies in this leading cause of disability in Western countries.
Competing interests: Michel Rossignol has received research funds from the sponsor Expanscience Laboratories on behalf of the Department of Epidemiology, Biostatistics and Occupational Health, to conduct part of the analysis and manuscript preparation for this project. Philippe Coste is an employee of the sponsor Expanscience as Medical Director.