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Occupational risk factors for hip arthritis

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Known or suggested risk factors for osteoarthritis of the hip (coxarthrosis) include physical workload, sporting activities, and obesity. Farmers and farm workers may be at particularly high risk and, within farming, tractor driving (especially in a twisted position), working with dairy herds or pigs, milking cows, and working on small farms have all been regarded as possible risk factors. Now a Danish study of four successive cohorts of male workers has provided fresh data about time trends and risks in different socioeconomic and occupational groups.

All employed Danish men aged 20–59 years in January 1981, 1986, 1991, and 1994 were grouped according to main occupation one year previously and followed up for two to five years for hospital admission with hip arthritis. The highest rates of first admission for this cause during 1994–99 were among self employed men and unskilled workers (standardised hospitalisation ratios (SHRs) 140 and 121) and unemployed men (SHR 156). Managers, salaried staff, and skilled workers had relatively low SHRs (56–96). Between 1981 and 1999 the SHR decreased slightly among self employed men and increased slightly among leading salaried staff and skilled and unskilled workers. Between 1981–85 and 1994–97 the SHR remained steady and high (281–286) among self employed farmers and was lower but rising (114–189) among farm employees. Men in agricultural tractor pools had an SHR of 210 in 1981–85 and 183 in 1994–99. Men who had much lower SHRs in 1994–99 included electronics mechanics and servicers (SHR 12), teachers (37), doctors (46) and armed forces (57). High risk occupations included bakers and pastry cooks (SHR 204), waiters and bartenders (204) and machine operators (207).

In recent decades the number of farms and farmers has fallen in Denmark but the number of farm workers has remained the same. Increased SHRs among farm workers might be due to their having taken over tasks previously done by farmers. Specific factors probably associated with increased risk of hip osteoarthritis include heavy lifting, prolonged standing, body vibration, tractor driving, and walking on rough ground.

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