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Original research
Increased risk of incident knee osteoarthritis in those with greater work-related physical activity
  1. Grace H Lo1,2,
  2. Michael J Richard3,
  3. Timothy E McAlindon3,
  4. Chantel Park4,
  5. Michael T Strayhorn1,5,
  6. Matthew S Harkey6,
  7. Lori Lyn Price7,
  8. Charles B Eaton8,9,
  9. Jeffrey B Driban3
  1. 1Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
  2. 2Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
  3. 3Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
  4. 4Division of Rheumatology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
  5. 5Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
  6. 6Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
  7. 7The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
  8. 8Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
  9. 9Department of Epidemiology, School of Public Health of Brown University, Providence, Rhode Island, USA
  1. Correspondence to Dr Grace H Lo, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA; ghlo{at}bcm.edu

Abstract

Objective Occupations involving greater physical activity may increase risk for knee osteoarthritis (OA). Existing studies have not evaluated work-related physical activity before OA onset. Hence, we aimed to evaluate the association between work-related physical activity and knee OA incidence.

Methods We performed a person-based longitudinal study using Osteoarthritis Initiative (OAI) data among people who volunteered or worked for pay without baseline radiographic knee OA or knee pain. Bilateral knee radiographs were obtained at baseline and annual follow-ups. We defined radiographic OA as Kellgren-Lawrence grade ≥2. Questions from the Physical Activity Scale for the Elderly at baseline and annual OAI visits provided information about work-related physical activity level and hours. We performed logistic regression with work-related physical activity level (mainly sitting, standing and some walking, walking while handling some materials) and hours as predictors. The outcome was incident person-based radiographic OA within the ensuing 12 months, over 48 months.

Results Among 951 participants (2819 observations), higher work-related physical activity levels had greater adjusted ORs for incident radiographic OA (people with jobs with standing and some walking: 1.11 (0.60–2.08), and walking while handling some materials: 1.90 (1.03–3.52), when compared with those with mainly sitting work-related activity). There was no association between number of hours worked and incident radiographic OA.

Conclusions People performing work that require walking while handling some materials have greater odds of incident knee OA than those with jobs mostly involving sitting. Strategies are needed to mitigate risk factors predisposing them to radiographic OA.

  • osteoarthritis
  • occupational health
  • physical exertion
  • longitudinal studies

Data availability statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. Datasets from the main Osteoarthritis Initiative are available on a public, open access repository: https://nda.nih.gov/oai/.

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Data availability statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. Datasets from the main Osteoarthritis Initiative are available on a public, open access repository: https://nda.nih.gov/oai/.

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Footnotes

  • Contributors GH-WL planned the study, created the data analysis plan, performed the statistical analyses, created the first draft of the manuscript and is the guarantor for the manuscript. MJR participated in data analyses interpretation, drafting and revising the manuscript and manuscript submission. TM participated in data analyses interpretation and drafting and revising the manuscript. CP participated in data analyses interpretation and drafting and revising the manuscript. MS participated in data analyses interpretation and drafting and revising the manuscript. MH participated in data analyses interpretation and drafting and revising the manuscript. LLP participated in data analyses interpretation and drafting and revising the manuscript. CE participated in primary data collection, data analyses interpretation and drafting and revising the manuscript. JD participated in data analyses interpretation and drafting and revising the manuscript.

  • Funding GH-WL was supported by K23 AR062127, an NIH/NIAMS funded mentored award, providing support for design and conduct of the study, analysis and interpretation of the data and preparation and review of this work. This work is supported in part with resources at the VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (#CIN 13-413), at the Michael E. DeBakey VA Medical Center, Houston, Texas, USA. Periarticular Bone Density as a Biomarker for Early Knee Osteoarthritis was sponsored by NIH/NIAMS (McAlindon R01 AR 060718) providing support for design and conduct of the study, analysis and interpretation of the data and preparation and review of this work. The Osteoarthritis Initiative is a public–private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the Osteoarthritis Initiative Study Investigators. Private funding partners include Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline and Pfizer. Private sector funding for the Osteoarthritis Initiative is managed by the Foundation for the National Institutes of Health.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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