背景:膝关节骨性关节炎(OA)一直与工作中的高身体工作量和特定身体因素有关,而对于髋关节OA,可用的研究较少,这仍然表明可能与繁重的工作和身体工作量有关。该研究的目的是评估暴露于工作场所物理因素与膝关节和髋关节置换术发生率之间的关系。作为这些关节中严重OA的标志。
方法:研究人群由参加2011年都灵人口普查的25-60岁员工组成。对于自1995年以来担任的每项工作,都通过从意大利O*NET数据库构建的工作暴露矩阵将身体因素的暴露分配给队列中的个人。使用泊松回归模型,膝关节和髋关节置换术的发病率,通过2012年至2018年的住院治疗确定,对7种不同身体危害的累积暴露量和由17种身体因素构建的身体工作量综合指标进行了检查(Ergo-Index).
结果:在体力劳动负荷的最高累积暴露四分位数(发生率比=1.98,95%置信区间:1.24-3.16)和所检查的所有单一危害中,膝关节OA的风险显着增加。与最低四分位数相比,随着暴露的增加,风险有显著趋势。相比之下,未发现与髋关节OA有关联,其相对风险接近或低于物理工作量和每个单一风险的所有高暴露四分位数。
结论:我们的结果表明,在工作中暴露于身体危险会增加患膝关节OA的可能性,但不是髋关节OA。
BACKGROUND: Knee osteoarthritis (OA) has been quite consistently associated with high physical workload and specific physical factors at work, while for hip OA, fewer studies are available, which still indicate possible associations with heavy
lifting and physical workload. The objective of the study was to assess the association between exposure to workplace physical factors and incidence of knee and hip arthroplasty, as markers of severe OA in these joints.
METHODS: The study population was composed of employees 25-60 years who participated in the Turin 2011 census. For each job held since 1995, exposure to physical factors was assigned to individuals in the cohort through a Job-Exposure Matrix constructed from the Italian O*NET database. Using Poisson regression models, the incidence of knee and hip arthroplasty for OA, identified through hospitalizations from 2012 to 2018, was examined in relation to cumulative exposure to 7 different physical hazards and a composite indicator of physical workload constructed from 17 physical factors (Ergo-Index).
RESULTS: The risk of knee OA was significantly increased in the highest cumulative exposure quartile of physical workload (incidence rate ratio = 1.98, 95% confidence interval: 1.24-3.16) and of all single hazards examined, compared to the lowest quartile, with significant trends in risk with increasing exposure. In contrast, no association was found with hip OA, whose relative risks were close to or below one in all higher-exposure quartiles of physical workload and of each single hazard.
CONCLUSIONS: Our results indicate that exposure to physical hazards at work increases the likelihood of developing knee OA, but not hip OA.