932 Work exposures and their relationship to the development of osteoarthritis: a systematic review

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Abstract

Introduction

Osteoarthritis (OA) ranks among the top ten causes of disability worldwide. Of increasing interest are occupational factors that contribute to the development of OA or aggravate its trajectory. This systematic review synthesised evidence for the relationship between work exposures and the development of OA to inform work disability prevention messaging and decision making and to identify future knowledge needs.

Methods

We implemented the systematic review process developed by the Institute for Work and Health and an adapted best evidence synthesis. Four electronic databases were searched from inception until May 2015. Articles that described the impact of work on OA were included in the review and examined knees, hips, spine, wrist, hands, or fingers, shoulder, ankle, foot, or toes, neck, elbow.

Result

The search yielded 3379 non-duplicate references with 67 studies meeting our inclusion criteria. Study designs included cross-sectional surveys (n=22), case-control studies (n=22), prospective cohorts (n=14), and retrospective cohorts (n=9). 96% of studies measured OA using reliable and valid measures. Measurement of work exposures was more variable with 33% (n=28) of studies not well described and 18% (n=12) using instruments with questionable or unknown reliability and validity. There was strong or moderate evidence of an increased risk for developing OA in hips or knees for several occupational tasks (e.g., lifting/load bearing activities, full body vibration, kneeling/bending/squatting) and for not having an increased risk of OA for walking, sitting, driving, climbing. Dose response data were highly variable and could not be synthesised for recommendations.

Discussion

This systematic review highlights that strong evidence exists for occupational risks and the development of OA in some joints, like knees and hips. However, data on complex job tasks (e.g., bending and lifting simultaneously) and dose response information are lacking. This is essential information going forward for prevention and early intervention efforts.

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