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Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers

Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers
Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers
Summary
We aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.

Introduction
The risks of hip fracture and hip arthroplasty are influenced by factors including socioeconomic status, education, urbanization, latitude of residence, and physical activity. Farming is an occupation encompassing rural living and high level of physical activity. Therefore, we aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden.


Methods
We studied the risk of hip fracture, and hip arthroplasty due to primary osteoarthritis, in all men and women aged 35 years or more in Sweden between 1987 and 2002. Documented occupations were available in 3.5 million individuals, of whom 97,136 were farmers. The effects of age, sex, income, education, location of residence, and occupation on risk of hip fracture or hip arthroplasty were examined using a modification of Poisson regression.

Results
A total of 4027 farmers and 93,109 individuals with other occupations sustained a hip fracture, while 5349 farmers and 63,473 others underwent a hip arthroplasty. Risk of hip fracture was higher with greater age, lower income, lower education, higher latitude, and urban area for all men and women. Compared to all other occupations, male farmers had a 20% lower age-adjusted risk of hip fracture (hazard ratio (HR) 0.80, 95%CI 0.77–0.84), an effect that was not seen in female farmers (HR 0.96, 95% CI 0.91–1.01). Both male and female farmers had a higher age-adjusted risk for hip arthroplasty.

Conclusions
Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.
0937-941X
Johansson, H.
04f12338-4dd1-437b-b9bc-e0884130c215
Hongslo Vala, C.
a25e3b2a-be29-4b3f-90b4-9ed338250303
Oden, A.
c018cdda-62cd-44a0-be3a-227484a568bb
Lorentzon, M.
52764ee1-f096-4e53-a266-9d27bd831319
McCloskey, E.
6d3df4aa-b438-4a83-bd06-06b6cbe3980f
Kanis, J.A.
14988b3e-d76f-44fd-ab3b-7739bd4de6db
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Ohlsson, C
04cc202c-f6df-4db5-9b6d-c547f2b6a43f
Lohmander, L. Stefan
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Karrholm, J.
8d6858fa-4086-47d3-9c5a-1bc54e8d3ca1
Mellstrom, D.
43d24c2f-97e4-423a-acec-6a13b3d477d9
Johansson, H.
04f12338-4dd1-437b-b9bc-e0884130c215
Hongslo Vala, C.
a25e3b2a-be29-4b3f-90b4-9ed338250303
Oden, A.
c018cdda-62cd-44a0-be3a-227484a568bb
Lorentzon, M.
52764ee1-f096-4e53-a266-9d27bd831319
McCloskey, E.
6d3df4aa-b438-4a83-bd06-06b6cbe3980f
Kanis, J.A.
14988b3e-d76f-44fd-ab3b-7739bd4de6db
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Ohlsson, C
04cc202c-f6df-4db5-9b6d-c547f2b6a43f
Lohmander, L. Stefan
8e88ec43-c9c8-47bf-832a-1db9e7ba0a16
Karrholm, J.
8d6858fa-4086-47d3-9c5a-1bc54e8d3ca1
Mellstrom, D.
43d24c2f-97e4-423a-acec-6a13b3d477d9

Johansson, H., Hongslo Vala, C., Oden, A., Lorentzon, M., McCloskey, E., Kanis, J.A., Harvey, N.C., Ohlsson, C, Lohmander, L. Stefan, Karrholm, J. and Mellstrom, D. (2018) Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers Osteoporosis International (doi:10.1007/s00198-017-4355-y).

Record type: Article

Abstract

Summary
We aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.

Introduction
The risks of hip fracture and hip arthroplasty are influenced by factors including socioeconomic status, education, urbanization, latitude of residence, and physical activity. Farming is an occupation encompassing rural living and high level of physical activity. Therefore, we aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden.


Methods
We studied the risk of hip fracture, and hip arthroplasty due to primary osteoarthritis, in all men and women aged 35 years or more in Sweden between 1987 and 2002. Documented occupations were available in 3.5 million individuals, of whom 97,136 were farmers. The effects of age, sex, income, education, location of residence, and occupation on risk of hip fracture or hip arthroplasty were examined using a modification of Poisson regression.

Results
A total of 4027 farmers and 93,109 individuals with other occupations sustained a hip fracture, while 5349 farmers and 63,473 others underwent a hip arthroplasty. Risk of hip fracture was higher with greater age, lower income, lower education, higher latitude, and urban area for all men and women. Compared to all other occupations, male farmers had a 20% lower age-adjusted risk of hip fracture (hazard ratio (HR) 0.80, 95%CI 0.77–0.84), an effect that was not seen in female farmers (HR 0.96, 95% CI 0.91–1.01). Both male and female farmers had a higher age-adjusted risk for hip arthroplasty.

Conclusions
Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.

Text Farmers r1 send - Accepted Manuscript
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Accepted/In Press date: 17 December 2017
e-pub ahead of print date: 12 January 2018

Identifiers

Local EPrints ID: 417314
URI: https://eprints.soton.ac.uk/id/eprint/417314
ISSN: 0937-941X
PURE UUID: 63fb9f68-2717-404a-a60d-124b6da59038

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Date deposited: 29 Jan 2018 17:30
Last modified: 16 Feb 2018 17:31

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Contributors

Author: H. Johansson
Author: C. Hongslo Vala
Author: A. Oden
Author: M. Lorentzon
Author: E. McCloskey
Author: J.A. Kanis
Author: N.C. Harvey
Author: C Ohlsson
Author: L. Stefan Lohmander
Author: J. Karrholm
Author: D. Mellstrom

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