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Occupation and risk of knee osteoarthritis and knee replacement a longitudinal, multiple-cohort study

Occupation and risk of knee osteoarthritis and knee replacement a longitudinal, multiple-cohort study
Occupation and risk of knee osteoarthritis and knee replacement a longitudinal, multiple-cohort study
Objectives: to examine the effect of occupation on knee osteoarthritis (OA) and total knee replacement (TKR) in working-aged adults.

Methods: we used longitudinal data from the Chingford, Osteoarthritis Initiative (OAI) and Multicentre Osteoarthritis (MOST) studies. Participants with musculoskeletal disorders and/or a history of knee-related surgery were excluded. Participants were followed for up to 19-years (Chingford), 96-months (OAI) and 60-months (MOST) for incident outcomes including radiographic knee OA (RKOA), symptomatic RKOA and TKR. In those with baseline RKOA, progression was defined as the time from RKOA incidence to primary TKR. Occupational job categories and work-place physical activities were assigned to levels of workload. Logistic regression was used to examine the relationship between workload and incident outcomes with survival analyses used to assess progression (reference group: sedentary occupations).

Results: heavy manual occupations were associated with a 2-fold increased risk (OR: 2.07, 95% CI 1.03 to 4.15) of incident RKOA in the OAI only. Men working in heavy manual occupations in MOST (2.7, 95% CI 1.17 to 6.26) and light manual occupations in OAI (2.00, 95% CI 1.09 to 3.68) had a 2-fold increased risk of incident RKOA. No association was observed among women. Increasing workload was associated with an increased risk of symptomatic RKOA in the OAI and MOST. Light work may be associated with a decreased risk of incident TKR and disease progression.

Conclusion: heavy manual work carries an increased risk of incident knee OA; particularly among men. Workload may influence the occurrence of TKR and disease progression.
0049-0172
1006-1014
Perry, Thomas A.
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Wang, Xia
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Gates, Lucy
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Parsons, Camille
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Sanchez-Santos, Maria T.
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Garriga, Cesar
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Cooper, Cyrus
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Nevitt, Michael C.
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Hunter, David J.
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Perry, Thomas A.
c8585ab1-e82b-47b3-8961-ab98cbf8e952
Wang, Xia
8bfcdb9b-fba3-457b-974b-de0281018fee
Gates, Lucy
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Parsons, Camille
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Sanchez-Santos, Maria T.
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Garriga, Cesar
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Cooper, Cyrus
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Nevitt, Michael C.
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Hunter, David J.
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Perry, Thomas A., Wang, Xia, Gates, Lucy, Parsons, Camille, Sanchez-Santos, Maria T., Garriga, Cesar, Cooper, Cyrus, Nevitt, Michael C. and Hunter, David J. (2020) Occupation and risk of knee osteoarthritis and knee replacement a longitudinal, multiple-cohort study. Seminars in Arthritis and Rheumatism, 50 (5), 1006-1014. (doi:10.1016/j.semarthrit.2020.08.003).

Record type: Article

Abstract

Objectives: to examine the effect of occupation on knee osteoarthritis (OA) and total knee replacement (TKR) in working-aged adults.

Methods: we used longitudinal data from the Chingford, Osteoarthritis Initiative (OAI) and Multicentre Osteoarthritis (MOST) studies. Participants with musculoskeletal disorders and/or a history of knee-related surgery were excluded. Participants were followed for up to 19-years (Chingford), 96-months (OAI) and 60-months (MOST) for incident outcomes including radiographic knee OA (RKOA), symptomatic RKOA and TKR. In those with baseline RKOA, progression was defined as the time from RKOA incidence to primary TKR. Occupational job categories and work-place physical activities were assigned to levels of workload. Logistic regression was used to examine the relationship between workload and incident outcomes with survival analyses used to assess progression (reference group: sedentary occupations).

Results: heavy manual occupations were associated with a 2-fold increased risk (OR: 2.07, 95% CI 1.03 to 4.15) of incident RKOA in the OAI only. Men working in heavy manual occupations in MOST (2.7, 95% CI 1.17 to 6.26) and light manual occupations in OAI (2.00, 95% CI 1.09 to 3.68) had a 2-fold increased risk of incident RKOA. No association was observed among women. Increasing workload was associated with an increased risk of symptomatic RKOA in the OAI and MOST. Light work may be associated with a decreased risk of incident TKR and disease progression.

Conclusion: heavy manual work carries an increased risk of incident knee OA; particularly among men. Workload may influence the occurrence of TKR and disease progression.

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Occupation and Risk of Knee Osteoarthritis and Knee Replacement a longitudinal, multiple-cohort study - Accepted Manuscript
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Accepted/In Press date: 2 August 2020
e-pub ahead of print date: 8 August 2020
Published date: 1 October 2020

Identifiers

Local EPrints ID: 443238
URI: http://eprints.soton.ac.uk/id/eprint/443238
ISSN: 0049-0172
PURE UUID: aab155e4-757c-488b-94b2-01be385cb733
ORCID for Lucy Gates: ORCID iD orcid.org/0000-0002-8627-3418
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 18 Aug 2020 16:31
Last modified: 04 Nov 2021 05:01

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Contributors

Author: Thomas A. Perry
Author: Xia Wang
Author: Lucy Gates ORCID iD
Author: Camille Parsons
Author: Maria T. Sanchez-Santos
Author: Cesar Garriga
Author: Cyrus Cooper ORCID iD
Author: Michael C. Nevitt
Author: David J. Hunter

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