Occupation, Physical Workload Factors, and Disability Retirement as a Result of Hip Osteoarthritis in Finland, 2005–2013

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Abstract

Objective.

To identify occupations with a high risk of disability retirement as a result of hip osteoarthritis (OA), and to examine the effect of physical workload factors on the occupational differences in disability retirement.

Methods.

A total of 1,135,654 (49.4% women) Finns aged 30–60 years in gainful employment were followed from 2005 to 2013 for full disability retirement as a result of hip OA. Information on pensions, occupation, and education were obtained from national registers. Physical workload was assessed by a sex-specific job exposure matrix. We calculated age-adjusted incidence rates and examined the associations of occupation, education, and physical workload factors with disability retirement using a competing risk regression model.

Results.

Age-adjusted incidence rate was 25 and 22 per 100,000 person-years in men and women, respectively. Both men and women working in lower-level nonmanual and manual occupations had an elevated age-adjusted risk of disability retirement as a result of hip OA. A very high risk of disability retirement was found among male construction workers, electricians, and plumbers (HR 12.7, 95% CI 8.4–19.7), and female professional drivers (HR 15.2, 95% CI 7.5–30.8) as compared with professionals. After adjustment for age and education, the observed occupational differences in disability retirement were largely explained by physical workload factors among men and to a smaller extent, among women.

Conclusion.

Our results suggest that education and physical workload factors appear to be the major reasons for excess disability retirement as a result of hip OA in manual occupations, particularly among men.

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Most cited references 27

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Johanne Martel-Pelletier, Andrew J Barr, Flavia Cicuttini … (2016)

Osteoarthritis (OA) is the most common joint disorder, is associated with an increasing socioeconomic impact owing to the ageing population and mainly affects the diarthrodial joints. Primary OA results from a combination of risk factors, with increasing age and obesity being the most prominent. The concept of the pathophysiology is still evolving, from being viewed as cartilage-limited to a multifactorial disease that affects the whole joint. An intricate relationship between local and systemic factors modulates its clinical and structural presentations, leading to a common final pathway of joint destruction. Pharmacological treatments are mostly related to relief of symptoms and there is no disease-modifying OA drug (that is, treatment that will reduce symptoms in addition to slowing or stopping the disease progression) yet approved by the regulatory agencies. Identifying phenotypes of patients will enable the detection of the disease in its early stages as well as distinguish individuals who are at higher risk of progression, which in turn could be used to guide clinical decision making and allow more effective and specific therapeutic interventions to be designed. This Primer is an update on the progress made in the field of OA epidemiology, quality of life, pathophysiological mechanisms, diagnosis, screening, prevention and disease management.

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D. Pereira, B Peleteiro, J. Araujo … (2011)

To understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints. A systematic review was carried out in PUBMED and SCOPUS databases comprising the date of publication period from January 1995 to February 2011. We attempted to summarise data on the incidence and prevalence of OA according to different methods of assessment: self-reported, radiographic and symptomatic OA (clinical plus radiographic). Prevalence estimates were combined through meta-analysis and between-study heterogeneity was quantified. Seventy-two papers were reviewed (nine on incidence and 63 on prevalence). Higher OA prevalences are seen when radiographic OA definition was used for all age groups. Prevalence meta-analysis showed high heterogeneity between studies even in each specific joint and using the same OA definition. Although the knee is the most studied joint, the highest OA prevalence estimates were found in hand joints. OA of the knee tends to be more prevalent in women than in men independently of the OA definition used, but no gender differences were found in hip and hand OA. Insufficient data for incidence studies didn't allow us to make any comparison according to joint site or OA definition. Radiographic case definition of OA presented the highest prevalences. Within each joint site, self-reported and symptomatic OA definitions appear to present similar estimates. The high heterogeneity found in the studies limited further conclusions. Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.