Influence of physically demanding occupations on the development of osteoarthritis of the hip: a systematic review

Susanne Unverzagt; Ulrich Bolm-Audorff; Thomas Frese; Julia Hechtl; Falk Liebers; Konstantin Moser; Andreas Seidler; Johannes Weyer; Annekatrin Bergmann

doi:10.1186/s12995-022-00358-y

Influence of physically demanding occupations on the development of osteoarthritis of the hip: a systematic review

J Occup Med Toxicol. 2022 Aug 24;17(1):18. doi: 10.1186/s12995-022-00358-y.

Authors

Susanne Unverzagt¹, Ulrich Bolm-Audorff², Thomas Frese³, Julia Hechtl⁴, Falk Liebers⁵, Konstantin Moser³, Andreas Seidler⁶, Johannes Weyer⁴, Annekatrin Bergmann⁴

Affiliations

¹ Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany. susanne.unverzagt@uk-halle.de.
² Department for Occupational Safety and the Environment, Regional Authority Darmstadt, Wilhelminenstraße 1 - 3, 64283, Darmstadt, Germany.
³ Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany.
⁴ Department of Occupational Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 20, 06112, Halle (Saale), Germany.
⁵ Division 3 Work and Health, Unit 3.1 Prevention of Work-related Diseases, Federal Institute for Occupational Safety and Health (BAuA), Friedrich-Henkel-Weg 1-25, 44149, Dortmund, Germany.
⁶ Institute and Polyclinic for Occupational and Social Medicine, Technical University of Dresden, Faculty of Medicine, Löscherstraße 18, 01309, Dresden, Germany.

Abstract

Background: Hip osteoarthritis (HOA) is a disabling disease affecting around 33 million people worldwide. People of working age and the elderly are at increased risk of developing HOA and the disease is associated with high costs at individual and societal levels due to sick leaves, job loss, total hip replacements and disability pension. This systematic review evaluated the influence of physically demanding occupations on the development of HOA in men.

Methods: Cohort studies, case-control studies and cross-sectional studies with publications in English or German, which assessed the association between exposure to physically demanding occupations and development of HOA, were searched in electronic databases (Medline, Embase, HSE-Line, Cochrane Library) and conference abstracts from 1990 until May 2020. We assessed the methodological quality of selected studies, interpreted all relative effect estimators as relative risks (RRs) and meta-analytically reviewed the effects of occupations with high physical workloads. All steps are based on a study protocol published in PROSPERO (CRD42015016894).

Results: Seven cohort studies and six case-control studies were included. An elevated risk to develop HOA was shown for six physically demanding occupational groups. Working in agriculture including fishery and forestry and food production doubles the risk of HOA. Construction, metal working and sales as well as exposure to whole body vibration while driving vehicles increases the risk by roughly 50 to 60%. Unskilled or basic level workers, who were frequently exposed to repetitive heavy manual work, had nearly a doubled risk (RR 1.89 95%CI: 1.29 to 2.77) compared to workers with lower exposure.

Conclusions: Existing studies state an association between various occupations with high physical workload and an increased risk of developing HOA. High Physical workloads include including lifting and carrying heavy loads, demanding postures, repetitive activities, long standing and running, as well as exposure to body vibrations. Occupational prevention and early detection as well as individual health promotion strategies should place their focus on reducing the impact of high physical strain at work sites.

Keywords: Hip; Musculoskeletal; Occupational; Osteoarthritis; Workplaces.

Publication types

Review