Jensen L K
L K Jensen, Department of Occupational Medicine, Regionshospitalet Skive, Resenvej 25, DK-7800 Skive, Denmark.
Occup Environ Med. 2008 Feb;65(2):72-89. doi: 10.1136/oem.2007.032466. Epub 2007 Jul 18.
The purpose of the study was to evaluate the evidence for an association between knee osteoarthritis (kneeOA) and physical work demands. Systematic searches were made, and epidemiological studies on kneeOA and heavy lifting, kneeling and climbing stairs published in 1966 to 2007 inclusive were reviewed. The quality of the studies was assessed and an overall evaluation of the degree of evidence of a causal relationship between kneeOA and physically demanding work was made, using specific criteria of the different degrees of evidence of causality. Limitations of the studies include few participants, use of different diagnostic criteria and a poor description of the exposure. It is concluded that moderate evidence was found for a relationship between kneeling, heavy lifting and kneeOA. For the combination of kneeling/squatting and heavy lifting the association seemed stronger than for kneeling/squatting or heavy lifting alone, but only a few studies were found concerning this relationship. Therefore the degree of evidence for a causal relationship was considered to be moderate. In the studies on the association between kneeOA and climbing stairs or ladders, there was an increased risk for kneeOA, but only a few studies were found and no dose-response relationship has been investigated. The evidence of a causal relationship is therefore considered to be limited.
该研究的目的是评估膝关节骨关节炎（kneeOA）与体力工作要求之间存在关联的证据。进行了系统检索，并对1966年至2007年（含）发表的关于kneeOA与重物搬运、跪姿和爬楼梯的流行病学研究进行了综述。评估了研究的质量，并使用不同因果关系证据程度的特定标准，对kneeOA与体力要求高的工作之间因果关系的证据程度进行了总体评估。研究的局限性包括参与者较少、使用不同的诊断标准以及对暴露情况描述不佳。结论是，发现有中等证据表明跪姿、重物搬运与kneeOA之间存在关联。对于跪姿/蹲姿和重物搬运的组合，这种关联似乎比单独的跪姿/蹲姿或重物搬运更强，但关于这种关系的研究较少。因此，因果关系的证据程度被认为是中等的。在关于kneeOA与爬楼梯或梯子之间关联的研究中，kneeOA的风险增加，但发现的研究较少，且未研究剂量反应关系。因此，因果关系的证据被认为是有限的。
