Muraki Shigeyuki, Akune Toru, Oka Hiroyuki, Mabuchi Akihiko, En-Yo Yoshio, Yoshida Munehito, Saika Akihiko, Nakamura Kozo, Kawaguchi Hiroshi, Yoshimura Noriko
University of Tokyo, Tokyo, Japan.
Arthritis Rheum. 2009 Jun 15;61(6):779-86. doi: 10.1002/art.24514.
To investigate the risk of radiographic knee osteoarthritis (OA) and lumbar spondylosis associated with occupational activity in elderly Japanese subjects using the large-scale population-based cohort of the Research on Osteoarthritis Against Disability (ROAD) study.
From the baseline survey of the ROAD study, 1,471 participants age > or =50 years (531 men and 940 women) living in mountainous and seacoast communities were analyzed. Information collected included a lifetime occupational history and details of specific work place physical activities. Radiographic severity at the knee and lumbar spine was determined by the Kellgren/Lawrence (K/L) grading system.
The prevalence of K/L grade > or =2 knee OA and lumbar spondylosis among agricultural, forestry, and fishery workers was significantly higher than among clerical workers and technical experts in the overall population. For occupational activities, sitting on a chair had a significant inverse association with K/L grade > or =2 knee OA and lumbar spondylosis. Standing, walking, climbing, and heavy lifting were associated with K/L grade > or =2 knee OA, but were not associated with K/L grade > or =2 lumbar spondylosis. Kneeling and squatting were associated with K/L grade > or =3 knee OA.
This cross-sectional study using a population-based cohort suggests that sitting on a chair is a significant protective factor against both radiographic knee OA and lumbar spondylosis in Japanese subjects. An occupational activity that includes heavy lifting appears to have a greater effect on knee OA than on lumbar spondylosis.
利用大规模基于人群的骨关节炎与残疾研究(ROAD)队列,调查日本老年人群中与职业活动相关的膝关节影像学骨关节炎(OA)和腰椎病的风险。
对ROAD研究基线调查中1471名年龄≥50岁(531名男性和940名女性)、居住在山区和沿海社区的参与者进行分析。收集的信息包括终生职业史和特定工作场所体力活动的详细信息。膝关节和腰椎的影像学严重程度通过凯尔格伦/劳伦斯(K/L)分级系统确定。
在总体人群中,农业、林业和渔业工人中K/L分级≥2级的膝关节OA和腰椎病患病率显著高于文职人员和技术专家。对于职业活动,坐在椅子上与K/L分级≥2级的膝关节OA和腰椎病呈显著负相关。站立、行走、攀爬和重物搬运与K/L分级≥2级的膝关节OA相关,但与K/L分级≥2级的腰椎病无关。跪和蹲与K/L分级≥3级的膝关节OA相关。
这项基于人群队列的横断面研究表明,坐在椅子上是日本人群预防膝关节影像学OA和腰椎病的重要保护因素。包括重物搬运在内的职业活动对膝关节OA的影响似乎比对腰椎病的影响更大。