Inserm U1018, Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France.
Scand J Work Environ Health. 2011 Jan;37(1):37-44. doi: 10.5271/sjweh.3123. Epub 2010 Oct 1.
Little is known about the long-term effect of occupational determinants on knee pain. We aimed to assess whether the risk factors for severe knee pain, observed with a cross-sectional approach, were still relevant after retirement, 12 years later.
All men participating in the ARPEGE side study of the GAZEL cohort (employees of the French national utility for energy production and distribution, recruited in 1989) and who answered the 1994 or 1995 general GAZEL self-administered questionnaire, were included. Weight and self-reported exposures over the entire working life were collected at baseline. Knee pain and its intensity were recorded in 1994-1995 and again in 2006. Moderate and severe knee pain, defined from an intensity or discomfort scale (threshold 3 on a 6-level scale in 1994-1995, and 4 on an 8-level scale in 2006), were the main outcomes.
At baseline, 1786 men were included. In 1994-1995, moderate knee pain was observed among 10.3% and severe pain in 12.8% of men. In 2006, 1482 men (83%) answered the questionnaire. Moderate and severe knee pain were observed in 18.6% and 16.3% of respondents, respectively. Working in a kneeling or squatting position was significantly associated with severe knee pain at baseline, taking into account age, sports, smoking habits, and body mass index [adjusted odds ratio (OR (adj)) 1.4, 95% confidence interval (95% CI) 1.1-1.9 for "ever exposed" and OR (adj)2.0, 95% CI 1.3-3.1 for >25 years of exposure]. In 2006, when most subjects were retired, the association between working in a kneeling or squatting position and severe pain was weaker but still significant (OR (adj)1.4, 95% CI 1.04-1.85).
The effect of high knee exposure in the working life on severe knee pain remains even after retirement, although decreased. An extended surveillance and prevention program for these workers could be proposed.
关于职业因素对膝关节疼痛的长期影响知之甚少。我们旨在评估在横断面研究中观察到的严重膝关节疼痛的危险因素，在 12 年后退休时是否仍然相关。
所有参加法国国家能源生产和分配公司（EDF）GAZEL 队列 ARPEGE 侧研究的男性（1989 年招募的员工）和在 1994 年或 1995 年回答 GAZEL 一般自我管理问卷的男性均被纳入研究。在基线时收集体重和整个工作生涯中的自我报告暴露情况。1994-1995 年记录膝关节疼痛及其强度，2006 年再次记录。中度和重度膝关节疼痛（定义为强度或不适量表（1994-1995 年为 6 级量表上的 3 级，2006 年为 8 级量表上的 4 级））是主要结局。
基线时，有 1786 名男性被纳入研究。1994-1995 年，10.3%的男性出现中度膝关节疼痛，12.8%的男性出现重度膝关节疼痛。2006 年，有 1482 名男性（83%）回答了问卷。分别有 18.6%和 16.3%的受访者出现中度和重度膝关节疼痛。考虑到年龄、运动、吸烟习惯和体重指数，在跪着或蹲着工作与基线时的严重膝关节疼痛显著相关[调整后的比值比（OR（adj））1.4，95%置信区间（95%CI）为 1.1-1.9，“曾接触”和 OR（adj）2.0，95%CI 为 1.3-3.1，>25 年接触]。2006 年，当大多数研究对象退休时，跪着或蹲着工作与严重疼痛之间的关联虽然减弱但仍然显著（OR（adj）1.4，95%CI 为 1.04-1.85）。
即使在退休后，工作生涯中膝关节高暴露对严重膝关节疼痛的影响仍然存在，尽管有所减弱。可以为这些工人提出延长监测和预防计划。
