Palumbo Aimee J, Michael Yvonne L, Burstyn Igor, Lee Brian K, Wallace Robert
Department of Epidemiology and Biostatistics, Drexel University, School of Public Health, Philadelphia, Pennsylvania, USA.
Department of Epidemiology and Biostatistics, Drexel University, School of Public Health, Philadelphia, Pennsylvania, USA Department of Environmental and Occupational Health, Drexel University, School of Public Health, Philadelphia, Pennsylvania, USA.
Occup Environ Med. 2015 Aug;72(8):567-72. doi: 10.1136/oemed-2014-102670. Epub 2015 May 20.
Hip fractures are leading causes of disability, morbidity and mortality among older women. Since physical activity helps maintain physical functioning and bone mineral density, occupational physical demand may influence fracture risk. This study investigates the association of occupational physical demand with hip fracture incidence among women.
The Women's Health Initiative Observational Study is a multiethnic cohort of 93,676 postmenopausal women, 50-79 years of age at enrolment, enrolled from 1994 to 1998 at 40 geographically diverse clinical centres throughout the USA. Outcomes including hip fractures were assessed annually and up to 3 jobs held since age 18 years were reported by each woman. Occupational physical demand levels were assigned for each job through linkage of occupational titles with Standard Occupational Codes and the Occupational Information Network. Average, cumulative and peak physical demand scores both before and after menopause and throughout women's work life were estimated.
Women were followed through 2010 for an average of 11.5 years; 1834 hip fractures occurred during this time. We did not observe an overall association of occupational physical demand with subsequent risk of hip fracture after adjusting for age, race/ethnicity, birth region and education.
Previous research on occupations and hip fracture risk in women is inconclusive. This study was able to take critical risk periods into account and control for confounding factors in a large cohort of older women to show that overall occupational physical demand neither increases nor decreases risk of hip fracture later in life.
髋部骨折是老年女性致残、发病和死亡的主要原因。由于体育活动有助于维持身体机能和骨密度，职业体力需求可能会影响骨折风险。本研究调查职业体力需求与女性髋部骨折发生率之间的关联。
女性健康倡议观察性研究是一个多民族队列，由93676名绝经后女性组成，入组时年龄在50 - 79岁之间，于1994年至1998年在美国各地40个地理位置不同的临床中心招募。每年评估包括髋部骨折在内的结局，每位女性报告自18岁以来从事过的至多3份工作。通过将职业头衔与标准职业代码和职业信息网络相联系，为每份工作分配职业体力需求水平。估计绝经前后以及女性整个工作生涯的平均、累积和峰值体力需求得分。
对女性随访至2010年，平均随访11.5年；在此期间发生了1834例髋部骨折。在调整年龄、种族/民族、出生地区和教育程度后，我们未观察到职业体力需求与随后髋部骨折风险之间的总体关联。
先前关于女性职业与髋部骨折风险的研究尚无定论。本研究能够考虑关键风险期并在一大群老年女性中控制混杂因素，以表明总体职业体力需求在晚年既不会增加也不会降低髋部骨折风险。
