Unit Applied Epidemiology, Institute for Occupational Safety and Health of the German Social Accident Insurance, 53757 Sankt Augustin, Germany.
Unit Musculoskeletal Workload, Institute for Occupational Safety and Health of the German Social Accident Insurance, 53757 Sankt Augustin, Germany.
Int J Environ Res Public Health. 2019 Sep 30;16(19):3681. doi: 10.3390/ijerph16193681.
In this review, we critically evaluated the evidence of exposure-response relationships between occupational workload and the risk of hip osteoarthritis. The existing evidence was evaluated in order for us to extrapolate possible doubling risk doses for hip osteoarthritis. Comprehensive searches for epidemiological studies of hip osteoarthritis and occupational workload were performed in literature databases (PubMed, EMBASE, Cochrane Work and Google Scholar) and recent reviews up to February 2019. In total, 85 papers met the preliminary inclusion criteria, and 10 studies indicating an exposure-response relationship between occupational workload and hip osteoarthritis were identified. All studies were assessed on the basis of their study design, defined quality scores and relevant confounders considered. An exposure-response relationship between heavy lifting and the risk of hip osteoarthritis is consistently observed among the male populations but not among the female populations. We quantified the doubling risk doses in two studies in which both an exposure-response relationship and cumulative exposure doses were stated. These two studies provided the highest quality level of all studies published to date. The estimated doubling risk doses in these two studies lie between 14,761 and 18,550 tons (daily lifting 2.2-2.8 tons, 220 days/year for 30 years). These results can be used for workplace interventions to prevent hip osteoarthritis.
在这篇综述中,我们批判性地评估了职业工作量与髋骨关节炎风险之间的暴露-反应关系的证据。我们评估了现有证据,以便推断出髋骨关节炎的可能双倍风险剂量。我们在文献数据库(PubMed、EMBASE、Cochrane Work 和 Google Scholar)和截至 2019 年 2 月的最新综述中对髋骨关节炎和职业工作量的流行病学研究进行了全面搜索。共有 85 篇论文初步符合纳入标准,确定了 10 项表明职业工作量与髋骨关节炎之间存在暴露-反应关系的研究。所有研究都根据其研究设计、定义的质量评分和考虑的相关混杂因素进行了评估。在男性人群中,重物搬运与髋骨关节炎风险之间存在一致的暴露-反应关系,但在女性人群中则没有。我们在两项研究中量化了暴露-反应关系和累积暴露剂量,并提出了双倍风险剂量。这两项研究提供了迄今为止发表的所有研究中最高的质量水平。这两项研究中的估计双倍风险剂量在 14761 到 18550 吨之间(每天举 2.2-2.8 吨,每年 220 天,持续 30 年)。这些结果可用于预防髋骨关节炎的工作场所干预措施。