Department of Clinical Sciences, Lund University, Lund, Sweden
Department of Orthopaedic Surgery, University of Chicago, Chicago, Illinois, USA.
Occup Environ Med. 2020 Mar;77(3):168-171. doi: 10.1136/oemed-2019-106184. Epub 2020 Jan 20.
It is postulated that increased load from pinch and grasp in occupational tasks increases the risk of thumb carpometacarpal (CMC1) osteoarthritis (OA). We sought to characterise the relationship between doctor-diagnosed CMC1 OA and occupation in a large working population.
We performed a matched case-control study using a Swedish healthcare register. We identified residents aged 30-65 years in 2013 with physician-diagnosed CMC1 OA from 1998 to 2013. We matched four controls per person with CMC1 OA by age, sex, education and postcode. Swedish Standard Classification of Occupations was used to assign occupation. Occupation was categorised as light, light-moderate, moderate and heavy labour. We used conditional logistic regression to estimate ORs with 95% CIs.
We identified 3462 patients with CMC1 OA and matched 13 211 controls. The mean age of the CMC1 OA group was 63 (SD 7) years, with 81% women. The ORs for CMC1 OA in men were 1.31 (95% CI 0.96 to 1.79) for light-moderate, 1.76 (95% CI 1.29 to 2.40) for moderate and 2.00 (95% CI 1.59 to 2.51) for heavy compared with light work. Women had ORs for CMC1 OA of 1.46 (95% CI 1.32 to 1.61) for light-moderate, 1.27 (95% CI 1.10 to 1.46) for moderate and 1.31 (95% CI 1.07 to 1.59) for heavy compared with light work.
The association between increased manual load in occupation and risk of CMC1 OA is more pronounced in men than in women, likely due to higher workload in the heavy labour category.
据推测，职业活动中捏夹负荷的增加会增加拇指腕掌（CMC1）骨关节炎（OA）的风险。我们试图在一个大型工作人群中描述 CMC1 OA 与职业之间的关系。
我们使用瑞典医疗保健登记处进行了一项匹配病例对照研究。我们在 2013 年从 1998 年至 2013 年确定了年龄在 30-65 岁之间的 CMC1 OA 患者，并对其进行了诊断。我们通过年龄、性别、教育程度和邮政编码为每位 CMC1 OA 患者匹配了 4 名对照者。使用瑞典职业标准分类来分配职业。职业分为轻、轻中度、中度和重度劳动。我们使用条件逻辑回归来估计 OR 及其 95%CI。
我们共发现了 3462 例 CMC1 OA 患者，并匹配了 13211 例对照者。CMC1 OA 组的平均年龄为 63（SD7）岁，其中 81%为女性。男性 CMC1 OA 的 OR 为轻中度劳动 1.31（95%CI96-1.79），中度劳动 1.76（95%CI1.29-2.40），重度劳动 2.00（95%CI1.59-2.51），与轻度劳动相比。女性 CMC1 OA 的 OR 为轻中度劳动 1.46（95%CI1.32-1.61），中度劳动 1.27（95%CI1.10-1.46），重度劳动 1.31（95%CI1.07-1.59），与轻度劳动相比。
在职业中，手动负荷的增加与 CMC1 OA 风险之间的关联在男性中比女性中更为明显，这可能是由于重体力劳动类别的工作量较高所致。
