Epidemiology Unit ASL TO3, Grugliasco, TO, Italy.
National Institute of Statistics (ISTAT), Rome, Italy.
Int Arch Occup Environ Health. 2023 Jan;96(1):143-154. doi: 10.1007/s00420-022-01912-1. Epub 2022 Jul 28.
The risk of developing osteoarthritis (OA) has been reported to increase with exposure to various ergonomic factors at work, although this finding is still debated in the literature. Aim of this study was to assess the association between prevalence of symptomatic OA and exposure to workplace ergonomic factors assigned through a job-exposures matrix (JEM).
The study population was composed of 24,604 persons of 40-69 years who participated in the National Health Survey 2013 and were employed at that occasion. Exposure to ergonomic factors was assigned to the study population through a JEM constructed from the Italian O*NET database, consisting of 17 physical factors, which were summed and averaged by job title (796 jobs) to obtain a combined exposure index. The outcome was self-reported OA characterized by moderate or severe limitations in daily activities. The relationship between OA prevalence and the combined exposure index in quartiles was examined using robust Poisson regression models adjusted for socio-demographics and potential confounders.
In the analysis adjusted for age and gender, the risk of OA was increased by approximately 20-30% in the second and third quartiles, and by 80% in the highest exposure quartile, compared to the least exposed, with a risk attenuation by approximately 15-20% controlling for other significant covariates.
Our results support a causal role of exposure to physical factors at work in the development of OA. As OA is associated with a great burden of disability, any effort should be made to reduce workers' exposure to ergonomic factors.
据报道，职业暴露于各种工作环境下的人体工程学因素会增加患骨关节炎（OA）的风险，尽管这一发现仍存在争议。本研究旨在评估通过工作环境暴露矩阵（JEM）分配的职业人体工程学因素暴露与症状性 OA 患病率之间的关联。
研究人群由 24604 名年龄在 40-69 岁之间的参加 2013 年全国健康调查且当时在职的人组成。通过意大利 O*NET 数据库构建的 JEM 将职业人体工程学因素分配给研究人群，该数据库包含 17 个物理因素，通过职业名称（796 种职业）进行求和平均，以获得综合暴露指数。通过自我报告 OA 来定义结果，其特征为日常活动受到中度或重度限制。使用稳健泊松回归模型调整社会人口统计学和潜在混杂因素后，按 quartiles 分析 OA 患病率与综合暴露指数之间的关系。
在调整年龄和性别的分析中，与暴露最少的 quartile 相比，第二和第三 quartiles 的 OA 风险增加了约 20-30%，最高暴露 quartile 的风险增加了 80%，而在控制其他重要协变量后，风险降低了约 15-20%。
我们的结果支持工作环境中物理因素暴露在 OA 发展中的因果作用。由于 OA 与残疾负担极大相关，应尽一切努力减少工人对人体工程学因素的暴露。
