Unverzagt Susanne, Bolm-Audorff Ulrich, Frese Thomas, Hechtl Julia, Liebers Falk, Moser Konstantin, Seidler Andreas, Weyer Johannes, Bergmann Annekatrin
Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany.
Department for Occupational Safety and the Environment, Regional Authority Darmstadt, Wilhelminenstraße 1 - 3, 64283, Darmstadt, Germany.
J Occup Med Toxicol. 2022 Aug 24;17(1):18. doi: 10.1186/s12995-022-00358-y.
Hip osteoarthritis (HOA) is a disabling disease affecting around 33 million people worldwide. People of working age and the elderly are at increased risk of developing HOA and the disease is associated with high costs at individual and societal levels due to sick leaves, job loss, total hip replacements and disability pension. This systematic review evaluated the influence of physically demanding occupations on the development of HOA in men.
Cohort studies, case-control studies and cross-sectional studies with publications in English or German, which assessed the association between exposure to physically demanding occupations and development of HOA, were searched in electronic databases (Medline, Embase, HSE-Line, Cochrane Library) and conference abstracts from 1990 until May 2020. We assessed the methodological quality of selected studies, interpreted all relative effect estimators as relative risks (RRs) and meta-analytically reviewed the effects of occupations with high physical workloads. All steps are based on a study protocol published in PROSPERO (CRD42015016894).
Seven cohort studies and six case-control studies were included. An elevated risk to develop HOA was shown for six physically demanding occupational groups. Working in agriculture including fishery and forestry and food production doubles the risk of HOA. Construction, metal working and sales as well as exposure to whole body vibration while driving vehicles increases the risk by roughly 50 to 60%. Unskilled or basic level workers, who were frequently exposed to repetitive heavy manual work, had nearly a doubled risk (RR 1.89 95%CI: 1.29 to 2.77) compared to workers with lower exposure.
Existing studies state an association between various occupations with high physical workload and an increased risk of developing HOA. High Physical workloads include including lifting and carrying heavy loads, demanding postures, repetitive activities, long standing and running, as well as exposure to body vibrations. Occupational prevention and early detection as well as individual health promotion strategies should place their focus on reducing the impact of high physical strain at work sites.
髋骨关节炎（HOA）是一种致残性疾病，全球约有3300万人受其影响。工作年龄段人群和老年人患HOA的风险增加，由于病假、失业、全髋关节置换和残疾抚恤金，该疾病在个人和社会层面都带来高昂成本。本系统评价评估了体力要求高的职业对男性HOA发病的影响。
在电子数据库（Medline、Embase、HSE-Line、Cochrane图书馆）和会议摘要中检索1990年至2020年5月期间发表的队列研究、病例对照研究和横断面研究，这些研究用英文或德文发表，评估了体力要求高的职业暴露与HOA发病之间的关联。我们评估了所选研究的方法学质量，将所有相对效应估计值解释为相对风险（RRs），并对体力负荷高的职业的影响进行了荟萃分析。所有步骤均基于在PROSPERO（CRD42015016894）上发表的研究方案。
纳入了7项队列研究和6项病例对照研究。6个体力要求高的职业群体显示出患HOA的风险升高。从事包括渔业和林业以及食品生产在内的农业工作使患HOA的风险加倍。建筑、金属加工和销售以及驾驶车辆时全身振动暴露使风险增加约50%至60%。经常暴露于重复性重体力劳动的非技术或基础水平工人与暴露较少的工人相比，风险几乎加倍（RR 1.89，95%CI：1.29至2.77）。
现有研究表明，各种体力负荷高的职业与患HOA风险增加之间存在关联。高体力负荷包括搬运重物、要求的姿势、重复性活动、长时间站立和跑步，以及暴露于身体振动。职业预防、早期检测以及个人健康促进策略应将重点放在减少工作场所高体力劳损的影响上。
