Extended reports
Prevalence of joint pain is higher among women in rural Japan
than urban Japanese-American women in Hawaii
a Department
of Public Health, Nagasaki University School of Medicine, Japan, b Hawaii
Osteoporosis Foundation, Honolulu, HI, c Department
of Orthopaedic Surgery, Mitsugi Public General Hospital, Japan
Correspondence to: Dr K Aoyagi, Department of Public Health, Nagasaki University, School of Medicine, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
Accepted for publication 31 December 1998
OBJECTIVE
Environmental
factors such as farming contribute to the frequency of joint symptoms.
The purpose of this study is to explore the possible role of
environment (lifestyle), by comparing the prevalence of joint pain
between Japanese in a rural farming district in Japan and in urban Hawaii.
SUBJECTS AND
METHODSCurrent or previous pain at specific
joints was surveyed among 222 women in rural Japan and 638 Japanese
women in urban Hawaii aged 60-79. The age adjusted prevalence was
compared using logistic regression.
RESULTSThe
prevalence of pain at one or more joints was approximately 70% in
Japan and 50% in Hawaii. The prevalence of knee pain in Japan ranged
from 36% at ages 60-69 years to 53% at 70-79 years (mean 41%),
whereas knee pain affected only 20% of women in Hawaii in both age
groups. The odds ratio (and 95% CI) was 3.2 (2.1, 4.8) for knee pain,
and 4.0 (2.2, 7.4) for mid-back pain in Japan, compared with Hawaii.
Pain was also significantly more common in Japan at the shoulder,
elbow, and ankle, but not at other joints. Women in Japan were shorter
and weighed less than in Hawaii. Adjustment for body mass index
increased the odds ratios to 4.4 (2.9, 6.8) for knee, and 4.5 (2.4, 8.5) for mid-back pain.
CONCLUSIONAlthough
the potential influence of cultural factors or other sources of bias
cannot be ruled out, the large differences in the prevalence of pain at
specific joints suggest that environmental factors are probably
responsible, because both populations are of similar genetic stock.
© 1999 by Annals of the Rheumatic Diseases
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