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Occupational risks for osteoarthritis of hip, knee, and hand need urgent study

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A national survey in France that has found evidence of early and severe work related osteoarthritis of hip, knee, and hand has disclosed a pressing need to identify risk factors and develop preventive measures.

It showed patterns which may help to define occupations at most risk. Defining risk factors in women cleaners, especially, deserves priority. This group had an excess prevalence over six times the prevalence in the general population and a unique pattern of all three joints affected. A fivefold excess prevalence occurred in self employed women in the clothing industry, who reported most repetitive hand movements and severest symptoms. There was roughly a threefold excess in self employed men and salaried women in construction, as in male and female agricultural workers, whose risk for hip and knee arthritis is well known. Comparing self employed and salaried workers may identify other risk factors for arthritis in hands. Early arthritis developed in material handlers, a subset of blue collar workers. About three quarters reported first symptoms before age 55—against half for the whole cohort.

The survey during January-September 2003 used the same primary care network as in a first survey. Doctors recruited their first two patients visiting for osteoarthritis of the hip, knee, and hand and recorded requisite information for each. Over 2800 patients aged 20–80 years with one year’s minimum lifetime employment were studied.

Osteoarthritis is the West’s leading cause of disability, but the link between occupation and osteoarthritis of hip, knee, and hand has not been well studied.

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