Background Patients diagnosed with OA have an increased risk of sick leave and disability pension.1 There is however little knowledge on how the risk differs between occupational groups. Despite a often higher prevalence of OA in women, most studies of occupational risk factors focus on male-dominated occupations and the knowledge on women and on typical female-dominated occupations is limited. 2
Objectives The main objective of this study was to investigate the association between occupation and the risk for sick leave and disability pension due to knee OA and hip OA. In doing so, we aimed at including occupations in both female-dominated and male- dominated job sectors.
Methods Population-based cohort study, including all residents 40-70 years in the Skåne region (1.23 million inhabitants), Sweden. We retrieved data on cause-specific sick leave and disability pension (2007-2012) from the Social Insurance Agency and variables on occupation and education from Statistics Sweden. Occupations were classified into job sectors using the International Standard Classification of Occupations (ISCO) 88. We calculated the gender-specific age-adjusted odds ratio (OR) of having had sick leave or disability pension due to knee or hip OA. We did so for subjects working in health care, child care, construction, cleaning, farming, metal work and transportation as compared to subjects working in business and administration (reference category).
Results Of 460 264 eligible subjects in the population, a total number of 3834 had sick leave or disability pension due to knee OA and 2233 due to hip OA. Adjusted for age and education, the odds of sick leave or disability pension due to knee OA was increased for women working in health care, OR 3.3 (95% CI 2.6-4.2) for sick leave and 10.0 (4.7-21.3) for disability pension, respectively, child care OR 3.0 (2.3-3.9) and 9.8 (4.4-22.2) and cleaning OR 3.1 (2.2-4.2) and 16.7 (7.5-37.4) and for men working in construction OR 3.0 (2.6-4.0) and 3.5 (2.0-6.1), and metal work OR 2.6 (2.4-5.3) and 4.4 (2.1-9.0). The odds ratio for sick leave and disability pension due to knee OA was increased also for persons working in occupations with higher educational requirements in health care (like specialist nurses) OR 2.5 (1.9-3.4) and 4.8 (2.3-9.7) and in child care (pre-primary teaching professionals), OR 2.2 (1.6-3.1) and 3.7 (1.6-8.7). For hip OA there was no statistically significant association, or only week associations with sick leave, but increased odds for disability pension for women in health care OR 6.9 (2.5-19.1), child care OR 5.9 (1.9-18.1) and cleaning OR 5.4 (1.5-19.7), and for men in farming OR 3.2 (1.2-8.6).
Conclusions Women in health care, child care and cleaning had an increased risk of sick leave and disability pension due to knee OA and of disability pension due to hip OA. In health care and child care the risk of sick leave and disability pension due to knee OA was increased also in occupations with higher educational requirements.
Hubertsson J, et al Risk of sick leave and disability pension in working-age women and men with knee osteoarthritis. Annals of the rheumatic diseases 2013;72(3):401-5.
Ezzat AM, et al Occupational physical loading tasks and knee osteoarthritis: a review of the evidence. Physiotherapie Canada 2014;66(1):91-107
Disclosure of Interest None declared