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Jobs determine primary osteoarthritis

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Evidence from the largest national study ever undertaken confirms growing suspicions about occupational influence on osteoarthritis (OA) and the need for more precise understanding in formulating preventive measures. Occupation—not merely old age—determines primary OA, claim the researchers.

Among almost 10 500 (10 412) patients, the prevalence of OA was highest in women aged 60–69 and men aged 70–79. Excess prevalence of OA was related to time in an occupation as well as occupational group. Other findings were that housekeeping was linked with excess OA for women over 60 (observed: expected (O/E) ratio 4.4) and truck driving for men aged over 70 (O/E ratio 6.7). Overall, the odds of OA for women were 1.0 for white collar workers, 2.9 “mixed,” and 2.6 for blue collar workers and for men 1.0, 1.2, and 1.7, respectively. Severity of OA was evident in those 2000 or so patients who were actively employed: 22% were off work owing to total work disability and 44% had partial work disability. The lowest proportion disabled by OA were white collar workers and the highest were blue collar workers.

Data came from the 1998 French National Survey on Health Impairment and Disability, a cross sectional pharmacoepidemiological study. The survey’s coverage was representative of the national population, permitting comparisons of prevalence of OA cases with expected prevalence in the general population for age, sex, and occupation. A unique network of rheumatologists in France made it possible to study such a large patient sample.

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