Civil Engineering Reference
In-Depth Information
29.2.1 Hip Disorders
Lindberg and Axmacher (1988) reported the prevalence of coxarthosis in the hip to be greater in male
farmers than in an age-matched group of urban dwellers. Vingard et al. (1991) classified blue-collar occu-
pations as to whether static or dynamic forces could be expected to act on the lower extremity. The
authors found that those employed in occupations that experienced greater loads on the lower extremity,
namely farmers, construction workers, firefighters, grain mill workers, butchers, and meat preparation
workers, had an increased risk of osteoarthritis (OA) of the hip. Similarly, Vingard et al. (1992) found
that disability pensions for hip OA were significantly more likely to be received by males employed as
farmers, forest workers, and construction workers. Given the occupations at risk, some have postulated
that the increased incidence of hip OA may be due to driving vehicles with high levels of whole body
vibration. Jarvholm et al. (2004), in comparing those having undergone hip replacement surgery with
appropriate reference groups, found that drivers who were exposed to higher levels of whole body
vibration were not at increased risk of hip OA. Yoshimura et al. (2000) reported a significant association
between occupational lifting and the incidence of hip OA. Specifically, they found that those whose first
job entailed regular lifting of 25 kg or more had an increased risk, as did individuals who regularly lifted
more than 50 kg in their primary job. Conversely, this same study found that those who spent greater
than 2 h sitting in their first job were at a reduced risk of developing the disorder.
29.2.2 Knee Disorders
Lindberg and Montgomery (1987) reported that knee OA, as defined by a “narrowing of the joint space
with a loss of distance between the tibia and the femur in one compartment, of one-half or more of the
distance in the other compartment of the same knee joint or the same compartment of the other knee, or
less than 3 mm,” was more common in those who had performed jobs that required heavy physical labor
for a long time. Kohatsu and Schurman (1990) found that, relative to controls, the individuals with
severe OA were two to three times more likely to have worked in occupations requiring moderate to
heavy physical work. Prolonged exposure (11 to 30 yr) to building and construction occupations
increased the risk of knee OA by 3.7 times (Holmberg et al., 2004). These same authors report that
farm, forestry, letter-carrying, cleaning, and health-care work were not associated with increased risk
of knee OA. Manninen et al. (2002), after adjusting for body mass index (BMI), prior knee injury,
and leisure activities, found that knee OA increased with in individuals with a history of high physical
workload, although the results were more consistent for women than for men.
Occupations with an increased frequency of knee bending and moderate physical demands have been
associated with increased knee OA in the older working population after adjusting for age, body mass,
knee injury history, smoking, and education level (Anderson and Felson, 1988; Felson et al., 1991). More-
over, it has been shown that the strength demands of the job were predictive of knee OA in the women
from this older age group (Anderson and Felson, 1988). The authors suggest that the increased OA in
those with long exposure to occupational tasks is indicative of the role of repetitive occupational
exposure. Further supporting the link between material handling jobs and knee problems is the
finding by McGlothlin (1996), who recently reported that beverage delivery personnel were experiencing
discomfort in the knees, in addition to the anticipated discomfort in the back and shoulders. The work
performed by these delivery personnel requires heavy lifting, kneeling, squatting, and, of course, driving.
Risk of knee OA has been reported to increase for those who reported prolonged kneeling, walking more
than two miles per day, and lift 25 kg or more on a regular basis (Coggon et al., 2000). Those whose occu-
pations required kneeling and squatting were more likely to experience knee OA (Manninen et al., 2002)
and be referred for meniscectomy procedures (Baker et al., 2003). Climbing was also found to increase
knee OA in men (Manninen et al., 2002). Similarly, the number of knee flexions (
45
8
) has been related
.
to the onset of occupational illness
injury by Craig et al. (2003). Chen et al. (2004) found that taxi drivers
were at increased risk of knee pain if their work duration exceeded 6 h per day. Further, it should be
recognized that personal risk factors for OA of the knee include heredity, obesity, and significant knee
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