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Occupational strain increases risk of hip osteoarthritis

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People who lift heavy loads at work have a higher risk of developing osteoarthritis of the hip, German researchers have found.

In a systematic review commissioned and funded by the German Federal Institute for Occupational Safety and Health, Annekatrin Bergmann and colleagues examined the literature for primary studies on the effects of exposure to physical strain and then meta-analytically reviewed the results that were amenable to comparisons.

Separately, the team assessed studies that had hip pain as an endpoint.

They found that the lifting of heavy loads increases the risk of hip osteoarthritis or total hip replacement, with exposure doubling the risk in men and increasing the risk by around 40% in women. Physically demanding work consisting of a combination of activities of various kinds (such as dealing with heavy loads, heavy manual work, or prolonged walking and standing) increases the risk by as much as 150% in men and by 40% in women. Hip pain was also reported more commonly in the exposed groups.

“An association exists between years of lifting heavy loads or other kinds of physical strain on the job and the risk of developing osteoarthritis of the hip,” the researchers concluded. “The greater the exposure, the greater the risk.”

They noted, however, that the evidence base for risk assessment in women is currently inadequate.

Based on their findings, the authors recommend that loads of 20 kg or more should not be lifted without mechanical assistance, and that occupational screening should include hips after 15-20 years in the job at the very latest, in order to detect signs of hip osteoarthritis as early as possible.

They also said that measures for reducing physical strain should be prioritised, because a relevant effect of training and exercise on the progression of hip osteoarthritis in the occupational context has not been shown to date.

The study is published in the latest issue of Deutsches Ärzteblatt International, the German Medical Association’s international bilingual science journal.