Risk of symptomatic osteoarthritis associated with exposure to ergonomic factors at work in a nationwide Italian survey

OBJECTIVE: The risk of developing osteoarthritis (OA) has been reported to increase with exposure to various ergonomic factors at work, although this finding is still debated in the literature. Aim of this study was to assess the association between prevalence of symptomatic OA and exposure to workplace ergonomic factors assigned through a job-exposures matrix (JEM). METHODS: The study population was composed of 24,604 persons of 40–69 years who participated in the National Health Survey 2013 and were employed at that occasion. Exposure to ergonomic factors was assigned to the study population through a JEM constructed from the Italian O*NET database, consisting of 17 physical factors, which were summed and averaged by job title (796 jobs) to obtain a combined exposure index. The outcome was self-reported OA characterized by moderate or severe limitations in daily activities. The relationship between OA prevalence and the combined exposure index in quartiles was examined using robust Poisson regression models adjusted for socio-demographics and potential confounders. RESULTS: In the analysis adjusted for age and gender, the risk of OA was increased by approximately 20–30% in the second and third quartiles, and by 80% in the highest exposure quartile, compared to the least exposed, with a risk attenuation by approximately 15–20% controlling for other significant covariates. CONCLUSION: Our results support a causal role of exposure to physical factors at work in the development of OA. As OA is associated with a great burden of disability, any effort should be made to reduce workers’ exposure to ergonomic factors.