Incidence of knee pain and its work-related risk factors in a

Incidence of knee pain and its work-related risk factors in a

Context and objectives
Methods
Results
Conclusion
Incidence of knee pain and its work-related risk
factors in a large working population
E Herquelot 1,2 , A Guéguen 1,2 , Y Roquelaure3 , J Bodin3 , C Ha 4 ,
A Leclerc 1,2 , M Goldberg1,2 , M Zins1,2 , A Descatha1,2,5
(1) University Versailles St-Quentin, France
(2) Inserm, Centre for research in Epidemiology and Population Health (CESP),
U1018, Population-Based Epidemiological Cohorts Research Platform, France
(3) LUNAM Université, Université d'Angers, Laboratoire d'ergonomie et
d'épidémiologie en santé au travail (LEEST)
(4) Institut de veille sanitaire (InVS), Département santé travail
(5) AP-HP, Poincaré University Hospital, Occupational Health Unit, Garches, France
12 juin 2014
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 1 / 10)
Context and objectives
Methods
Results
Conclusion
Context and objectives
Knee pain (KP) : prevalence 31% in population >40 years
Incidence : From 3 to 31 per 100 person-years (PY)
: 15.6% of incident radiographic knee osteoarthritis after 7 to 10 years
: 3 cases per 100 PY >30 days with KP in the last year
: 8.2 cases per 100 PY >1 day with KP in the previous month (new
employed workers)
: 31 cases per 100 PY most days with KP in the previous month (in
general practice)
KP = invalidating condition that could reect
Felson et al. 1997
Miranda et al. 2002
Jones et al. 2007
Ingham et al. 2011
Knee osteoarthritis
Knee injuries, Knee bursitis, Referred pain,...
Objectives
Estimation of the incidence of knee pain
Evaluation of the associations between incidence of knee pain
and occupational factors
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 2 / 10)
Context and objectives
Methods
Results
Conclusion
Cohort COSALI
COSALI = 2 successive surveys of a large sample of workers in the
Loire Valley area of West Central France ⇒ 3710 workers included
Baseline self-administered questionnaires in 2002-2005 on :
Personal factors : age, body mass index (BMI)
Occupational factors :
The Borg Rating of Perceived Exertion Scale (scale :6 to 20) :
hard exertion to exhaustion (14 to 20)
eq. Physical workload
Handling of loads (>4 kg) >2 hours/day
Kneeling >2 hours/day
Sitting <4 hours/day
eq. Standing
Musculoskeletal symptoms : Nordic questionnaire
⇒
knee pain
Follow-up self-administered questionnaires in 2007-2010 on :
Musculoskeletal symptoms : Nordic questionnaire
E Herquelot
Incidence of knee pain & occupational factors
⇒
knee pain
12 juin 2014( 3 / 10)
Context and objectives
Methods
Results
Conclusion
Models
Knee pain :
Chronic :
≥30
days of KP in the previous year
Other : 1-29 days of KP in the previous year
Outcome = Incident pain = No knee pain at baseline AND knee
pain at follow-up
Number of incident pain
Incidence rate of knee pain = Total
length of follow-up
Logistic multinomial models separately by sex
Chronic vs no knee pain
Other vs no knee pain
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 4 / 10)
Context and objectives
Methods
Results
Conclusion
Study population
Workers included in 2002-2005
N=3710
BMI≥18.5 and without knee pain in 2002-2005
N=2576
Not followed
Followed
N=960 (37%)
N=1616 (63%)
Followed more frequently :
≥
45
Women
Executives
with pain in other areas at baseline
Followed and not followed similar for kneeling and handling loads
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 5 / 10)
Context and objectives
Methods
Results
Conclusion
Incidence of knee pain
Chronic knee pain
Other knee pain
All knee pain
N (%)
71 (7.7)
2.0
1.5 to 2.5
135 (14.7)
3.8
3.1 to 4.4
206 (22.4)
5.7
5.0 to 6.6
* per 100 worker-years
Chronic knee pain
Other knee pain
All knee pain
N (%)
51 (7.3)
Women
IR* 95% CI
2.0
1.4 to 2.6
108 (15.5)
4.1
3.4 to 5.0
159 (22.8)
6.1
5.2 to 7.1
* per 100 worker-years
E Herquelot
Men
IR* 95% CI
Incidence of knee pain & occupational factors
12 juin 2014( 6 / 10)
Context and objectives
Methods
Results
Conclusion
Incidence of knee pain - Univariate models among men
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 7 / 10)
Context and objectives
Methods
Results
Conclusion
Incidence of knee pain - Univariate models among men
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 7 / 10)
Context and objectives
Methods
Results
Conclusion
Incidence of knee pain - Univariate models among men
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 7 / 10)
Context and objectives
Methods
Results
Conclusion
Incidence of knee pain - Univariate models among women
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 8 / 10)
Context and objectives
Methods
Results
Conclusion
Incidence of knee pain - Univariate models among women
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 8 / 10)
Context and objectives
Methods
Results
Conclusion
Incidence of knee pain - Univariate models among women
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 8 / 10)
Context and objectives
Methods
Results
Conclusion
Incidence of knee pain - Multivariate models
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 9 / 10)
Context and objectives
Methods
Results
Conclusion
Incidence of knee pain - Multivariate models
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 9 / 10)
Context and objectives
Methods
Results
Conclusion
Incidence of knee pain - Multivariate models
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 9 / 10)
Context and objectives
Methods
Results
Conclusion
Conclusion
Incidence of knee pain : low in range of previous studies (3 to 31
per 100 person-years (PY))
All knee pain : Men 5.7 [5.0 ;6.6] Women 6.1 [5.2 ;7.1]
Chronic knee pain : Men 2.0 [1.5 ;2.5] Women 2.0 [1.4 ;2.6]
Risk factors of incidence of knee pain :
Men
Women
Chronic pain Others pain Chronic pain Others pain
Age
x
x
BMI
x
Handling loads > 4kg
x
Kneeling
x
Pain in other areas
x
x
x
x
Perspectives :
Studying risk factors of incidence of knee pain by origin (arthritis,
injuries,...)
E Herquelot
Incidence of knee pain & occupational factors
12 juin 2014( 10 / 10)