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

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

E Herquelot ^{1 , 2} , A Guéguen ^{1 , 2} , Y Roquelaure ³ , J Bodin ³ , C Ha ⁴ , A Leclerc ^{1 , 2} , M Goldberg ^{1 , 2} , M Zins ^{1 , 2} , A Descatha ^{1 , 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

Context and objectives

Knee pain (KP) : prevalence 31% in population >40 years Incidence : From 3 to 31 per 100 person-years (PY)

Felson et al. 1997 : 15.6% of incident radiographic knee osteoarthritis after 7 to 10 years Miranda et al. 2002 : 3 cases per 100 PY >30 days with KP in the last year

Jones et al. 2007 : 8.2 cases per 100 PY >1 day with KP in the previous month (new employed workers)

Ingham et al. 2011 : 31 cases per 100 PY most days with KP in the previous month (in general practice)

KP = invalidating condition that could reect

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)

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 ⇒ knee pain

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

Incidence rate of knee pain = Number of incident 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)

Study population

Workers included in 2002-2005 N=3710

BMI ≥ 18.5 and without knee pain in 2002-2005 N=2576

Not followed

N=960 (37%) Followed

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

Incidence of knee pain

N (%) Men IR* 95% CI Chronic knee pain 71 (7.7) 2.0 1.5 to 2.5 Other knee pain 135 (14.7) 3.8 3.1 to 4.4 All knee pain 206 (22.4) 5.7 5.0 to 6.6

* per 100 worker-years

Women

N (%) IR* 95% CI

Chronic knee pain 51 (7.3) 2.0 1.4 to 2.6 Other knee pain 108 (15.5) 4.1 3.4 to 5.0 All knee pain 159 (22.8) 6.1 5.2 to 7.1

* per 100 worker-years

E Herquelot Incidence of knee pain & occupational factors 12 juin 2014( 6 / 10)

Incidence of knee pain - Univariate models among men

Incidence of knee pain - Univariate models among men

E Herquelot Incidence of knee pain & occupational factors 12 juin 2014( 7 / 10)

Incidence of knee pain - Univariate models among men

Incidence of knee pain - Univariate models among women

E Herquelot Incidence of knee pain & occupational factors 12 juin 2014( 8 / 10)

Incidence of knee pain - Univariate models among women

Incidence of knee pain - Univariate models among women

E Herquelot Incidence of knee pain & occupational factors 12 juin 2014( 8 / 10)

Incidence of knee pain - Multivariate models

Incidence of knee pain - Multivariate models

E Herquelot Incidence of knee pain & occupational factors 12 juin 2014( 9 / 10)

Incidence of knee pain - Multivariate models

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 x

Kneeling x x x

Pain in other areas 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)