Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment
Abstract Background There is consistent evidence from observational studies of an association between occupational lifting and carrying of heavy loads and the diagnosis of hip osteoarthritis. However, due to the heterogeneity of exposure estimates considered in single studies, a dose-response relati...
| Main Authors: | , , , , , , , , , |
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| 格式: | 文件 |
| 语言: | English |
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BMC
2018-06-01
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| 丛编: | BMC Musculoskeletal Disorders |
| 主题: | |
| 在线阅读: | http://link.springer.com/article/10.1186/s12891-018-2085-8 |
| _version_ | 1828260097941307392 |
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| author | Andreas Seidler Laura Lüben Janice Hegewald Ulrich Bolm-Audorff Annekatrin Bergmann Falk Liebers Christina Ramdohr Karla Romero Starke Alice Freiberg Susanne Unverzagt |
| author_facet | Andreas Seidler Laura Lüben Janice Hegewald Ulrich Bolm-Audorff Annekatrin Bergmann Falk Liebers Christina Ramdohr Karla Romero Starke Alice Freiberg Susanne Unverzagt |
| author_sort | Andreas Seidler |
| collection | DOAJ |
| description | Abstract Background There is consistent evidence from observational studies of an association between occupational lifting and carrying of heavy loads and the diagnosis of hip osteoarthritis. However, due to the heterogeneity of exposure estimates considered in single studies, a dose-response relationship between cumulative physical workload and hip osteoarthritis could not be determined so far. Methods This study aimed to analyze the dose-response relationship between cumulative physical workload and hip osteoarthritis by replacing the exposure categories of the included studies with cumulative exposure values of an external reference population. Our meta-regression analysis was based on a recently conducted systematic review (Bergmann A, Bolm-Audorff U, Krone D, Seidler A, Liebers F, Haerting J, Freiberg A, Unverzagt S, Dtsch Arztebl Int 114:581–8, 2017). The main analysis of our meta-regression comprised six case-control studies for men and five for women. The population control subjects of a German multicentre case-control study (Seidler A, Bergmann A, Jäger M, Ellegast R, Ditchen D, Elsner G, Grifka J, Haerting J, Hofmann F, Linhardt O, Luttmann A, Michaelis M, Petereit-Haack G, Schumann B, Bolm-Audorff U, BMC Musculoskelet Disord 10:48, 2009) served as the reference population. Based on the sex-specific cumulative exposure percentiles of the reference population, we assigned exposure values to each category of the included studies using three different cumulative exposure parameters. To estimate the doubling dose (the amount of physical workload to double the risk of hip osteoarthritis) on the basis of all available case-control-studies, meta-regression analyses were conducted based on the linear association between exposure values of the reference population and the logarithm of reported odds ratios (ORs) from the included studies. Results In men, the risk to develop hip osteoarthritis was increased by an OR of 1.98 (95% CI 1.20–3.29) per 10,000 tons of weights ≥20 kg handled, 2.08 (95% CI 1.22–3.53) per 10,000 tons handled > 10 times per day and 8.64 (95% CI 1.87–39.91) per 106 operations. These estimations result in doubling dosages of 10,100 tons of weights ≥20 kg handled, 9500 tons ≥20 kg handled > 10 times per day and 321,400 operations of weights ≥20 kg. There was no linear association between manual handling of weights at work and risk to develop hip osteoarthritis in women. Conclusions Under specific conditions, the application of an external reference population allows for the derivation of a dose-response relationship despite high exposure heterogeneities in the pooled studies. |
| first_indexed | 2024-04-13T03:18:21Z |
| format | Article |
| id | doaj.art-4910cda4d03f4dc4aa62e0e5c6e67af3 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-13T03:18:21Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-4910cda4d03f4dc4aa62e0e5c6e67af32022-12-22T03:04:50ZengBMCBMC Musculoskeletal Disorders1471-24742018-06-0119111210.1186/s12891-018-2085-8Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignmentAndreas Seidler0Laura Lüben1Janice Hegewald2Ulrich Bolm-Audorff3Annekatrin Bergmann4Falk Liebers5Christina Ramdohr6Karla Romero Starke7Alice Freiberg8Susanne Unverzagt9Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine, Technical University DresdenInstitute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine, Technical University DresdenInstitute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine, Technical University DresdenDivision of Occupational Health, Department of Occupational Safety and Environment, Regional Government of South HesseInstitute for Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-WittenbergFederal Institute of Occupational Safety and HealthInstitute for Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-WittenbergInstitute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine, Technical University DresdenInstitute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine, Technical University DresdenInstitute for Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-WittenbergAbstract Background There is consistent evidence from observational studies of an association between occupational lifting and carrying of heavy loads and the diagnosis of hip osteoarthritis. However, due to the heterogeneity of exposure estimates considered in single studies, a dose-response relationship between cumulative physical workload and hip osteoarthritis could not be determined so far. Methods This study aimed to analyze the dose-response relationship between cumulative physical workload and hip osteoarthritis by replacing the exposure categories of the included studies with cumulative exposure values of an external reference population. Our meta-regression analysis was based on a recently conducted systematic review (Bergmann A, Bolm-Audorff U, Krone D, Seidler A, Liebers F, Haerting J, Freiberg A, Unverzagt S, Dtsch Arztebl Int 114:581–8, 2017). The main analysis of our meta-regression comprised six case-control studies for men and five for women. The population control subjects of a German multicentre case-control study (Seidler A, Bergmann A, Jäger M, Ellegast R, Ditchen D, Elsner G, Grifka J, Haerting J, Hofmann F, Linhardt O, Luttmann A, Michaelis M, Petereit-Haack G, Schumann B, Bolm-Audorff U, BMC Musculoskelet Disord 10:48, 2009) served as the reference population. Based on the sex-specific cumulative exposure percentiles of the reference population, we assigned exposure values to each category of the included studies using three different cumulative exposure parameters. To estimate the doubling dose (the amount of physical workload to double the risk of hip osteoarthritis) on the basis of all available case-control-studies, meta-regression analyses were conducted based on the linear association between exposure values of the reference population and the logarithm of reported odds ratios (ORs) from the included studies. Results In men, the risk to develop hip osteoarthritis was increased by an OR of 1.98 (95% CI 1.20–3.29) per 10,000 tons of weights ≥20 kg handled, 2.08 (95% CI 1.22–3.53) per 10,000 tons handled > 10 times per day and 8.64 (95% CI 1.87–39.91) per 106 operations. These estimations result in doubling dosages of 10,100 tons of weights ≥20 kg handled, 9500 tons ≥20 kg handled > 10 times per day and 321,400 operations of weights ≥20 kg. There was no linear association between manual handling of weights at work and risk to develop hip osteoarthritis in women. Conclusions Under specific conditions, the application of an external reference population allows for the derivation of a dose-response relationship despite high exposure heterogeneities in the pooled studies.http://link.springer.com/article/10.1186/s12891-018-2085-8Physical workloadOsteoarthritis of the hipMeta-regressionExposure-risk relationship |
| spellingShingle | Andreas Seidler Laura Lüben Janice Hegewald Ulrich Bolm-Audorff Annekatrin Bergmann Falk Liebers Christina Ramdohr Karla Romero Starke Alice Freiberg Susanne Unverzagt Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment BMC Musculoskeletal Disorders Physical workload Osteoarthritis of the hip Meta-regression Exposure-risk relationship |
| title | Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment |
| title_full | Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment |
| title_fullStr | Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment |
| title_full_unstemmed | Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment |
| title_short | Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment |
| title_sort | dose response relationship between cumulative physical workload and osteoarthritis of the hip a meta analysis applying an external reference population for exposure assignment |
| topic | Physical workload Osteoarthritis of the hip Meta-regression Exposure-risk relationship |
| url | http://link.springer.com/article/10.1186/s12891-018-2085-8 |
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