Introduction
This topic covers occupational osteoarthrosis, the most common work-related joint disease. You should be able to define it, name the joints and work factors involved, explain the stages of cartilage damage, describe the clinical picture, state the criteria used to link the disease to work, outline treatment and prevention, and explain how medical expertise is done.
Definition and classification
Occupational osteoarthrosis is a chronic, degenerative-dystrophic disorder of joints in which progressive loss of articular cartilage, subchondral bone remodelling and osteophyte formation develop because of prolonged mechanical overload at work. It is classed as occupational when the work exposure is the main or a major cause, and it is distinguished from primary (age-related or idiopathic) osteoarthrosis and from secondary osteoarthrosis caused by trauma, inflammation or metabolic disease.
Etiology and risk factors
The disease results from repeated or heavy loading of particular joints. The joints most often affected are:
- knee joints, especially in workers who kneel, squat or climb often
- hip joints, in workers who carry loads or stand for long periods
- lumbar and cervical spine, in workers with heavy lifting or constrained postures
- elbow, shoulder and wrist joints, in workers with repetitive or forceful upper-limb work
The main occupational risk factors are:
- manual handling of heavy loads and frequent lifting
- awkward or sustained postures, such as kneeling, squatting or working overhead
- repetitive movements and high joint forces
- whole-body vibration and jolting
- previous intra-articular fractures or repeated microtrauma
- psychosocial stress and long working hours, which add to muscle tension and load on the joints
- personal factors that increase the risk, such as obesity, older age, and joint malalignment