Research Article: The Association between Osteoarthritis and Occupational Clusters in the Korean Population: A Nationwide Study

Date Published: January 18, 2017

Publisher: Public Library of Science

Author(s): Hongdeok Seok, Sung Jae Choi, Jin-Ha Yoon, Gwan Gyu Song, Jong-Uk Won, Jae-Hoon Kim, Jaehoon Roh, Jae Hyun Jung, Mikko Juhani Lammi.


Osteoarthritis (OA) is a considerable health problem worldwide. It is known to be associated with certain occupational risk factors. We examined the prevalence rate of OA by occupational cluster. Data were collected from the Korea National Health and Nutrition Examination Surveys (2010–2013). The total number of unweighted sample size was 9,905 participants: 4,460 men and 5,445 women, and OA prevalence was 5.3% and 18.4% respectively. OA patients were defined as participants with knee/hip joint pain and radiographic change of knee/hip joint. Occupational type was classified as either white, pink, blue, or green collar based on the occupational characteristics following physical demand: white for manager and professionals; pink for clerks and service/sales workers; blue for craft/trade workers, machine operators and assemblers, and elementary manual workers; and green for agricultural/fishery workers. We calculated the odds ratios (ORs) and 95% confidence intervals (95% CI) for the odds of a participant’s having OA according to the occupational cluster, with gender stratification. The multiple logistic regression model showed that, compared to the white collar group, the ORs of the pink, blue, and green collar workers were 1.23 (95% CI 0.64–2.36), 1.85 (95% CI 1.18–2.88), and 2.91 (95% CI 1.86–4.54), respectively, in males, and 2.53 (95% CI 1.71–3.73), 2.86 (95% CI 1.94–4.21), and 3.90 (95% CI 2.60–5.83), respectively in females. The prevalence rate of OA was associated with the occupational cluster, in order from highest to lowest: green, blue, pink, and white collar.

Partial Text

Osteoarthritis (OA) is a structural and functional degenerative joint disease involving the cartilage and the surrounding tissue [1]. OA is the most common joint disease in the world, with a prevalence of 10–15% of adults, and causes chronic pain and disability [2,3]. In a study in Korea, OA prevalence was 3.3% in males and 16.0% in females aged 50 years and older [4]. Because the average life span is gradually increasing, OA is also likely to increase with the size of the aged population. OA has considerable effects on social life and quality of life. OA has become an especially conspicuous problem in the recent era, in which people tend to actively work into old age.

Table 1 provides the characteristic of study. The total number of weighted study subject were approximately 5.8million in males, approximately 6.1million in females. In males, 27.4% were white collar, 14.2% were pink collar, 41.3% were blue collar, and 17.1% were green collar. In females, 14.1% were white collar, 32.2% were pink collar, 34.2% were blue collar, and 19.5% were green collar. In males, 5.3% had OA, in spite of, in females, 18.4% had OA.

We classified the occupations into four occupation-cluster groups by physical loading. The amount of manual labor, in order from highest to lowest, was green, blue, pink, and white collar group. Actually, our study showed that the green-collar group showed the highest prevalence rate of OA, followed by the blue-collar group, and then the pink-collar group. The white-collar group showed the lowest prevalence in both male and female. In the Cochran-Armitage trend test, about OA according to occupation in order white, pink, blue, and green, also statistically significant. On the basis of these results, we argued that physical labor can induce and develop OA. Particularly in the blue and green-collar groups, occupation was more strongly associated with OA than any other risk factor with the exception of age, including alcohol consumption, smoking status, obesity, hypertension, and DM (Table 2). Thus, occupation type was the second mostly important risk factor among the covariates tested in our study.




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