To examine the association of the interleukin 1 gene (IL1) cluster polymorphisms and their haplotypes with bilateral distal interphalangeal joint osteoarthritis (DIP OA).
Radiographs of both hands of 295 dentists and 248 teachers were examined and classified for the presence of OA using reference images. Bilateral DIP OA was defined by the presence of radiographic findings of grade 2 or more in at least 1 symmetrical pair of the DIP joints. We genotyped 10 single-nucleotide polymorphisms (SNP) in the IL1R1, IL1RL2, IL1A, IL1B, and IL1RN genes using polymerase chain reaction-based methods. Haplotypes were statistically reconstructed using the PHASE program. The association between the genotypes/diplotypes and bilateral DIP OA was examined with logistic regression analysis.
Two IL1B SNP (rs1143634 and rs1143633) were associated with bilateral DIP OA. The carriers of the IL1B rs1143634 minor allele had an increased OA risk [odds ratio (OR) 1.6; 95% confidence interval (CI) 1.08-2.26] compared to the noncarriers. The association was stronger in the dentists. The distribution of the IL1B rs1143633 genotype fit a recessive mode of inheritance (OR 3.03, 95% CI 1.35-6.83, p = 0.006). Two IL1B-IL1RN extended haplotype alleles (211-1 and 121-1) were associated with bilateral DIP OA. An interaction between the IL1B rs1143634 and the IL1R1-IL1RL2 and IL1B-IL1RN extended haplotypes and occupation (increased risk of OA among dentists only) was observed.
Our results provide further evidence for the role of IL1 gene cluster polymorphisms in the etiology of OA and suggest that some of these may predispose DIP joints to the effects of mechanical overload.
Teachers' work overload has been the subject of intense research, and the results of these studies show that a substantial proportion of teachers perceive their job as very stressful.
To investigate how different formulations of high demands and low decision latitude was related to teachers' burnout, and to estimate the possible interaction between these factors.
The sample consisted of 1,028 school teachers.
Multivariate covariant analyses (MANCOVA) was used to evaluate the relationship between a high-strain job defined by 3 different cut-off points and burnout. Logistical regression analysis was used to estimate the separate and joint effects of demand and decision authority on emotional exhaustion. Interaction between high demands and low decision authority was analysed using relative excess risk due to interaction (RERI). An attributable proportion (AP) was calculated in order to estimate the proportion of emotionally exhausted teachers among those exposed to both risk factors that was attributable to their synergistic interaction. The group of teachers who perceived their job as a low-strain job was used as the reference group in the analysis.
The effect of job strain on burnout was proved to be consistent and robust across alternative formulations. The main effect of high demands exceeded that of low decision authority in relation to emotional exhaustion. Furthermore, the 2 factors acted synergistically to increase the risk of burnout.
In the case of burnout, teachers who perceived their job as highly demanding and low in control, 69% of the effect could be attributed to the synergism of these 2 factors.
Both low back pain (LBP) and obesity are common public health problems, yet their relation remains controversial. The aim of this study was to investigate the associations between weight-related factors and the prevalence of LBP in young adults in Finland. Participants in the ongoing Cardiovascular Risk in Young Finns Study aged 24-39 years were included (N = 2,575). In 2001, 31.2% of men and 39.5% of women reported LBP with recovery within a month or recurrent or continuous pain during the preceding 12 months. For women only, those with higher body mass index, waist circumference, hip circumference, waist-to-hip ratio, serum leptin level, and C-reactive protein level showed an increased prevalence of LBP. With all weight-related factors in the model, only waist circumference was related to LBP in women. For women, the odds ratios of LBP were 1.2 (95% confidence interval: 0.8, 1.8) for a waist circumference of 80-87.9 cm and 1.8 (95% confidence interval: 1.0, 3.2) for a waist circumference of > or =88 cm compared with a waist circumference of
To assess the association between smoking and low back pain with meta-analysis.
We conducted a systematic search of the MEDLINE and EMBASE databases until February 2009. Eighty-one studies were reviewed and 40 (27 cross-sectional and 13 cohort) studies were included in the meta-analyses.
In cross-sectional studies, current smoking was associated with increased prevalence of low back pain in the past month (pooled odds ratio [OR] 1.30, 95% confidence interval [CI], 1.16-1.45), low back pain in the past 12 months (OR 1.33, 95% CI, 1.26-1.41), seeking care for low back pain (OR 1.49, 95% CI, 1.38-1.60), chronic low back pain (OR 1.79, 95% CI, 1.27-2.50) and disabling low back pain (OR 2.14, 95% CI, 1.11-4.13). Former smokers had a higher prevalence of low back pain compared with never smokers, but a lower prevalence of low back pain than current smokers. In cohort studies, both former (OR 1.32, 95% CI, 0.99-1.77) and current (OR 1.31, 95% CI, 1.11-1.55) smokers had an increased incidence of low back pain compared with never smokers. The association between current smoking and the incidence of low back pain was stronger in adolescents (OR 1.82, 95% CI, 1.42-2.33) than in adults (OR 1.16, 95% CI, 1.02-1.32).
Our findings indicate that both current and former smokers have a higher prevalence and incidence of low back pain than never smokers, but the association is fairly modest. The association between current smoking and the incidence of low back pain is stronger in adolescents than in adults.
Cause-specific sickness absence trends by occupational class and industrial sector in the context of recent labour market changes: a Finnish panel data study.
We aimed to provide previously unestablished information on population-based differences in cause-specific sickness absence trends between occupational classes and further between four large industrial sectors within the different occupational classes while controlling for other socioeconomic factors and employment patterns. We focused on the period 2005-2013, during which the labour market underwent large economic and structural changes in many countries.
Register-based panel data study.
Large representative datasets on Finnish wage earners aged 25-59 years.
Annual risk of sickness absence (>10?working days) based on repeated logistic regression.
Between 2005 and 2013, the proportion of employees with sickness absence decreased. Occupational class differences in sickness absence trends varied by disease group. Overall, the decrease in absences was smallest among lower non-manual employees. Sickness absence levels were highest in the health and social work sector and in the manufacturing sector within the non-manual and manual classes, respectively. Absences due to musculoskeletal diseases decreased temporarily during the peak of the economic recession in 2009, particularly in the manufacturing sector within the manual class. The decrease in absences due to musculoskeletal diseases was smallest in the trade sector within the lower occupational classes. Overall, education, income and employment patterns partly explained the differences in the absence levels, but not in the trends.
We found a complex interplay between the associations of occupational class and industrial sector with sickness absence trends. During the economic recession, absences due to musculoskeletal diseases decreased temporarily in a segment of wage earners who were known to have been hit hard by the recession. However, the trend differences were not explained by the measured structural changes in the characteristics of the study population. Both occupational class and industrial sector should be taken into account when tackling problems of work disability.
Retirement is a major life transition affecting health behaviors. The aim of this study was to examine within-individual changes in body mass index (BMI) during transition from full-time work to statutory retirement by sex and physical work characteristics.
A multiwave cohort study repeated every 4 years and data linkage to records from retirement registers. Participants were 5426 Finnish public-sector employees who retired on a statutory basis in 2000-2011 and who reported their body weight one to three times prior to (w-3, w-2, w-1), and one to three times after (w+1, w+2, w+3) retirement.
During the 4-year retirement transition (w+1, vs. w-1) men showed decline in BMI, which was most marked among men with sedentary work (-0.18?kg/m2, 95% CI -.30 to -0.05). In contrast, BMI increased during retirement transition in women and was most marked among women with diverse (0.14?kg/m2, 95% CI 0.08 to 0.20) or physically heavy work (0.31?kg/m2, 95% CI 0.16 to 0.45). Physical activity during leisure time or commuting to work, alcohol consumption or smoking did not explain the observed changes during retirement transition.
In this study statutory retirement was associated with small changes in BMI. Weight loss was most visible in men retiring from sedentary jobs and weight gain in women retiring from diverse and physically heavy jobs.
Notes
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To evaluate the interaction between the COL9A3 gene polymorphism and persistent obesity in relation to lumbar disc degeneration.
Obesity has been suggested to be a risk factor for disc degeneration. There is some indication for an association between collagen IX genes and lumbar disc disease characterized by sciatica. However, the interaction between those factors in their influences on the risk of disc degeneration has not been studied.
Blood samples from 135 middle-aged men who had undergone magnetic resonance imaging (MRI) of the lumbar spine were analyzed for the presence of an arginine to tryptophan change in the COL9A3 gene (Trp3 allele). The men represented three occupations: 41 were machine drivers, 42 were carpenters, and 52 were office workers. The discs L2/L3-L5/S1 were evaluated on MRI, using decreased signal intensity of the nucleus pulposus, posterior disc bulges, and decreased disc height as signs of disc degeneration. Based on self-reports on body height and weight currently and at the age of 25 years, obesity history was classified as no obesity, persistent obesity, and other. Rothman's synergy index was used as a measure of interaction between two factors.
The Trp3 allele and persistent obesity acted synergistically to increase the risk of dark nucleus pulposus, posterior disc bulge, and decreased disc height at L4/L5; of multilevel posterior disc bulges; and of decreased disc height. From 45% to 71% of disc degeneration among persistently obese individuals with the Trp3 allele could be attributed to the synergism of these two factors.
The effect of obesity on lumbar disc degeneration seems to be modified by the collagen IX gene polymorphism, so that people who carry the Trp3 allele are at increased risk if they are persistently obese.
Finnish Institute of Occupational Health, Centre of Expertise for Health and Work Ability, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland. Eija.Haukka@ttl.fi
Source
Int Arch Occup Environ Health. 2006 Nov;80(2):141-8
The co-occurrence of musculoskeletal pain symptoms in seven body sites and their combinations among women in kitchen work were studied.
Data on musculoskeletal pain during the past 3 months in the neck, shoulders, forearms/hands, low back, hips, knees and ankles/feet were gathered by questionnaire from 495 female workers (mean age 45 years) in connection with an ergonomic intervention study in municipal kitchens of four cities in Finland. Altogether 122 kitchens (60% of those eligible) participated in the study. The response rate in the participating kitchens was 98%.
The 3-month prevalence of any musculoskeletal pain was 87%, the most common sites being the neck (71%), low back (50%) and forearms/hands (49%). About 73% of the subjects had pain in at least two, 36% in four or more, and 10% in 6-7 sites. In pair wise comparisons, e.g. neck pain was associated with pain in other sites with prevalence ratios (PR) varying from 1.3 to 1.6, and ankle or foot pain with ratios between 1.9 and 2.4. The seven pain symptoms occurred in more than 80 different combinations. When the co-occurrence of pain was studied in three larger anatomical areas, i.e. any pain in the axial (neck and low back), upper limb and lower limb areas, subjects reporting concurrent pain in all three were the largest category (36% of the respondents). Altogether 53% of the workers reported pain in at least the axial and upper limb areas, and 48% in at least the axial and lower limb areas.
Widespread co-occurrence of musculoskeletal pain symptoms was common among female kitchen workers with slight predominance in the upper body.
To investigate the association of radiographic finger osteoarthritis (OA), hand use, and lifestyle factors with incident and persistent finger joint pain among female dentists and teachers.
Random samples of female dentists (n = 295) and teachers (n = 248) ages 45-63 years were examined by radiography for the presence of finger joint OA. Body weight was measured. Information on finger joint pain during the past 30 days, height, smoking, and leisure-time hand activity was collected by questionnaire. Five years later, 482 women (89%; 65% still active occupationally) responded to a survey on finger joint pain.
The incidence and persistence of finger joint pain were higher among the subjects with OA compared to those without OA. The relative risk (RR) of incident pain in the first through the third fingers was 1.8 (95% confidence interval [95% CI] 1.2-2.7) in the right hand and the RR in the left hand was 3.0 (95% CI 2.0-4.6), allowing for age, occupation, and lifestyle factors. The corresponding figures for the fourth and fifth fingers were RR 2.3 (95% CI 1.4-3.8) in the right and RR 1.9 (95% CI 1.1-3.5) in the left hand. Regarding persistent pain, the RRs varied between 2.4 and 5.4. Body mass index, smoking, or leisure-time hand activity were not associated with pain. The dentists tended to have a higher incidence of pain in the first through the third fingers of the right hand compared with the teachers.
Radiographic finger joint OA was a significant determinant of both persistent and incident finger joint pain in a 5-year followup among middle-aged women. Hand use may modify the association between radiographic OA and finger joint pain.
Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, Finland. johanna.kausto@ttl.fi
Source
Int Arch Occup Environ Health. 2011 Oct;84(7):773-88
There is growing evidence that physical and psychosocial exposures at work increase the risk of musculoskeletal disorders. The aim of this study was to describe the distribution and co-occurrence of these risk factors in the working population.
We used data from the Health 2000 survey carried out in Finland in 2000-2001. The sample of our study consisted of 2,491 men and 2,613 women who had been actively working during the year preceding the survey. Logistic regression and exploratory factor analysis were used to analyze the co-occurrence of the work-related risk factors.
Exposure to high physical work load and several co-occurring work load factors was more prevalent among men than women. In women, as opposed to men, the highest exposure to most physical work load factors was found in their later work life. Gender and age showed weak associations with psychosocial work load factors. Low socioeconomic position, in both genders, was related to an increased risk of being exposed to several co-occurring physical or psychosocial factors. Physical exposures most frequently co-occurred with high job demands and low job control in men. Among women, physical exposures were found to co-occur with high job demands, low job control and job insecurity.
This study provides novel information on the occupational exposures in general working population. It appears that co-occurrence of physical and psychosocial exposures should be considered in research and prevention of musculoskeletal disorders. In addition, a broader set of occupational factors, e.g., work organization, are suggested to be included in future studies to cover all the relevant determinants.
