Safety and Health at Work

Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency (산업안전보건연구원)
권호 표지
DOI QR코드

DOI QR Code

Work-Related Risk Factors of Knee Meniscal Tears in Korean Farmers: A Cross-Sectional Study

  • Hong, Chae Young (Department of Occupational and Environmental Medicine, Chosun University Hospital) ;
  • Lee, Chul Gab (Department of Occupational and Environmental Medicine, Chosun University Hospital) ;
  • Kim, Dong Hwi (Department of Orthopedic Medicine, Chosun University Hospital) ;
  • Cho, Yong Soo (Department of Radiology, Chosun University Hospital) ;
  • Kim, Kweon Young (Department of Rehabilitation Medicine, Chosun University Hospital) ;
  • Ryu, So Yeon (Department of Preventive Medicine, Chosun University Hospital) ;
  • Song, Han Soo (Department of Occupational and Environmental Medicine, Chosun University Hospital)
  • Received : 2020.01.28
  • Accepted : 2020.05.27
  • Published : 2020.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Meniscal tears are among the major risk factors for knee osteoarthritis progression. This study aimed to investigate the relationship between meniscal tears and work-related factors in the farming occupation. Methods: The participants included 486 farmers (238 men and 248 women), aged 40-69 years, who were among the 550 farmers registered in the Korea Farmer's Knee Cohort (KFKC). Data such as those on gender, age, body mass index (BMI), mechanical axis, cumulative heavy-lifting working time (CLWT), cumulative squatting working time (CSWT), and previous knee injury history were collected from the questionnaire, along with whole leg radiographic findings. Two radiologists assessed the magnetic resonance images of both knees to confirm the presence of meniscal tears. The factors related to meniscal tears were analyzed by multiple logistic regression. Results: A total of 54.5% of the farmers (48.7% of men and 60.1% of women) had meniscal tears. These tears were associated with gender, age, and BMI. We also identified an association between meniscal tears and CSWT, an especially important factor in farming [10,000-19,999 working hours, odds ratio = 2.16, 95% confidence interval (CI): 1.14-4.07, ≥20,000 working hours, odds ratio = 2.35, 1.45-3.80]. However, mechanical axis, knee injury history, and CLWT were not significantly related to meniscal tears. Conclusion: This study's findings show that squatting for long periods, as an occupational factor, is related to meniscal tears.

Keywords

Acknowledgement

The authors thank the Ministry of Agriculture, Food and Rural Affairs for financial and administrative assistance for this study.

References

  1. Fox AJ, Bedi A, Rodeo SA. The basic science of human knee menisci: structure, composition, and function. Sports Health 2012;4(4):340-51.
  2. Khan M, Evaniew N, Bedi A, Ayeni OR, Bhandari M. Arthroscopic surgery for degenerative tears of the meniscus:a systematic review and meta-analysis. CMAJ 2014;186(14):1057-64.
  3. Mordecai SC, Al-Hadithy N, Ware HE, Gupte CM. Treatment of meniscal tears: an evidence based approach. World J Orthop 2014;5(3):233-41.
  4. Chung KS, Ha JK, Kim YS, Kim JH, Ra HJ, Kong DH, et al. National trends of meniscectomy and meniscus repair in Korea. J Korean Med Sci 2019;34(32):e206.
  5. Katano H, Koga H, Ozeki N, Otabe K, Mizuno M, Tomita M, et al. Trends in isolated meniscus repair and meniscectomy in Japan, 2011-2016. J Orthop Sci 2018;23(4):676-81.
  6. Abrams GD, Frank RM, Gupta AK, Harris JD, McCormick FM, Cole BJ. Trends in meniscus repair and meniscectomy in the United States, 2005-2011. Am J Sports Med 2013;41(10):2333-9.
  7. Nguyen JC, De Smet AA, Graf BK, Rosas HG. MR imaging-based diagnosis and classification of meniscal tears. Radiographics 2014;34(4):981-99.
  8. Englund M, Guermazi A, Gale D, Hunter DJ, Aliabadi P, Clancy M, et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 2008;359(11):1108-15.
  9. Zanetti M, Pfirrmann CWA, Schmid MR, Romero J, Seifert B, Hodler J. Patients with suspected meniscal tears: prevalence of abnormalities seen on MRI of 100 symptomatic and 100 contralateral asymptomatic knees. Am J Roentgenol 2003;181(3):635-41.
  10. Englund M, Guermazi A, Roemer FW, Aliabadi P, Yang M, Lewis CE, et al. Meniscal tear in knees without surgery and the development of radiographic osteoarthritis among middle-aged and elderly persons: the Multicenter Osteoarthritis Study. Arthritis Rheum 2009;60(3):831-9.
  11. Ding C, Martel-Pelletier J, Pelletier JP, Abram F, Raynauld JP, Cicuttini F, et al. Knee meniscal extrusion in a largely non-osteoarthritic cohort: association with greater loss of cartilage volume. Arthritis Res Ther 2007;9(2):R21.
  12. Melrose J, Fuller ES, Little CB. The biology of meniscal pathology in osteoarthritis and its contribution to joint disease: beyond simple mechanics. Connect Tissue Res 2017;58(3-4):282-94.
  13. Snoeker BA, Bakker EW, Kegel CA, Lucas C. Risk factors for meniscal tears: a systematic review including meta-analysis. J Orthop Sports Phys Ther 2013;43(6):352-67.
  14. Jensen LK, Rytter S, Marott JL, Bonde JP. Relationship between years in the trade and the development of radiographic knee osteoarthritis and MRIdetected meniscal tears and bursitis in floor layers. A cross-sectional study of a historical cohort. BMJ Open 2012;2(3):e001109.
  15. Mikkelsen S, Brauer C, Pedersen EB, Alkj￦r T, Koblauch H, Simonsen EB, et al. A Cohort study on meniscal lesions among airport baggage handlers. PloS One 2016;11(6):e0157336.
  16. Seok H, Choi SJ, Yoon JH, Song GG, Won JU, Kim JH, et al. The association between osteoarthritis and occupational clusters in the Korean population: a nationwide study. PLoS One 2017;12(1):e0170229.
  17. Kotowski SE, Davis KG, Kim H, Lee KS. Identifying risk factors of musculoskeletal disorders on Korean farms. Work 2014;49(1):15-23.
  18. Walker-Bone K, Palmer K. Musculoskeletal disorders in farmers and farm workers. Occup Med (Lond) 2002;52(8):441-50.
  19. Hunter DJ, Guermazi A, Lo GH, Grainger AJ, Conaghan PG, Boudreau RM, et al. Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score). Osteoarthritis Cartilage 2011;19(8):990-1002.
  20. Song M-H, Yoo S-H, Kang S-W, Kim Y-J, Park G-T, Pyeun Y-S. Coronal alignment of the lower limb and the incidence of constitutional varus knee in Korean females. Knee Surg Relat Res 2015;27(1):49-55.
  21. Beals CT, Magnussen RA, Graham WC, Flanigan DC. The prevalence of meniscal pathology in asymptomatic athletes. Sports Med 2016;46(10):1517-24.
  22. Unay K, Akcal MA, Gokcen B, Akan K, Esenkaya I, Poyanli O. The relationship between intra-articular meniscal, chondral, and ACL lesions: finding from 1,774 knee arthroscopy patients and evaluation by gender. Eur J Orthop Surg Traumatol 2014;24(7):1255-62.
  23. Kotowski SE, Davis KG, Kim H, Lee K-S. Identifying risk factors of musculoskeletal disorders on Korean farms. Work 2014;49(1):15-23.
  24. Jones JC, Burks R, Owens BD, Sturdivant RX, Svoboda SJ, Cameron KL. Incidence and risk factors associated with meniscal injuries among active-duty US military service members. J Athl Train 2012;47(1):67-73.
  25. Ford GM, Hegmann KT, White Jr GL, Holmes EB. Associations of body mass index with meniscal tears. Am J Prev Med 2005;28(4):364-8.
  26. Laberge MA, Baum T, Virayavanich W, Nardo L, Nevitt MC, Lynch J, et al. Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects-data from the Osteoarthritis Initiative. Skeletal Radiol 2012;41(6):633-41.
  27. Verbeek J, Mischke C, Robinson R, Ijaz S, Kuijer P, Kievit A, et al. Occupational exposure to knee loading and the risk of osteoarthritis of the knee: a systematic review and a dose-response meta-analysis. Saf Health Work 2017;8(2):130-42.
  28. Baker P, Reading I, Cooper C, Coggon D. Knee disorders in the general population and their relation to occupation. Occup Environ Med 2003;60(10):794-7.
  29. Zhang Y, Hunter DJ, Nevitt MC, Xu L, Niu J, Lui LY, et al. Association of squatting with increased prevalence of radiographic tibiofemoral knee osteoarthritis: the Beijing Osteoarthritis Study. Arthritis Rheum 2004;50(4):1187-92.
  30. Thambyah A, Goh JC, De SD. Contact stresses in the knee joint in deep flexion. Med Eng Phys 2005;27(4):329-35.
  31. McMillan G, Nichols L. Osteoarthritis and meniscus disorders of the knee as occupational diseases of miners. Occup Environ Med 2005;62(8):567-75.
  32. Koh IJ, Kim TK, Chang CB, Cho HJ, In Y. Trends in use of total knee arthroplasty in Korea from 2001 to 2010. Clin Orthop Rel Res 2013;471(5):1441-50.
  33. Holmberg S, Thelin A, Thelin N. Is there an increased risk of knee osteoarthritis among farmers? A population-based caseecontrol study. Int Arch Occup Environ Health 2004;77(5):345-50.