2013-12-01 12:00 - Messages

Associations of work activities requiring pinch or hand grip or exposure to hand-arm vibration with finger and wrist osteoarthritis

A systematic review
Objective : We systematically reviewed the epidemiologic evidence linking finger and wrist osteoarthritis (OA) with work activities requiring pinch or hand grip or exposure to hand-arm vibration.
Methods : PubMed and Embase databases were searched up to June 2013. We selected studies providing quantitative risk estimates of radiographic diagnosed finger and/or wrist joint OA (hand OA) in relation to work activities involving pinch or hand grip or exposure to hand-arm vibration. We used specific criteria to evaluate completeness of reporting, potential confounding, and bias. Weighted average risk estimates were computed using random-effects models.
Results : Of the 21 studies retrieved, 19 were cross-sectional, 1 was a prospective cohort, and 1 a case–control study. For pinch-grip work, the average risk of OA across 6 studies was moderately elevated for proximal interphalangeal (IP) joints [relative risk (RR) 1.76, 95% confidence interval (95% CI) 1.28–2.43)] and the first carpometacarpal joint (RR 2.18, 95% CI 1.40–3.39), but not for distal IP, metacarpalphalangeal, or wrist joints. For hand-grip work, the overall risk for hand OA (any joint) across 10 studies was RR 1.40 (95% CI 1.05–1.86) with strong heterogeneity across a total of 24 risk estimates (I2 statistic for heterogeneity=0.784, P <0.001). For hand-arm vibration exposure, 5 studies did not reveal consistent evidence for increased risk for finger or wrist OA.
Conclusion : Epidemiological studies provide limited evidence that pinch and, to a lesser extent, hand grip may increase the risk for finger OA, but causal relations cannot be resolved because of cross-sectional designs and inadequate characterization of biomechanical strain to the hand and wrist.

Source : Hammer PEC, Kryger AI, Kirkeskov L, Bonde JP. Scand J Work Environ Health. 2013.


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