{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:19:17Z","timestamp":1791958757285,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,8,31]],"date-time":"2020-08-31T00:00:00Z","timestamp":1598832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the association between occupational exposures and knee osteoarthritis (OA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched for observational studies that examined the relationship between occupational exposures and knee OA and total knee replacement. Four databases were searched up to October 1, 2019. Two reviewers independently assessed study quality using the Newcastle\u2010Ottawa Scale and evidence quality using the Grading of Recommendations Assessment, Development and Evaluation approach. Subgroup meta\u2010analyses were conducted for important study characteristics and each type of occupational exposure. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated for the meta\u2010analysis using random\u2010effects models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty eligible studies were identified including 25 case\u2013control (n = 20,505 total participants), 36 cross\u2010sectional (n = 139,463 total participants), and 19 cohort studies (n = 16,824,492 total participants). A synthesis of 71 studies suggested increased odds of knee OA (OR 1.52 [95% CI 1.37\u20131.69]) by combining different physically demanding jobs and occupational activities as compared to sedentary occupations and\/or low\u2010exposure groups. Odds of knee OA were greater in males and in industry\u2010based studies and studies assessing lifetime occupational exposures. There were 9 specific job titles that were associated with knee OA, including farmer, builder, metal worker, and floor layer. Occupational lifting, kneeling, climbing, squatting, and standing were all associated with higher odds of knee OA as compared to the odds of knee OA in sedentary workers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Strenuous, physically demanding occupations and occupational activities were associated with increased odds of knee OA as supported by moderate\u2010quality evidence. Specifically, agricultural and construction sectors, which typically involve heavy lifting, frequent climbing, prolonged kneeling, squatting, and standing, carried increased odds of knee OA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24333","type":"journal-article","created":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T01:01:15Z","timestamp":1594170075000},"page":"1213-1223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["Occupational Risk in Knee Osteoarthritis: A Systematic Review and Meta\u2010Analysis of Observational Studies"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3172-9390","authenticated-orcid":false,"given":"Xia","family":"Wang","sequence":"first","affiliation":[{"name":"Royal North Shore Hospital University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0499-3033","authenticated-orcid":false,"given":"Thomas A.","family":"Perry","sequence":"additional","affiliation":[{"name":"Royal North Shore Hospital University of Sydney, Sydney, New South Wales, Australia, and University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Arden","sequence":"additional","affiliation":[{"name":"University of Oxford, Oxford, UK, and Southampton General Hospital, University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7721-0493","authenticated-orcid":false,"given":"Lingxiao","family":"Chen","sequence":"additional","affiliation":[{"name":"Royal North Shore Hospital University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille M.","family":"Parsons","sequence":"additional","affiliation":[{"name":"Southampton General Hospital University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus","family":"Cooper","sequence":"additional","affiliation":[{"name":"Southampton General Hospital National Institute for Health Research Biomedical Research Centre University of Southampton, and University Hospital Southampton NHS Foundation Trust  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Gates","sequence":"additional","affiliation":[{"name":"University of Oxford, Oxford, UK, and University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Royal North Shore Hospital University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2016.01.006"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1179\/oeh.2002.8.4.339"},{"key":"e_1_2_8_4_1","first-page":"249","article-title":"Rheumatism in coal miners. 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