Table 2.
Eligible publications and key extracted data, in descending order of methodological rating as determined by the AMSTAR 2 instrument22
| Author, Year [Reference Number] | Review type; N of included studies, years of publication of included studies | Types of studies included | Focus | Key findings | Methodological rating (AMSTAR 2) |
|---|---|---|---|---|---|
| Knee OA | |||||
| Ezzat & Li, 201429 | Systematic review of 32 studies (1952‐2011) | Cross sectional, case‐control and cohort | Relationships between occupational physical loading of various types and knee OA | Moderate evidence that combined heavy lifting and kneeling constitute a risk factor for knee OA; limited evidence for heavy lifting, kneeling, stair climbing, or occupational groups being individual occupational risk factors for knee OA. Elevated BMI and previous injury have a role in the development of knee OA. There was a moderate level of evidence for males but limited evidence for females | Moderate |
| Jensen, 200830 | Systematic review of 25 studies (1952‐2005) | Cross sectional, case‐control and cohort | Occupational risk factors for development of knee OA | Moderate evidence for kneeling and heavy lifting as risk factors for knee OA, with the combination of both associated with greater risk. Stair and ladder climbing were also associated with increased risk of knee OA. The evidence was stronger for males than females | Moderate |
| McMillan & Nichols, 200531 | Systematic review of 19 studies (1952‐2000) | Case‐control and cohort | Occupational risk factors for knee OA in miners | Work involving kneeling and or squatting is associated with increased risk of knee OA. Frequent or prolonged kneeling or squatting is associated with double the risk of knee OA observed in the general population. Lifting with squatting/kneeling is associated with further increases in risk | Moderate |
| McWilliams et al, 201128 | Systematic review and meta‐analysis of 66 studies (1955‐2010) | Cross sectional, case‐control and cohort | Occupational risk factors for OA of the knee | Occupational activities incorporating kneeling, lifting, carrying, squatting or other knee bending activities are associated with increased risk of knee OA | High |
| Palmer, 201232 | Systematic review of 43 studies (1968‐2010) | Cross sectional, case‐control and cohort | Occupational risk factors for OA of the knee | Good evidence exists that physical work activities incorporating kneeling, squatting, lifting or climbing increase risk of, and can aggravate, knee OA. High BMI also independently related to knee OA | Moderate |
| Reid et al, 201023 | Narrative review of 7 studies (1988‐2008) | Cross sectional, case‐control and cohort | Occupational risk factors for musculoskeletal disorders of the knee, including knee OA | Kneeling and squatting are primary risk factors for knee OA, with crawling, stair/ladder climbing, lifting/carrying/moving, walking and standing up from a knee/squat/crawl also associated with an increased risk of knee OA | Not applicable—narrative, not systematic, review |
| Silverwood et al, 201525 | Systematic review with meta‐analysis of 46 studies (1991‐2011) | Cohort | Evidence for risk factors for knee OA in older adults | Kneeling and lifting were significantly related to knee OA. Heavy physical workload and knee bending not significantly related to knee OA. Previous knee injury, female sex, overweight, and obesity are also risk factors for knee OA | Moderate |
| Hip OA | |||||
| Bergmann et al, 201727 | Systematic review and meta‐analysis of 23 studies (1991‐2014) | Case‐control and cohort | Relationships between heavy lifting and carrying and hip OA | An association exists between years of heavy lifting and carrying and risk of developing hip OA. The effects were lower for females, possibly due to females being underrepresented in studies | Moderate |
| Jensen, 200833 | Systematic review of 19 studies (1985‐2004) | Cross sectional, case‐control and cohort | Occupational risk factors for development of hip OA | Moderate to strong evidence for heavy lifting being a risk factor for hip OA in farmers. Limited evidence for climbing stairs or ladders as risk factors for hip OA. The evidence was stronger for males than for females | Moderate |
| Seidler et al, 201826 | Systematic review with meta‐analysis of 23 studies (1991‐2014) | Case‐control | Dose‐response relationship between different types of physical workload and OA of the hip | An increased risk of hip OA is associated with heavy lifting and as heavy lifting increases, risk of OA increases. A linear association was found between manual handling of weights and hip OA in males but not females | Moderate |
| Sulsky et al, 201234 | Systematic review of 30 studies (1984‐2009) | Case‐control and cohort | The relationships between physical workloads and hip OA | Heavy lifting is a risk factor for hip OA and long‐term exposure to standing may also increase the risk of hip OA | Moderate |
| OA in various joints | |||||
| Fransen et al, 201110 | Systematic review of 22 studies (2007‐2010) | Cross sectional, case‐control and cohort | The role of occupational risk factors in the development of knee and hip OA | Men involved in farming or construction are at increased risk of developing chronic hip and knee pain and OA. The risk of knee and hip OA from regular lifting, kneeling and crawling is increased with concomitant obesity | Critically low |
| Richmond et al, 201312 | Systematic review with meta‐analysis of 43 studies (1977‐2008) | Cross sectional, case‐control, cohort and case series | Occupational risk factors for OA in the lower limb | Occupational activity including heavy lifting, squatting, kneeling and climbing stairs is associated with an increased risk of OA at the knee and hip. No evidence for occupational activity and ankle OA. Other factors including obesity and previous joint injury are also associated with an increased risk of hip and knee OA | Moderate |
| Vignon et al, 200635 | Systematic review of 76 studies (1988‐2004) | Cross sectional and case‐control | The relationship between specific occupational activities and knee and hip OA | There is high level of evidence of a positive relationship between physically demanding occupational activity, including heavy lifting and climbing, and knee and hip OA | Moderate |
| Aluoch & Wao, 200936 | Systematic review of 16 studies (1987‐2008) | Cross sectional and case‐control | Occupational risk factors associated with the development of OA in any joints of the body. | Strong relationship between physical strain experienced while performing physically demanding jobs and the incidence of OA of the knee and hip | Moderate |
| Yucesoy et al, 201524 | Narrative review of 30 studies (1988‐2011) | Cross sectional and case‐control | Occupational risk factors for OA | Heavy physical workload is the most common risk factor for OA in several anatomical locations including the knee and hip. Other risk factors include kneeling, regular stair climbing, crawling, bending, whole‐body vibration and repetitive movements | Not applicable—narrative, not systematic, review |
Abbreviations: AMSTAR, A MeaSurement Tool to Assess systematic Reviews; BMI, body mass index; OA, osteoarthritis.