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Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers

Journal article
Authors Helena Johansson
Cecilie Hongslo Vala
A. Oden
Mattias Lorentzon
E. McCloskey
J. A. Kanis
N. C. Harvey
Claes Ohlsson
L. S. Lohmander
Johan Kärrholm
Dan Mellström
Published in Osteoporosis International
Volume 29
Issue 3
Pages 741-749
ISSN 0937-941X
Publication year 2018
Published at Centre for Bone and Arthritis Research
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Institute of Clinical Sciences, Department of Orthopaedics
Pages 741-749
Language en
Links https://doi.org/10.1007/s00198-017-...
Keywords Arthroplasty, Epidemiology, Hip fracture, Occupation, Osteoarthritis, Osteoporosis, Physical activity, Sweden, body-mass index, physical-activity, knee osteoarthritis, women, work, men, population, metaanalysis, occupation, association, Endocrinology & Metabolism
Subject categories Orthopedics, Geriatrics

Abstract

We aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty. Introduction The risks of hip fracture and hip arthroplasty are influenced by factors including socioeconomic status, education, urbanization, latitude of residence, and physical activity. Farming is an occupation encompassing rural living and high level of physical activity. Therefore, we aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. Methods We studied the risk of hip fracture, and hip arthroplasty due to primary osteoarthritis, in all men and women aged 35 years or more in Sweden between 1987 and 2002. Documented occupations were available in 3.5 million individuals, of whom 97,136 were farmers. The effects of age, sex, income, education, location of residence, and occupation on risk of hip fracture or hip arthroplasty were examined using a modification of Poisson regression. Results A total of 4027 farmers and 93,109 individuals with other occupations sustained a hip fracture, while 5349 farmers and 63,473 others underwent a hip arthroplasty. Risk of hip fracture was higher with greater age, lower income, lower education, higher latitude, and urban area for all men and women. Compared to all other occupations, male farmers had a 20% lower age-adjusted risk of hip fracture (hazard ratio (HR) 0.80, 95% CI 0.77-0.84), an effect that was not seen in female farmers (HR 0.96, 95% CI 0.91-1.01). Both male and female farmers had a higher age-adjusted risk for hip arthroplasty. Conclusions Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.

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