Review

Scand J Work Environ Health 2014;40(2):133-145    pdf full text

doi:10.5271/sjweh.3409

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

by Hammer PEC, Shiri R, Kryger AI, Kirkeskov L, Bonde JP

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 (HAV).

Methods PubMed and Embase databases were searched up to June 2013. We selected studies assessing the associations of radiographic diagnosed finger and/or wrist joint OA with work activities involving pinch or hand grip or exposure to HAV. We used specific criteria to evaluate completeness of reporting, potential confounding, and bias. Pooled odds ratios (OR) were computed using random-effects meta-analyses.

Results Of the 19 studies included, 17 were cross-sectional, 1 was a prospective cohort, and 1 a case–control study. The meta-analyses of studies that controlled their estimates for at least age and gender showed the associations of pinch grip work with proximal interphalangeal joint [OR 1.56, 95% confidence interval (95% CI) 1.09–2.23] and the first carpometacarpal joint OA (OR 2.10, 95% CI 1.06–4.17), but not with distal interphalangeal, metacarpalphalangeal, or wrist joints OA. Hand grip work and exposure to HAV were not associated with any finger or wrist OA.

Conclusion Epidemiological studies provide limited evidence that pinch grip may increase the risk of wrist or finger OA, but causal relation cannot be resolved because of cross-sectional designs and inadequate characterization of biomechanical strain to the hand and wrist.

This article refers to the following texts of the Journal: 2012;38(3):282-290  2013;39(4):325-334  1987;13(4):290-300  1994;20(2):101-106  2004;30(3):234-240
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