Skip to main content

Advertisement

Log in

Review of Epidemiologic Studies on Occupational Factors and Lower Extremity Musculoskeletal and Vascular Disorders and Symptoms

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

The epidemiologic literature on lower extremity musculoskeletal disorders (MSDs), vascular disorders, and occupational mechanical factors is relatively sparse, compared to the low back and upper extremities. The present literature review aims to summarize and evaluate the current literature on lower extremity vascular disorders, MSDs, and symptoms, and to update previous literature reviews. A search was conducted in PubMed. Articles were included if they had a lower extremity musculoskeletal outcome, and a workplace factor(s). They were evaluated based upon their generalizability, exposure, and outcome assessments, study design, and controlling of confounders. Most of the literature has focused on osteoarthritis of the hip and knee, whereas not much research has been done examining the feet/ankles and lower legs. Overall, better exposure assessment is needed to examine the causal pathway between occupational factors and MSDs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Redfern MS, Chaffin DB. The effects of floor types on standing tolerance industry. In: Aghazadeh F, ed. Trends in ergonomics/human factors V. New York: Elsevier Science, 1988.

    Google Scholar 

  2. Work-Related Injury Query System (in conjunction with the National Electronic Injury Surveillance System), 2004.

  3. Baker P, Reading I, Cooper C, Coggon D. Knee disorders in the general population and their relation to occupation. Occup Environ Med 2003; 60: 794–797.

    Google Scholar 

  4. O’Reilly SC, Muir KR, Doherty M. Occupation and knee pain: A community study. Osteoarthritis Cartilage 2000; 8: 78–81.

    Google Scholar 

  5. Maetzel A, Makela M, Hawker G, Bombardier C. Osteoarthritis of the hip and knee and mechanical occupational exposure—A systematic overview of the evidence. J Rheumatol 1997; 24: 1599–1607.

    Google Scholar 

  6. Lievense A, Bierma-Zeinstra A, Verhagen A, Verhaar J, Koes B. Influence of work on the development of osteoarthritis of the hip: A systematic review. J Rheumatol 2001; 28(11): 2520–2528.

    Google Scholar 

  7. Schouten JSAG, de Bie RA, Swaen G. An update on the relationship between occupational factors and osteoarthritis of the hip and knee. Curr Opin Rheumatol 2002; 14: 89–92.

    Google Scholar 

  8. Kirkeskov JL, Eenberg W. Occupation as a risk factor for knee disorders. Scand J Work Environ Health 1996; 22: 165–175.

    Google Scholar 

  9. Callam MJ. Epidemiology of varicose veins. Brit J Surg 1994; 81: 167–173.

    Google Scholar 

  10. Evans CJ, Fowkes FGR, Hajivassiliou CA, Harper DR, Ruckley CV. Epidemiology of varicose veins: A review. Int Angiol 1994; 13(3): 263–270.

    Google Scholar 

  11. Hobson J. Venous insufficiency at work. Angiology 1997; 48(7): 577–582.

    Google Scholar 

  12. Jawien A. The influence of environmental factors in Chronic Venous Insufficiency. Angiology 2003; 54 (s1): s19–s31.

    Google Scholar 

  13. Kristensen TS. Cardiovascular diseases and the work environment. Scand J Work Environ Health 1989; 15: 165–179.

    Google Scholar 

  14. Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar-fasciitis: A matched case-control study. J Bone Joint Surg 2003; 85a(5): 872–877.

    Google Scholar 

  15. Ryan GA. The prevalence of musculo-skeletal symptoms in supermarket workers. Ergonomics 1989; 32(4): 359–371.

    Google Scholar 

  16. deZwart BCH, Broersen JPJ, Frings-Dresen MHW, van Dijk FJH. Repeated survey on changes in musculoskeletal complaints relative to age and work demands. Occup Environ Med 1997; 54: 793–799.

    Google Scholar 

  17. de Zwart BC, Broersen JP, van der Beek AJ, Frings-Dresen MH. Occupational classification according to work demands: An evaluation study. Int J Occup Med Environ 1997; 10(3): 283–295.

    Google Scholar 

  18. Merlino LA, Rosecrance JC, Anton D, Cook TM. Symptoms of musculoskeletal disorders among apprentice construction workers. Appl Occup Environ Hyg 2003; 18(1): 57–64.

    Google Scholar 

  19. Dawson J, Thorogood M, Marks S, Juszczak E, Dodd C, Lavis G, Fitzpatrick R. The prevalence of foot problems in older women: A cause for concern. J Public Health Med 2002; 24(2): 77–84.

    Google Scholar 

  20. Bergenudd H, Lindgarde F, Nilsson B. Prevalence and coincidence of degenerative changes of the hands and feet in middle age and their relationship to occupational work load, intelligence, and social background. Clin Orthop 1989; Feb (239): 306–310.

    Google Scholar 

  21. Akesson I, Johnsson B, Rylander L, Moritz U. Musculoskeletal disorders among female dental personnel—Clinical examination and a 5-year follow-up study of symptoms. Int Arch Occup Environ Health 1999; 72: 395–403.

    Google Scholar 

  22. Engels JA, van der Gulden JWJ, Senden TF, van’t Hof B. Work-related risk factors for musculoskeletal complaints in the nursing profession: Results of a questionnaire survey. OEM 1996; 53: 636–641.

    Google Scholar 

  23. Lemasters GK, Atterbury MR, Booth-Jones AD, Bhattacharya A, Ollila-Glenn N, Forrester C, Forst L. Prevalence of work related musculoskeletal disorders in active union carpenters. Occup Environ Med 1998; 55: 421–427.

    Google Scholar 

  24. Gamperiene M, Stigum H. Work related risk factors for musculoskeletal complaints in the spinning industry in Lithuania. Occup Environ Med 1999; 56: 411–416.

    Google Scholar 

  25. Cham R, Redfern MS. Effect of flooring on standing comfort and fatigue. Hum Factors 2001; 43(3): 381–391.

    Google Scholar 

  26. Redfern MS. Influence of flooring on standing fatigue. Hum Factors 1995; 37(3): 570–581.

    Google Scholar 

  27. Redfern MA, Cham R. The influence of flooring on standing comfort and fatigue. AIHAJ 2000; 61: 700–708.

    Google Scholar 

  28. Brand FN, Dannenberg AL, Abbott RD, Kannel WB. The epidemiology of varicose veins: The Framingham Study. Am J Prev Med 1988; 4: 96–101.

    Google Scholar 

  29. Tuchsen F, Krause N, Hannerz N, Burr H, Kristensen TS. Standing at work and varicose veins. Scand J Work Environ Health 2000; 26(5): 414–420.

    Google Scholar 

  30. Scott TE, LaMorte WW, Gorin DR, Menzoian JO. Risk factors for chronic venous insufficiency: A dual case-control study. J Vasc Surg 1995; 22: 622–628.

    Google Scholar 

  31. Kontosic I, Vukelic M, Drescik I, Mesaros-Kanjski E, Materljan E, Jonjic A. Work conditions as risk factors for varicose veins of the lower extremities in certain professions of the working population of Rijeka. Acta Med Okayama 2000; 54(1): 33–38.

    Google Scholar 

  32. Fowkes FGR, Lee AJ, Evans CJ, Allan PL, Bradbury AW, Ruckley CV. Lifestyle risk factors for lower limb venous reflux in the general population: Edinburgh Vein Study. Int J Epidemiol 2001; 30: 846–852.

    Google Scholar 

  33. Lee AJ, Evans CJ, Allan PL, Ruckley CV, Fowkes FGR. Lifestyle factors and the risk of varicose veins: Edinburgh vein study. J Clin Epidemiol 2003; 56: 171–179.

    Google Scholar 

  34. Lacroix P, Aboyans V, Preux PM, Houles MB, Laskar M. Epidemiology of venous insufficiency in an occupational population. Int Angiol 2003; 22: 172–176.

    Google Scholar 

  35. Engels JA, van der Gulden JWJ, Senden TF, Hertog CAWM, Kolk JJ, Binkhorst RA. Physical work load and its assessment among the nursing staff in nursing homes. JOM 1994; 36(3): 338–345.

    Google Scholar 

  36. Madelein PP, Voigt M, Arendt-Nielsen L. Subjective, physiological and biomechanical responses to prolonged manual work performed standing on hard and soft surfaces. Eur J Appl Physiol 1998; 77: 1–9.

    Google Scholar 

  37. Van Dieen JP, Vrielink HHEO. Evaluation of work-rest schedules with respect to the effects of postural workload in standing work. Ergonomics 1998; 41(12): 1832–1844.

    Google Scholar 

  38. Jensen LK, Eenberg W. Occupation as a risk factor for knee disorders. Scand J Work Environ Health 1996; 22: 165–175.

    Google Scholar 

  39. Lau EC, Cooper C, Lam D, Chan VNH, Tsang KK, Sham A. Factors associated with osteoarthritis of the hip and knee in Hong Kong Chinese: Obesity, joint injury and occupational activities. Am J Epidemiol 2000; 152: 855–862.

    Article  CAS  PubMed  Google Scholar 

  40. Yoshimura N, Nishioka S, Kinoshita H, Hori N, Nishioka T, Ryujin M, Mantani Y, Miyake M, Coggon D, Cooper C. Risk factors for knee osteoarthritis in Japanese women: Heavy weight, previous joint injuries, and occupational activities. J Rheumatol 2004; 31: 157–162.

    Google Scholar 

  41. Cooper C, McAlindon T, Coggon D, Egger P, Dieppe P. Occupational activity and osteoarthritis of the knee. Ann Rheum Dis 1994; 53: 90–93.

    Google Scholar 

  42. Coggon D, Croft P, Kellingray S, Barrett D, McLaren M, Cooper C. Occupational physical activities and osteoarthritis of the knee. Arthritis Rheum 2000; 43(7): 1443–1449.

    Google Scholar 

  43. Bagge E, Bjelle A, Eden S, Svanborg A. Factors associated with radiographic osteoarthritis: Results from the population study of 70-year-old people in Goteberg. J Rheumatol 1991; 18: 1218–1222.

    Google Scholar 

  44. Felson DT, Hannan MT, Naimark A, Berkeley J, Gordon G, Wilson PWF, Anderson J. Occupational physical demands, knee bending, and knee osteoarthritis: Results from the Framingham study. J Rheumatol 1991; 18: 1587–1592.

    Google Scholar 

  45. Dawson J, Juszczak E, Thorogood M, Marks S-A, Dodd C, Fitzpatrick R. An investigation of risk factors for symptomatic osteoarthritis of the knee in women using a life course approach. J Epidemiol Community Health 2003; 57: 823–830.

    Google Scholar 

  46. Manninen P, Heliovaara M, Riihimaki H, Suoma-Iainen O. Physical workload and the risk of severe knee osteoarthritis. Scand J Work Environ Health 2002; 28(1): 25–32.

    Google Scholar 

  47. Teichtahl A, Wluka A, Cicuttini FM. Abnormal biomechanics: A precursor or result of knee osteoarthritis? Br J Sports Med 2003; 37: 289–290.

    Google Scholar 

  48. Kerrigan DC, Todd MK, Riley PO. Knee osteoarthritis and high-heeled shoes. Lancet 1998; 351: 1399–1401.

    Google Scholar 

  49. Baker P, Coggon D, Reading I, Barrett D, McLaren M, Cooper C. Sports injury, occupational physical activity, joint laxity and meniscal damage. J Rheumatol 2002; 29: 557–563.

    Google Scholar 

  50. Chen JC, Denneriein JT, Shih TS, Chen CJ, Cheng YM, Chang WP, Ryan LM, Christiani, DC. Knee pain and driving duration: A secondary analysis of the taxi drivers’ health study. Am J Public Health 2004; 94(4): 575–581.

    Google Scholar 

  51. Miranda H, Vikari-Juntura E, Martikainen R, Riihimaki H. A prospective study on knee pain and its risk factors. Osteoarthritis Cartilage 2002; 10: 623–630.

    Google Scholar 

  52. Jensen LK, Mikkelsen S, Loft IP, Eenberg W. Work-related knee disorders in floor layers and carpenters. JOEM 2000; 42(8): 835–842.

    Google Scholar 

  53. Lagerstrom M, Wenemark M, Hagberg M, Hjelm EW. Occupational and individual factors related to musculoskeletal symptoms in five body regions among Swedish nursing personnel. Int Arch Occup Environ Health 1995; 68: 27–35.

    Google Scholar 

  54. Sobti A, Cooper C, Inskip H, Searle S, Coggon D. Occupational physical activity and long-term risk of musculoskeletal symptoms: A national survey of post office pensioners. Am J Ind Med 1997; 32: 76–83.

    Google Scholar 

  55. Tuchsen F, Hannerz H, Jensen MV, Krause N. Socioeconomic status, occupation and risk of hospitalization due to coxarthrosis in Denmark 1981–99. Ann Rheum Dis 2003; 62: 1100–1105.

    Google Scholar 

  56. Croft P, Cooper C, Wickham C, Coggon D. Osteoarthritis of the hip and occupational activity. Scand J Work Environ Health 1992; 18: 59–63.

    Google Scholar 

  57. Roach KE, Persky V, Miles T, Budiman-Mak E. Biomechanical aspects of occupation and osteoarthritis of the hip: A case-control study. J Rheumatol 1994; 21: 2334–2340.

    Google Scholar 

  58. Pope DP, Hunt IM, Birrell FN, Silman AJ, Macfarlane GJ. Hip pain onset in relation to cumulative workplace and leisure time mechanical load: A population based case-control study. Ann Rheum Dis 2003; 62: 322–326.

    Google Scholar 

  59. Tuchsen F, Hannerz H, Burr H, Lund T, Krause N. Risk factors predicting hip pain in a 5-year prospective cohort study. Scand J Work Environ Health 2003; 29(1): 35–39.

    Google Scholar 

  60. Toren A, Oberg K, Lembke B, Enlund K, Rask-Andersen A. Tractor-driving hours and their relation to self-reported low-back and hip symptoms. Appl Ergon 2002; 33: 139–146.

    Google Scholar 

  61. Wiktorin C, Hjelm EW, Winkel J, Koster M, Stockholm MUSIC I Study Group. Reproducibility of a questionnaire for assessment of physical load during work and leisure time. JOEM 1996; 38(2): 190–201.

    Google Scholar 

  62. Wiktorin C, Karlqvist L, Winkel J, Stockholm MUSIC I study group. Scand J Work Environ Health 1993; 19: 208–214.

    Google Scholar 

  63. Keyserling WM, Brouwer M, Silverstein BA. A checklist for evaluating ergonomic risk factors resulting from awkward posture of the legs, trunk and neck. Int J Ind Ergon 1992; 9: 283–301.

    Google Scholar 

  64. Kivimaki J. Occupationally related ultrasonic findings in carpet and floor layers’ knees. Scand J Work Environ Health 1992; 34(5): 496–499.

    Google Scholar 

  65. Myllymaki T, Tikkakoski T, Typpo T, Kivimaki J, Suramo I. Carpet-layer’s knee: An ultrasonographic study. Acta Radiol 1993; 18: 400–402.

    Google Scholar 

  66. Madeleine P, Voigt M, Arendt-Nielsen L. Subjective, physiological and biomechanical responses to prolonged manual work performed standing on hard and soft surfaces. Eur J Appl Physiol 1998; 77: 1–79.

    Google Scholar 

  67. Krause N, Kaplan GA, Cohen RD, Salonen R, Salonen JT. Standing at work and progression of carotid atherosclerosis. Scand J Work Environ 2000; 26(3): 227–236.

    Google Scholar 

  68. Krijnen RM, de Boer EM, Ader HJ, Bruynzeel DP. Venous insufficiency in male workers with a standing profession. Part 1: Epidemiology. Dermatology 1997; 194(2): 111–120.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

D’Souza, J.C., Franzblau, A. & Werner, R.A. Review of Epidemiologic Studies on Occupational Factors and Lower Extremity Musculoskeletal and Vascular Disorders and Symptoms. J Occup Rehabil 15, 129–165 (2005). https://doi.org/10.1007/s10926-005-1215-y

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-005-1215-y

Keywords

Navigation