title: Analysis of the Third National Health and Nutrition Examination Survey (NHANES III) using expert ratings of job categories.
abstract: BACKGROUND
  Few epidemiologic studies have addressed the exposure-response relationships between work activities and symptomatic knee osteoarthritis (OA). This analysis used data from a national survey and ergonomists' ratings to address this issue.
  
  
  METHODS
  Interview and knee X-ray data were obtained from the Third National Health and Nutrition Examination Survey. Occupational ratings were obtained using ergonomists. A weighted logistic regression was used.
  
  
  RESULTS
  Among men, a significant exposure-response relationship was found between symptomatic knee OA and kneeling. In both genders, there was a significant trend in heavy lifting and severe symptomatic knee OA. Approximately 20.7% of knee OA can be attributed to kneeling >14% of the workday among men.
  
  
  CONCLUSIONS
  The significant exposure-response relationships suggest that modest reductions in certain occupational activities can reduce the burden of knee OA. The study was limited by unvalidated expert ratings. Research is needed to identify hazardous characteristics of work activities and to clarify exposure-response relationships.
authors.affiliation: Department of Environmental Health Sciences, The University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: D'Souza
authors.forename: Robert A
authors.initials: RA
authors.lastname: Werner
authors.forename: W Monroe
authors.initials: WM
authors.lastname: Keyserling
authors.forename: Brenda
authors.initials: B
authors.lastname: Gillespie
authors.forename: Randall
authors.initials: R
authors.lastname: Rabourn
authors.forename: Sheryl
authors.initials: S
authors.lastname: Ulin
authors.forename: Alfred
authors.initials: A
authors.lastname: Franzblau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017770:Lifting; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009784:Occupational Diseases / Q000453:epidemiology; D016273:Occupational Exposure; D016017:Odds Ratio; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011859:Radiography; D012720:Severity of Illness Index; D013647:Task Performance and Analysis; D014481:United States / Q000453:epidemiology