title: Racial differences in knee osteoarthritis pain: potential contribution of occupational and household tasks.
abstract: OBJECTIVE
  We examined whether occupational and household tasks contributed to differences in pain between African Americans and whites with radiographic knee osteoarthritis (OA).
  
  
  METHODS
  Participants from the Johnston County Osteoarthritis Project self-reported the frequency (often/always vs never/seldom/sometimes) of performing 9 occupational tasks involving lower extremity joint loading at their longest job (N = 868) and current job (N = 273), as well as 8 household tasks ever performed (N = 811) and currently being performed (N = 767). The associations of the numbers of occupational or household tasks with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale were first examined in simple linear regression models. If significantly associated with greater pain, each of these was included in adjusted linear regression models to examine whether the association of race with pain remained statistically significant.
  
  
  RESULTS
  African Americans reported significantly greater WOMAC pain scores than whites. Exposures to more occupational tasks at the longest job and the current job were associated with greater WOMAC pain scores (p < 0.01). The association of race with greater pain scores remained statistically significant when controlling for occupational tasks at the longest job, but was reduced by 26% and no longer significant when controlling for the number of current occupational tasks. Exposures to an increasing number of household tasks were associated with lower pain scores and were not further analyzed.
  
  
  CONCLUSIONS
  Current performance of physically demanding occupational tasks contributed to racial differences in pain severity among individuals with knee OA. Better workplace policies to accommodate OA-related limitations may help to reduce racial differences in pain.
authors: Health Services Research and Development Service, Durham Veterans Affairs Medical Center, Durham, North Carolina 27705, USA. kelli.allen@duke.edu
authors: Kelli D
authors: KD
authors: Allen
authors: Jiu-Chiuan
authors: JC
authors: Chen
authors: Leigh F
authors: LF
authors: Callahan
authors: Yvonne M
authors: YM
authors: Golightly
authors: Charles G
authors: CG
authors: Helmick
authors: Jordan B
authors: JB
authors: Renner
authors: Todd A
authors: TA
authors: Schwartz
authors: Joanne M
authors: JM
authors: Jordan
mesh_terms: D000368:Aged; D044383:Black People / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000503:physiopathology*; D010146:Pain / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000503:physiopathology*; D011859:Radiography; D012720:Severity of Illness Index; D013647:Task Performance and Analysis; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American