title: Associations of work activities requiring pinch or hand grip or exposure to hand-arm vibration with finger and wrist osteoarthritis: a meta-analysis.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors: Department for Occupational and Environmental Medicine, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark. paulahammer@dadlnet.dk.
authors: Paula E C
authors: PE
authors: Hammer
authors: Rahman
authors: R
authors: Shiri
authors: Ann I
authors: AI
authors: Kryger
authors: Lilli
authors: L
authors: Kirkeskov
authors: Jens Peter
authors: JP
authors: Bonde
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D053421:Hand-Arm Vibration Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D010003:Osteoarthritis / Q000453:epidemiology* / Q000209:etiology; D052581:Pinch Strength; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D012737:Sex Factors; D014732:Vibration / Q000009:adverse effects*; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*