The Epidemiology and Risk of Developing Osteoarthritis among Albertan Farm Residents
Creators: Rahmanzadeh Koucheh, Elaheh
Publisher: name: University of Alberta Library
Year: 2023

<p>Background<br>
In Canada, approximately 3.9 million cases of osteoarthritis (OA) were reported in individuals aged 20 years or more, which highlights OA as a type of joint disease characterized by degeneration that significantly impacts a considerable portion of the population. According to estimates, the prevalence of OA in Canada will rise to 25% of the total population and nearly 30% of the workforce by 2040. However, certain groups may be at a higher risk for developing this condition, including farmers who engage in repetitive manual tasks and experience prolonged periods of kneeling, standing, or heavy lifting. The physical demands of farming can lead to increased strain on the joints, making farmers more susceptible to developing OA. Despite the farmers are a critical component of the Canadian economy, and their physical health is essential to maintaining productivity and economic growth, insufficient research has been conducted on OA among this particular high-risk group in Canada.<br>
Objectives<br>
This study aimed to estimate the risk of developing OA in individuals who are 20 years of age or older and reside on farms in Alberta and compared to non-farm rural and urban cohorts. Other objectives for this study include estimating the age-sex-specific incidence rate of OA, the lifetime risk of developing OA, and the non-injury mortality rate over 21 years.<br>
Method<br>
A historical cohort study was implemented, using a large sample (n = 430,293) of three cohorts: the farm, non-farm rural, and urban cases from Alberta administrative databases for the fiscal years 2000-2001 through 2020-2021. Case ascertainment for OA was defined by an algorithm that consisted of one hospital admission, two physician visits within a two-year interval, or two ambulatory care visits within two years. Using person-years (PYs) of follow-up as the denominator, crude incidence, age-sex-specific incidence, lifetime risk, and mortality rates of OA were estimated. To account for the effect of residency on the development of OA, Cox proportional hazard model was applied.<br>
Results<br>
The results of this study identified 26,957 cases of OA in the farm cohort over 1,706,256 PYs of follow-up, with an overall incidence rate of 14.72 (95% CI: 14.51, 14.93) per 1000 PYs during the 21 years. The crude incidence rate of OA in the farm cohort was 10.58 (95% CI: 9.79, 11.36) per 1000 PYs in 2021. The risk of developing OA was determined 6% (95% CI: 4, 8) and 9% (95% CI: 7, 12) greater for farm and non-farm rural populations than for the urban cohort, respectively, after adjusting for age and sex. Farm residents were observed to have a higher mortality-adjusted lifetime risk of developing OA (27.7%) than their non-farm rural and urban counterparts. Non-injury mortality among farm residents with OA was found to be 13.16 (95% CI: 12.87, 13.45) per 1000 PYs.<br>
Conclusion<br>
This study contributes significant findings on the incidence and impact of OA among farmers in Alberta. Our findings indicate that individuals residing in rural areas, including farmers, are at a higher risk of developing OA compared to the urban group. The higher mortality-adjusted lifetime risk of developing OA among farm residents highlights the necessity of specific interventions aimed at reducing the impact of this condition in rural communities. Further research is required to identify specific occupational and lifestyle risk factors associated with OA among farmers and to develop effective strategies for prevention and management.</p>