Dataset Information

Arthritis diagnosis and symptoms are positively associated with specific physical job exposures in lower- and middle-income countries: cross-sectional results from the World Health Organization's Study on global AGEing and adult health (SAGE).

ABSTRACT:

Background

In higher income countries, work-related squatting and heavy lifting have been associated with increased arthritis risk. Here, we address the paucity of data regarding associations between arthritis and work-related physical stressors in lower- and middle-income countries.

Methods

Data were extracted from the Study on global AGEing and adult health (SAGE) Wave 1 (2007-10) for adults (aged ?50 years) from Ghana, India, Russia and South Africa for whom detailed occupation data was available (n?=?21,389; 49.2% women). Arthritis cases were identified using a symptom-defined algorithm (current) and self-reported doctor-diagnosis (lifetime). A sex-specific Job Exposure Matrix was used to classify work-related stressors: heavy physical work, kneeling/squatting, heavy lifting, arm elevation and awkward trunk posture. Using the International Standard Classification of Occupations, we linked SAGE and the Job Exposure Matrix. Logistic regression was used to investigate associations between arthritis and work-related stressors, adjusting for age (10 year age groupings), potential socioeconomic-related confounders, and body mass index. Excess exposure risk due to two-way interactions with other risk factors were explored.

Results

Doctor-diagnosed arthritis was associated with heavy physical work (adjusted odds ratios [OR] 1.12, 95%CI 1.01-1.23), awkward trunk posture (adjusted OR 1.23, 95%CI 1.12-1.36), kneeling or squatting (adjusted OR 1.25, 95%CI 1.12-1.38), and arm elevation (adjusted OR 1.66, 95%CI 1.37-2.00). Symptom-based arthritis was associated with kneeling or squatting (adjusted OR 1.27, 95%CI 1.08-1.50), heavy lifting (adjusted OR 1.33, 95%CI 1.11-1.58), and arm elevation (adjusted OR 2.16, 95%CI 1.63-2.86). Two-way interactions suggested excess arthritis risk existed for higher body mass index, and higher income or education.

Conclusions

Minimization of occupational health risk factors is common practice in higher income countries: attention should now be directed toward reducing work-related arthritis burden in lower- and middle-income countries.

SUBMITTER: Brennan-Olsen SL

PROVIDER: S-EPMC5994040 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Arthritis diagnosis and symptoms are positively associated with specific physical job exposures in lower- and middle-income countries: cross-sectional results from the World Health Organization's Study on global AGEing and adult health (SAGE).

Brennan-Olsen Sharon L SL Solovieva Svetlana S Viikari-Juntura Eira E Ackerman Ilana N IN Bowe Steven J SJ Kowal Paul P Naidoo Nirmala N Chatterji Somnath S Wluka Anita E AE Leech Michelle T MT Page Richard S RS Sanders Kerrie M KM Gomez Fernando F Duque Gustavo G Green Darci D Mohebbi Mohammadreza M

BMC public health 20180608 1

<h4>Background</h4>In higher income countries, work-related squatting and heavy lifting have been associated with increased arthritis risk. Here, we address the paucity of data regarding associations between arthritis and work-related physical stressors in lower- and middle-income countries.<h4>Methods</h4>Data were extracted from the Study on global AGEing and adult health (SAGE) Wave 1 (2007-10) for adults (aged ≥50 years) from Ghana, India, Russia and South Africa for whom detailed occupation ...[more]

PMID: 29884171

Similar Datasets

Project description:Background: Recent studies suggest the importance of distinguishing the severity levels of disability in the older adult population. However, there is still no consensus regarding an optimal classification. Few studies have estimated the prevalence of severe disability, and the results have been confined to high-income countries. There is no evidence for low- and middle-income countries (LMICs). Therefore, the aim of this study was to provide estimates of the levels of severity associated with disability in older adult populations in LMICs and to examine their relationship with health and socioeconomic factors. Methods: We used data from the Study on global AGEing and adult health (SAGE), wave 1 (2007-2010). Nationally representative samples of adults over 50 years from China, Ghana, India, Mexico, Russian Federation, and South Africa were analyzed (n = 33,641). We measured disability using the World Health Organization Disability Assessment Instrument version 2.0 (WHODAS 2.0). Disability levels according to severity were identified through the use of latent class analysis. Socioeconomic and health factors associated with severe disability were estimated using ordinal logistic regression models. Results: We identified four groups of older adult: (1) without disability, 43.4%; (2) mild disability, 33.3%; (3) moderate disability, 15.3%; and (4) severe disability, 8.0%. These results were heterogeneous for the six countries analyzed. Education and socioeconomic status were significantly associated with severe disability along with the following chronic conditions: angina, arthritis, asthma, cataracts, chronic obstructive pulmonary disease, depression, diabetes, and stroke. Severe disability was also associated with the frailty status, sarcopenia, and mild cognitive impairment. Conclusions: In this study, we estimated severity levels of disability for the older adult population in LMICs. Our results show that severe disability affects 8% of older adult, and that there are important socioeconomic and health factors associated with this condition. Measuring the severity of disability is a critical element to study the causes and consequences of aging. Moreover, the identification of older adult with severe disability is vital to design prevention programs, modify interventions, or develop enabling environments.

Project description:Organ transplantation has become an effective means to extend lives; however, a major obstacle is the lack of availability of cadaveric organs. India has one of the lowest cadaver organ donation rates in the world. If India could increase the donor rate, the demand for many organs could be met. Evidence from high-income countries suggests that an organ donor registry can be a valuable tool for increasing donor rates. The purpose of this study is to determine whether the implementation of an organ donor registry is a feasible and appropriate policy option to enhance cadaver organ donation rates in a lower-income country.This qualitative policy analysis employs semi-structured interviews with physicians, transplant coordinators, and representatives of organ donation advocacy groups in Mumbai. Interviews were designed to better understand current organ donation procedures and explore key informants' perceptions about Indian government health priorities and the likelihood of an organ donor registry in Mumbai. The 3-i framework (ideas, interests, and institutions) is used to examine how government decisions surrounding organ donation policies are shaped.Findings indicate that organ donation in India is a complex issue due to low public awareness, misperceptions of religious doctrines, the need for family consent, and a nation-wide focus on disease control. Key informants cite social, political, and infrastructural barriers to the implementation of an organ donor registry, including widely held myths about organ donation, competing health priorities, and limited hospital infrastructure.At present, both the central government and Maharashtra state government struggle to balance international pressures to improve overall population health with the desire to also enhance individual health. Implementing an organ donor registry in Mumbai is not a feasible or appropriate policy option in India's current political and social environment, as the barriers, identified through the 3-i framework lens, may be too difficult to overcome. Despite the evidence supporting the use of donor registries as a means to enhance organ donation rates, it is clear that context is critical and that it is not always practical to apply evidence-based policy solutions from high-income countries to lower-income settings.

Project description:ImportanceMany randomized clinical trials (RCTs) led by high-income countries (HICs) now enroll patients from lower middle-income countries (LMICs) and upper middle-income countries (UMICs). Although enrolling diverse populations promotes research collaborations, there are issues regarding which countries participate in RCTs and how this participation may contribute to global research.ObjectiveTo describe which UMICs and LMICs participate in RCTs led by HICs.Design, setting, and participantsA cross-sectional study of all oncology RCTs published globally during January 1, 2014, to December 31, 2017, was conducted. The study cohort was restricted to RCTs led by HICs that enrolled participants from LMICs and UMICs. Study analyses were conducted in November 1, 2021, to May 31, 2022.Main outcomes and measuresA bibliometric approach (Web of Science 2007-2017) was used to explore whether RCT participation was proportional to other measures of cancer research activity. Participation in RCTs (ie, percentage of RCTs in the cohort in which each LMIC and UMIC participated) was compared with country-level cancer research bibliometric output (ie, percentage of total cancer research bibliometric output from the same group of countries that came from a specific LMIC and UMIC).ResultsAmong the 636 HIC-led RCTs, 186 trials (29%) enrolled patients in LMICs (n = 84 trials involving 11 LMICs) and/or UMICs (n = 181 trials involving 26 UMICs). The most common participating LMICs were India (42 [50%]), Ukraine (39 [46%]), Philippines (23 [27%]), and Egypt (12 [14%]). The most common participating UMICs were Russia (115 [64%]), Brazil (94 [52%]), Romania (62 [34%]), China (56 [31%]), Mexico (56 [31%]), and South Africa (54 [30%]). Several LMICs are overrepresented in the cohort of RCTs based on proportional cancer research bibliometric output: Ukraine (46% of RCTs but 2% of cancer research bibliometric output), Philippines (27% RCTs, 1% output), and Georgia (8% RCTs, 0.2% output). Overrepresented UMICs include Russia (64% RCTs, 2% output), Romania (34% RCTs, 2% output), Mexico (31% RCTs, 2% output), and South Africa (30% RCTs, 1% output).Conclusions and relevanceIn this cross-sectional study, a substantial proportion of RCTs led by HICs enrolled patients in LMICs and UMICs. The LMICs and UMICs that participated in these trials did not match overall cancer bibliometric output as a surrogate for research ecosystem maturity. Reasons for this apparent discordance and how these data may inform future capacity-strengthening activities require further study.

Dataset Information

Arthritis diagnosis and symptoms are positively associated with specific physical job exposures in lower- and middle-income countries: cross-sectional results from the World Health Organization's Study on global AGEing and adult health (SAGE).

Background

Methods

Results

Conclusions

Publications

Arthritis diagnosis and symptoms are positively associated with specific physical job exposures in lower- and middle-income countries: cross-sectional results from the World Health Organization's Study on global AGEing and adult health (SAGE).

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets