Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers
Helena Johansson,1,2,9 Cecilie Hongslo Vala,2 Anders Odén,3 Mattias Lorentzon,2,9 Eugene McCloskey,3 John A Kanis,1,3 Nicholas C Harvey,4,5 Claes Ohlsson,8 L Stefan Lohmander,6 Johan Kärrholm,7 and Dan Mellström2,9Hip
Purpose
The risks of hip fracture and hip arthroplasty are influenced by factors including socioeconomic status, education, urbanization, latitude of residence, and physical activity. Farming is an occupation encompassing rural living and high level of physical activity. Therefore, we aimed to study the risk of hip fracture and risk of hip arthroplasty amongst farmers in Sweden.
Methods
We studied the risk of hip fracture, and hip arthroplasty due to primary osteoarthritis, in all men and women aged 35 years or more in Sweden between 1987 and 2002. Documented occupations were available in 3.5 million individuals, of whom 97,136 were farmers. The effects of age, sex, income, education, location of residence and occupation on risk of hip fracture or hip arthroplasty were examined using a modification of Poisson regression.
Results
4,027 farmers and 93,109 individuals with other occupations sustained a hip fracture, while 5,349 farmers and 63,473 others underwent a hip arthroplasty. Risk of hip fracture was higher with greater age, lower income, lower education, higher latitude and urban area for all men and women. Compared to all other occupations, male farmers had a 20% lower age-adjusted risk of hip fracture (hazard ratio (HR) 0.80, 95%CI 0.77-0.84), an effect that was not seen in female farmers (HR 0.96, 95% CI 0.91-1.01). Both male and female farmers had a higher age-adjusted risk for hip arthroplasty.
Conclusions
Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.
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