Wednesday, May 25, 2005

Arthritis Month - Ignoring Root Causes (I)

BrooklynDodger found an interesting post relevent to ergonomics on the Occupational Medicine listserve:
Original post [summary];

Notice to Readers: National Arthritis Month --- May 2005

May is National Arthritis Month. This year, the Arthritis Foundation is urging persons with arthritis to get active for better health. [actually, recommendations look to be for preventing arthritis] Regular moderate physical activity improves the health and function of joints and reduces the risk for other chronic conditions. Physical activity helps protect joints by strengthening muscles and improving balance and joint nutrition, which leads to better flexibility, joint motion, and physical function. Long-term benefits include reduced pain, improvedmental health, and delayed disability (1). Walking is an ideal activity for most persons with arthritis because itis low impact, can be incorporated into usual daily activities, and does not require special equipment or facilities. A free copy of the Arthritis Today Walking Guide is available at CDC, along with 36 state arthritisprograms, the Arthritis Foundation, and other organizations, continue toimplement the National Arthritis Action Plan.

National arthritis action plan: a public healthstrategy. Atlanta, GA: Arthritis Foundation; 1999. Available at

What was missing was ergonomics and occupational exposure. The reply to the list serve noted

"I was irritated enough to download the Arthritis Foundation action plan and
skim it. The plan does mention occupational injury in the middle of the
pack for causes of arthritis, maybe as much as half a page in a 64 page
document, with no action items related.

"This is the same old same old blame the victim, exhortation approach to
public health which dominates all CDC health communications. Although
the action plan mentions "primary prevention," it's mostly obesity and
exercise. Scientifically, it would be nice if CDC would calculate
whether routine factory and construction work, for example, meet their
guidelines for exercise. Before they dog people who are pounding steel
10 hours on the assembly line for not training for marathons afterwards,
figure out how many METS are expended and whether they are meeting the
walking quota quoted below."

BrooklynDodger had recently posted a commentary showing that jobs with knee bending were associated with increased knee osteoarthritis. An acquaintance with bad knees told the Dodger that medical advice was that causes were hereditary, with no mention of occupation.

Maybe the Dodger's frustration with CDC and the Arthritis Foundation is misplaced. About 60% of the workforce is in executive, professional, administrative and technical jobs, mostly jobs with no special physical demands [other than prolonged static posture of the upper body.] About 18% of people are in operator and assembler jobs, and some of them are not specially stressful. So maybe occupational ergonomics is just left out because it's a minority's problem, and a less than elite minority as well.

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