Knee osteoarthritis in a chestnut farmer - Case Report.

INTRODUCTION: Several studies have dealt with the issue of professional risk factors and onset of knee osteoarthritis (OA). In particular, occupational epidemiological studies have provided evidence that activities resulting in biomechanical overload may be linked with an increased risk of knee OA - also among farmers. To our knowledge, no cases of knee OA among chestnut farmers have been reported in the literature. CASE REPORT: We report the case of a 70-year-old Caucasian male who has worked for more than 50 years on a chestnut farm. In 2007, an X-ray and a MRI, performed after a workplace accident to his left knee, showed the presence of knee OA. His job required a range of repetitive tasks, such as squatting, kneeling, climbing, walking on sloping terrain, assuming uncomfortable postures, and lifting and carrying heavy loads for the great majority of the working day. All the aforementioned tasks are known occupational risk factors for knee OA. Regarding individual risk factors, at the time of the first diagnosis of knee OA, the worker was 64-years-old with a body mass index of 26.5 kg/m2. He reported no cases of arthritis among his relatives and no sports playing on his part. In addition, his medical history revealed the presence of two minor lumbar disc herniations and tendinitis of the long head of the biceps. CONCLUSION: Considering the lack of major individual risk factors for knee OA, it is reasonable to suppose that five decades of exposure to biomechanical overload as a chestnut farmer was a relevant risk factor for the onset of the disease.

[Efficiency of health surveillance in occupational medicine]. / Efficacia della sorveglianza sanitaria in Medicina del Lavoro.

Medical surveillance is one of the primary instruments in occupational health activities and is considered essential to maintain employees' good health. However, the efficacy of medical surveillance has not been sufficiently tested. The aim of this review was to evaluate the usefulness of medical surveillance, using available literature on Pubmed for the period 2005 to 2014. Although on the basis of a small number of studies, our conclusion is that medical surveillance could be considered effective. Apart from the case of occupational asthma, it must be emphasised that the number of evaluation studies is small, especially in some areas, as well as the one of biomechanical overload.

[Musculoskeletal disorders in farmers]. / Patologie muscoloscheletriche in agricoltura.

Musculoskeletal disorders are a relevant issue among farmers. From the literature it emerges a convincing evidence for an association of arthritis of the hip and work in the agricultural sector, while there is a less evidence when studying knee osteoarthritis and farming. For what concerns cervicobrachial pain, current available epidemiological data are not sufficient to define farmers at risk. Moreover, there is uncertainty about the role of hand-arm vibration as a strong risk factor among farmers. Overall, the high occurrence of musculoskeletal disorders among farmers highligths the need for more specific studies in order to assess the various tasks performed by agricultural workers from which to derive appropriate prevention interventions.