Review of occupational risk factors associated with osteoarthritis of the hip

Project No. IFA 1110


completed 12/2011


Coxarthritis (osteoarthritis of the hip) is still not fully understood. Many studies exist which describe various influencing factors as being the cause of this widespread disease. Occupational and non-occupational factors are considered possible causes, and a genetic predisposition is regarded as a possible influencing factor. Exposures leading to coxarthritis are difficult to quantify, since multiple workload factors are often present simultaneously. In addition, a weakness in diagnosis leads to false interpretations.
The objective of the project was to write a systematic review on occupational risk factors associated with coxarthritis, and to deliver recommendations for effective prevention in practical occupational safety and health. The relevant epidemiological studies in the international literature were analysed and reviewed with regard to whether an exposure-risk relationship can be derived from them. Possible prevention measues and recommendations for further research were derived.


The studies of relevance to the subject were identified through comprehensive literature searches and selected for critical evalutation by the following selection criteria: quantitative or semi-quantitative exposure estimates and described diagnostic criteria for coxarthritis. The 30 studies which satisfied these criteria were analysed and evaluated both quantitatively and qualitatively. Six studies out of them were identified as being acceptable for quantitative risk assessment. The 30 studies are summarized. The project was conducted by ENVIRON, co-ordinated by the Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), and consulted by an expert working group.
The review was published in 2012.


The results from the 30 studies selected are too heterogeneous in diagnosis of coxarthritis and assessment of workload exposures to develop a quantitative exposure-risk relationship. A clear trend is however evident, that heavy lifting and carrying or standing over long periods may increase the risk of coxarthritis. The prevention approaches should therefore concentrate on limiting the duration and amount of these activities as much as possible. Future studies should focus more on qualitative and quantitative exposure assessment. Diagnostic criteria should be documented as precisely and objectively as possible.

Last Update:



Financed by:
  • Deutsche Gesetzliche Unfallversicherung e. V. (DGUV)
Research institution(s):
  • Institut für Arbeitsschutz der Deutschen Gesetzlichen Unfallversicherung (IFA)
  • Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung - Institut der Ruhr-Universität Bochum (IPA)
  • BG BAU - Berufsgenossenschaft der Bauwirtschaft

-cross sectoral-

Type of hazard:

mechanical hazards


Epidemiologie, Arbeitsumwelt (Belastungen, Gefährdungen, Expositionen, Risiken), Ergonomie

Description, key words:

osteoarthritis of the hip, coxarthritis, work-related health hazards, workload, mechanical stress, risk assessment, exposure-risk relationship, systematic review, dose-response-relationship