¹Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
²Technische Universität Dresden, Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine (IPAS), Dresden, Germany
³Institute for Occupational Medicine and Public Health, Saarland University, Homburg/Saar, Germany

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Introduction: Osteoarthritis of the wrist and finger joints is common in the general population. It can lead to significant functional impairments in daily life with pain, joint stiffness, and loss of hand strength. Several non-modifiable factors, such as age, female sex and genetics, are associated with higher prevalence, but local biomechanical stress, including hand-arm vibrations, repetitive movements, force exertion, and impact forces of the hand, can further affect these joints. This systematic review aims to identify occupational exposures as risk factors for osteoarthritis in the wrist or finger joints.

Methods: The protocol for our systematic review was registered in PROSPERO (CRD42024514450). We developed a sensitive search strategy to identify relevant epidemiological observational studies on the association between hand osteoarthritis and occupational exposures. In June 2024, we searched EMBASE, MEDLINE, CINAHL, Web of Science, and EBSCO Open Dissertation. Additionally, we searched Google Scholar and relevant institutional websites for grey literature. Study selection was conducted according to predefined eligibility criteria, which focused on a primary diagnosis of non-inflammatory osteoarthritis as the outcome and occupations or occupational activities as the exposure, thereby increasing specificity. Data on study characteristics, occupational risks, and outcome measures are currently extracted from the included studies. All included studies will be assessed for risk of bias. Study selection, data extraction, and risk of bias evaluation are independently performed by two reviewers. If studies are sufficiently clinically and methodologically homogenous, we will perform a quantitative synthesis and rate the results according to GRADE.

Results: After duplicate removal, the database search resulted in 13,778 references. Another 318 references were identified by screening relevant systematic reviews and Google Scholar. As a result, 38 publications, representing 22 individual studies, met the eligibility criteria and were included for data extraction.

The included studies were published between 1952 and 2023. Most studies focus on European populations, with the majority conducted in Scandinavian countries and only a few in other parts of Europe. Further studies were conducted in the United States, Japan, and China. About two-thirds of the studies are cross-sectional, while only some are cohort or case-control studies. Most frequently, exposure to hand-arm vibrations or multiple simultaneous exposures was studied. Radiologically confirmed osteoarthritis was reported as the most common outcome. However, only a few studies focused on specific joints and disease stages, while the majority of studies reported osteoarthritis in either the wrist or finger joints without further specification.

Discussion: The included studies show high heterogeneity in exposure and outcome definitions. They evaluate various joints of the hand and fingers, along with different stages and symptoms of osteoarthritis. Furthermore, occupational exposures are often mixed, making summarizing the evidence challenging.