Zdravstveni radnici i osteoartritis kolena: april kao podsetnik na zanemareni rizik
Sažetak
Iako se često posmatra kao oboljenje opšte populacije, klinička zapažanja ukazuju na to da značajan deo pregleda zbog bola u kolenu usled osteoartritisa obuhvata upravo zaposlene u zdravstvu, što upućuje na moguće opterećenje koje prevazilazi očekivani nivo za odrasle osobe istog životnog doba. U postojećim istraživanjima navodi se visoka učestalost simptoma oboljenja kolena kod zdravstvenih radnika, uključujući prevalenciju od 47% za mišićno‑skeletne poremećaje kolena povezanih sa poslom kod perioperativnih medicinskih sestara. Međutim, ova istraživanja se bave simptomima, a ne dijagnostikovanim osteoartritisom, ostavljajući nedovoljno ispitan stvarni teret strukturnog oboljenja u toj populaciji. Radne obaveze koje uključuju dugotrajno stajanje, intenzivno hodanje, često okretanje, klečanje, čučanje i fizički zahtevno zbrinjavanje bolesnika, nameću trajno opterećenje koje može ubrzati degeneraciju zgloba. Povećanje starosne granice za penzionisanje dodatno produžava godine izloženosti, povećavajući rizik od hroničnih mišićno‑skeletnih oboljenja. Uprkos tome, osteoartritis kolena ostaje uglavnom odsutan iz politika zaštite na radu. Intervencije na radnom mestu čiji troškovi nisu veliki, poput struktuiranih pauza za kretanje, kratkih vežbi snage i dosledne upotrebe pomagala, predstavljaju obećavajuće pristupe, iako su trenutni dokazi ograničeni i potrebna su dalja istraživanja radi potvrde njihovog preventivnog efekta. Zakonom regulisane mere, poput skraćenog radnog vremena za starije radnike, mogu dodatno smanjiti kumulativno opterećenje. Nova tehnološka rešenja, uključujući pomoć robota u zbrinjavanju bolesnika, pokazuju potencijal za smanjenje izloženosti velikim silama. Prepoznavanje osteoartritisa kolena kao problema profesionalnog rizika koji se može sprečiti, ključno je za očuvanje pokretljivosti, dobrobiti i dugoročne radne sposobnosti zdravstvenog kadra.
Reference
Gorce P, Jacquier-Bret J. Continental effect on work-related musculoskeletal disorders prevalence among nurses: systematic review and meta-analysis. BMC Nurs 2025; 24(1): 1335. DOI: 10.1186/s12912-025-03945-6.
Chen CY, Lu SR, Yang SY, Liang FW, Wang JJ, Ho CH, et al. Work-related musculoskeletal disorders among physical thera-pists in Taiwan. Medicine (Baltimore) 2022; 101(7): e28885. DOI: 10.1097/MD.0000000000028885.
Khadour FA, Khadour YA, Alawdi SA. Prevalence of Work-Related Musculoskeletal Disorders and Associated Factors Among Doctor of Physical Therapy in Syria: A Cross-Sectional Study. Health Sci Rep 2025; 8(5): e70767. DOI: 10.1002/hsr2.70767.
Attar SM. Frequency and risk factors of musculoskeletal pain in nurses at a tertiary centre in Jeddah, Saudi Arabia: a cross sectional study. BMC Res Notes 2014; 7: 61. DOI: 10.1186/1756-0500-7-61.
Gandolfi MG, Zamparini F, Spinelli A, Risi A, Prati C. Muscu-loskeletal Disorders among Italian Dentists and Dental Hy-gienists. Int J Environ Res Public Health 2021; 18(5): 2705. DOI: 10.3390/ijerph18052705.
Britannica Editors. World Health Organization [Internet]. Encyclopedia Britannica; 2026 [cited 2026 March 31; accessed on 2026 Feb 18]. Available from: https://www.britannica.com/topic/World-Health-Organization
GBD 2021 Osteoarthritis Collaborators. Global, regional, and na-tional burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol 2023; 5(9): e508–22. DOI: 10.1016/S2665-9913(23)00163-7.
Sun H, Sun L, Liu M, Zhuang Y, Ning X, Yang H, et al. Global burden of high BMI-related osteoarthritis and causal effects of obesity: a GBD 1990-2021 and bidirectional two-sample Mendelian randomization study. Int J Surg 2025; 111(12): 9110–20. DOI: 10.1097/JS9.0000000000003133.
Ouyang Y, Dai M. Global, regional, and national burden of knee osteoarthritis: findings from the Global Burden of Dis-ease study 2021 and projections to 2045. J Orthop Surg Res 2025; 20(1): 766. DOI: 10.1186/s13018-025-06140-0.
Hart DJ, Doyle DV, Spector TD. Incidence and risk factors for radiographic knee osteoarthritis in middle-aged women: the Chingford Study. Arthritis Rheum 1999; 42(1): 17–24. DOI: 10.1002/1529-0131(199901)42:1<17::AID-ANR2>3.0.CO;2-E.
Fransen M, Agaliotis M, Bridgett L, Mackey MG. Hip and knee pain: role of occupational factors. Best Pract Res Clin Rheu-matol 2011; 25(1): 81–101. DOI: 10.1016/j.berh.2011.01.012.
Tomita R, Sasaki E, Sato E, Sakamoto Y, Kimura Y, Tsushima T, et al. Knee Pain Expansion in Early Osteoarthritis: Findings from Iwaki Cohort Study. J Pain Res 2025; 18: 3643–52. DOI: 10.2147/JPR.S526036.
Neogi T, Felson D, Niu J, Nevitt M, Lewis CE, Aliabadi P, et al. Association between radiographic features of knee osteoarthri-tis and pain: results from two cohort studies. BMJ 2009; 339: b2844. DOI: 10.1136/bmj.b2844.
Alexopoulos EC, Tanagra D, Detorakis I, Gatsi P, Goroyia A, Michalopoulou M, et al. Knee and low back complaints in pro-fessional hospital nurses: occurrence, chronicity, care seeking and absenteeism. Work 2011; 38(4): 329–35. DOI: 10.3233/WOR-2011-1136.
Gold JE, Kurowski A, Gore RJ; ProCare Research Team; Punnett L. Knee pain in nursing home workers after implementation of a safe resident handling program. Am J Ind Med 2018; 61(10): 849–60. DOI: 10.1002/ajim.22902.
Clari M, Godono A, Garzaro G, Voglino G, Gualano MR, Migliaretti G, et al. Prevalence of musculoskeletal disorders among perioperative nurses: a systematic review and META-analysis. BMC Musculoskelet Disord 2021; 22(1): 226. DOI: 10.1186/s12891-021-04057-3.
Hashmi A, Scott S, Jung M, Meng QJ, Tobias JH, Beynon RA, et al. Associations between work characteristics and osteoarthri-tis: A cross-sectional study of 285,947 UK Biobank partici-pants. Osteoarthr Cartil Open 2025; 7(1): 100565. DOI: 10.1016/j.ocarto.2025.100565.
Wang X, Perry TA, Arden N, Chen L, Parsons CM, Cooper C, et al. Occupational Risk in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Observational Studies. Arthritis Care Res (Hoboken) 2020; 72(9): 1213–23. DOI: 10.1002/acr.24333.
Jensen LK. Knee osteoarthritis: influence of work involving heavy lifting, kneeling, climbing stairs or ladders, or kneel-ing/squatting combined with heavy lifting. Occup Environ Med 2008; 65(2): 72–89. DOI: 10.1136/oem.2007.032466.
Voinier D, Neogi T, Master H, Thoma LM, Brunette M, Jakiela J, et al. Sitting may increase risk for radiographic incidence and progression of knee osteoarthritis over 2 years: Data from a large cohort study. Musculoskeletal Care 2023; 21(4): 1075–84. DOI: 10.1002/msc.1786.
Wang Y, Zhang Y, Zhao C, Cai W, Wang Z, Zhao W. Physical Activity, Sedentary Behavior, and Osteoarthritis: A Two-Sample Mendelian Randomization Analysis. Iran J Public Health 2023; 52(10): 2099–108. DOI: 10.18502/ijph.v52i10.13848.
Janssen TI, Voelcker-Rehage C. Leisure-time physical activity, occupational physical activity and the physical activity para-dox in healthcare workers: A systematic overview of the liter-ature. Int J Nurs Stud 2023; 141: 104470. DOI: 10.1016/j.ijnurstu.2023.104470.
Törnblom M, Haglund E, Bremander A, Nilsdotter A, Andersson ML, Hettiarachchi P, et al. Associations between knee pain and knee-loading physical activities at work and leisure - a cross-sectional study based on accelerometer measurements. BMC Musculoskelet Disord 2025; 26(1): 345. DOI: 10.1186/s12891-025-08589-w.
Legal Information System of the Republic of Serbia. Law on Pension and Disability Insurance 34/03-1, 64/04-3, 84/04-37, 85/05-3, 101/05-28, 63/06-27, 5/09-45, 107/09-179, 30/10-145, 101/10-246, 93/12-180, 62/13-6, 108/13-4, 75/14-13, 142/14-190, 73/18-3, 46/19-159, 86/19-31, 62/21-3, 125/22-222, 138/22-288, 75/23-3, 76/23-3, 94/24-248. Serbia: Official Gazette of the Republic of Serbia. Available from: https://pravno-informacioni-sistem.rs/eli/rep/sgrs/skupstina/zakon/2003/34/1/reg (Ser-bian)
So BCL, Lee EWF, Ng S, Man SS. Prevalence and associated factors of work-related musculoskeletal disorder symptoms amongst emergency medical service workers. Sci Rep 2025; 15(1): 19806. DOI: 10.1038/s41598-025-04945-x.
Andrasfay T. Mismatch Between Physical Health and Job De-mands among Older Workers by Full Retirement Age. Innova-tion in Aging 2021; 5(S1): 905–6. DOI:10.1093/geroni/igab046.3281.
Kang Y, Liu C, Ji Y, Zhang H, Wang Y, Bi W, et al. The burden of knee osteoarthritis worldwide, regionally, and nationally from 1990 to 2019, along with an analysis of cross-national inequalities. Arch Orthop Trauma Surg 2024; 144(6): 2731–43. DOI: 10.1007/s00402-024-05250-4.
Sepehrian R, Aghaei Hashjin A, Farahmandnia H. Nurses' view-point of sustaining work despite musculoskeletal pain: A qual-itative study. J Educ Health Promot 2024; 13: 481. DOI: 10.4103/jehp.jehp_1689_23.
Muraki S, Akune T, Oka H, Mabuchi A, En-Yo Y, Yoshida M, et al. Association of occupational activity with radiographic knee osteoarthritis and lumbar spondylosis in elderly patients of population-based cohorts: a large-scale population-based study. Arthritis Rheum 2009; 61(6): 779–86. DOI: 10.1002/art.24514.
Duong V, Abdel Shaheed C, Ferreira ML, Narayan SW, Venkate-sha V, Hunter DJ, et al. Risk factors for the development of knee osteoarthritis across the lifespan: A systematic review and meta-analysis. Osteoarthritis Cartilage 2025; 33(10): 1162–79. DOI: 10.1016/j.joca.2025.03.003.
Zhang S, Nie M, Peng J, Ren H. Effectiveness of Physical Activ-ity-Led Workplace Health Promotion Interventions: A Sys-tematic Review. Healthcare (Basel) 2025; 13(11): 1292. DOI: 10.3390/healthcare13111292.
Janki S, Mulder EEAP, IJzermans JNM, Tran TCK. Ergonomics in the operating room. Surg Endosc 2017; 31(6): 2457–66. DOI: 10.1007/s00464-016-5247-5.
Vitoulas S, Konstantis V, Drizi I, Vrouva S, Koumantakis GA, Sakellari V. The Effect of Physiotherapy Interventions in the Workplace through Active Micro-Break Activities for Em-ployees with Standing and Sedentary Work. Healthcare (Basel) 2022; 10(10): 2073. DOI: 10.3390/healthcare10102073.
Michael HJ, Pham HD, Li LSK, Semciw AI, Scholes MJ, Hanning-ton M, et al. The Efficacy of Closed Versus Open Kinetic Chain Exercise in Knee Osteoarthritis-A Systematic Review and Meta-Analysis. Physiother Res Int 2025; 30(4): e70105. DOI: 10.1002/pri.70105.
Skovlund SV, Østergaard MSE, Seeberg KGV, Suetta C, Aagaard P, Andersen LL, et al. Workplace-based prevention and man-agement of knee pain: a systematic review. Scand J Work En-viron Health 2025; 51(1): 3–14. DOI: 10.5271/sjweh.4195.
Moseng T, Vliet Vlieland TPM, Battista S, Beckwée D, Bo-yadzhieva V, Conaghan PG, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update. Ann Rheum Dis 2024; 83(6): 730–40. DOI: 10.1136/ard-2023-225041.
Brinkmann A, Böhlen CF, Kowalski C, Lau S, Meyer O, Diek-mann R, et al. Providing physical relief for nurses by collabora-tive robotics. Sci Rep 2022; 12(1): 8644. DOI: 10.1038/s41598-022-12632-4.
Gyllensten K, Andersson G, Muller H. Experiences of reduced work hours for nurses and assistant nurses at a surgical de-partment: a qualitative study. BMC Nurs 2017; 16: 16. DOI: 10.1186/s12912-017-0210-x.
Schiller H, Lekander M, Rajaleid K, Hellgren C, Åkerstedt T, Barck-Holst P, et al. Total workload and recovery in relation to worktime reduction: a randomised controlled intervention study with time-use data. Occup Environ Med 2018; 75(3): 218–26. DOI: 10.1136/oemed-2017-104592.
Voglino G, Savatteri A, Gualano MR, Catozzi D, Rousset S, Boiet-ti E, et al. How the reduction of working hours could influ-ence health outcomes: a systematic review of published stud-ies. BMJ Open 2022; 12(4): e051131. DOI: 10.1136/bmjopen-2021-051131.
Legal Information System of the Republic of Slovenia. Employment Relations Act (ZDR‑1). Official Gazette of the Republic of Slovenia 21/13, 78/13, 47/15, 33/16, 52/16, 15/17, 22/19, 81/19, 203/20, 119/21, 202/21, 15/22, 54/22, 114/23, 136/23, 70/25. Slovenia: Official Gazette of the Republic of Slovenia. Available from: https://pisrs.si/pregledPredpisa?id=ZAKO5944 (Slovenian)