Aim: On the basis of the industry-specific prophylactic
medical examinations of the lower
extremities of persons working in the construction
industry, significant symptoms and their
association with occupations and work processes
are to be described. Foci for preventive
measures are to be defined from the results.
Methods: The cross-sectional study made use
of data from preventive medical examinations
of 108,963 (1994–2003) mainly male employees
evaluated on the basis of age, work processes
and occupation. They were combined
with results of a questionnaire covering musculoskeletal
complaints in 4640 employees.
Results: The frequency of complaints and
of clinical findings for the lower extremities
was in both cases higher for the knees than
for the hip joints. There is a marked difference
between the frequency of complaints and
that of clinical findings; e.g. 27.2 % of men
who were 55 years old or older complained
of knee problems but medical examination
revealed clinical findings in only 9.5 %. The
prevalence of persons with clinical findings
in the knees in these occupations corresponded
with the duration of working in a kneeling
position. Symptoms developed mostly
symmetrically in the knees but not in the hip
joints. Of the categories of strain to which
the persons were exposed, forced attitudes
played a much greater role in increasing the
incidence of symptoms than did heavy loads,
which are of only little significance.
Conclusions: The results document the practical
significance of prophylactic medical examinations
for the differentiation of functional
disorders and for timely recognition of the
necessity for preventive action. Prophylaxis is
not a substitute for detailed diagnosis when
the medical symptoms are severe. For the hip
joints, symptoms suggesting an association
with work or other mechanical stress are less
marked. These results are of relevance for the
assessment of real risks at the workplace.
