The effect of cigarette smoking on musculoskeletal‐related disability

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Abstract
Background: This study describes cigarette smoking's effect on development of physical disability following initial musculoskeletal‐related hospitalization.Methods: We followed 15,140 US Army personnel hospitalized for common musculoskeletal disorders between 1989–1996 for up to 8 years (1997) to assess risk for long‐term physical disability.Results: Trends between increased smoking level and long‐term disability were identified for persons with knee injuries, rotator cuff injuries, and intervertebral disc displacement. In proportional hazards models, disability was significantly associated with heavy smoking among all subjects (relative hazard (RH) = 1.21). Both heavy smokers (RH = 1.49) and light to moderate smokers (RH = 1.44) were at greater risk for disability following meniscal injuries. Excess fraction due to smoking among subjects with meniscal injuries who currently smoke was 38%.Conclusions: Findings suggest an association between smoking and development of disability following meniscal injury. Given the high excess fraction of disability associated with smoking, other studies are needed to confirm this association. Am. J. Ind. Med. 43:337–349, 2003. Published 2003 Wiley‐Liss, Inc.