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Agricultural workers have physically demanding occupations. In this study of Saskatchewan farmers, the authors examined (1) self-reported prevalence of physician-diagnosed rheumatoid arthritis and osteoarthritis; and (2) the impact of these chronic arthridities on engagement in physical tasks related to farming. This study was conducted through a cross-sectional analysis of baseline data from the Saskatchewan Farm Injury Cohort Study in which 2,473 adult residents upon 1,216 farms participated. Collected survey data included demographic and health information; regional musculoskeletal symptoms for each participant assessed via the Standard Nordic Questionnaire; and engagement in various specific physical tasks or activities associated with mixed farming practices. Of the 2,473 respondents, 13% reported chronic arthritic diagnoses (10% osteoarthritis, 4% rheumatoid arthritis, with 1% from each category overlapping with both forms of arthritis). Participants reporting arthritis were more likely to also report disabling musculoskeletal symptoms involving their shoulders, elbows, hands, lower back, hips, knees, and ankles. Farmers with arthritis reported less participation in all physical farming activities studied, including various machinery operations, herd maintenance and veterinary activities, overhead work, shoveling/pitchfork work, and lifting/carrying. When adjusted for age, gender, and comorbidities, operation of combines and shoveling/pitchfork work continued to be significantly less engaged in by farmers with arthritis. The overall prevalence of arthritis was consistent with general population prevalence, although the category of rheumatoid arthritis was overrepresented. Farmers with arthritis were significantly less likely to participate in combine operation and shoveling/pitchfork chores compared with their counterparts without arthritis. [ABSTRACT FROM AUTHOR]

Objectives. To compare the incidence of renal ANCA-associated vasculitis (AAV) in urban vs more rural populations in northern Saskatchewan, and as a secondary objective to compare time to diagnosis between these geographic areas.Methods. Northern Saskatchewan has a population of 562 882 of which approximately 260 600 live in the major urban area. A pathology database search for renal biopsy reports suggestive of AAV between January 2007 and December 2011 and subsequent chart review yielded 33 new diagnoses of granulomatosis polyangiitis (GPA) or microscopic polyangiitis (MPA). Data extraction included demographics, residential data, serological status, recorded symptom onset and estimations of BVAS, five-factor score (FFS) and vasculitis damage index (VDI).Results. Of 33 renal AAV cases, 24.2 % (n = 8) lived within the city. The incidence rate for urban residents was 6.1 cases/million/year, and for those residing elsewhere, 16.5 cases/million/year. The odds ratio for the more rural population was 2.69 (95% CI 1.3, 7.5). Mean time to diagnosis was 1.33 (s.d. 0.94) months for urban and 3.52 (s.d. 3.83) months for more rural patients (P = 0.002, 95% CI 0.7, 3.9). Secondary analysis supported these observations with higher BVAS, VDI and FFS scores in patients living outside the urban centre.Conclusion. The incidence of renal biopsy-proven AAV was higher in patients living in northern Saskatchewan smaller communities and rural settings. A significantly longer time to diagnosis existed for patients outside the urban centre and was associated with poorer BVAS, VDI and FFS scores. [ABSTRACT FROM AUTHOR]

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Objectives: To estimate provincial all-cause mortality rates of Saskatchewan people with rheumatoid arthritis (RA) for comparison with the general population over time and between different geographic regions., Methods: Saskatchewan provincial administrative health databases (2001-2019) were utilized as data sources. Two RA case definitions were employed: (1) ≥ 3 physician billing diagnoses, at least 1 from a specialist (rheumatologist, general internist or orthopaedic surgeon) within 2 years; (2) ≥ 1 hospitalization diagnosis (ICD-9 code 714, and ICD-10-CA codes M05, M06). Data from these definitions were combined to create an administrative data RA cohort. All-cause mortality rates across geographic regions, between rural/urban residences and between sexes were examined., Results: Over an 18-year span, between fiscal-year 2001-2002 and fiscal-year 2018-2019, age- and sex-adjusted mortality rates ranged from 17.10 to 21.04 (95% CI 14.77, 19.44; 18.03, 24.05)/1000 RA person-years, compared with mortality rates for the general Saskatchewan population without RA, which ranged from 9.37 to 10.88 (95% CI 9.23, 9.51; 10.72, 11.05)/1000 person-years. Fiscal-year mortality rate ratios ranged from 1.82 to 2.13 (95% CI 1.56, 2.13; 1.83, 2.46). Provincial mortality rates were higher in men than in women for both general and RA populations. Northern Saskatchewan mortality rates were significantly higher in the general population but did not achieve significance compared with other provincial regions for the RA population. Regression analysis identified age, male sex, RA and geographic region as factors contributing to increased mortality. A trend towards lower mortality rates over time was observed., Conclusion: Higher mortality rates were observed in the RA population overall. Men had higher mortality rates, as did residents of Northern Saskatchewan compared with residents of other regions for the general population.

Objective: To use the 2003 International Restless Legs Syndrome Study Group (IRLSSG) diagnostic criteria and to evaluate restless legs syndrome (RLS) prevalence in a rheumatoid arthritis (RA) and osteoarthritis (OA) population. Further, we wished to evaluate physician awareness of this disorder by as reflected in prevalence of preexisting diagnoses of RLS in these populations., Methods: This was a questionnaire study of Saskatchewan RA and OA patients enrolled in a longitudinal database study. A data collection instrument, including the 2003 IRLSSG criteria for RLS was distributed to the patients enrolled., Results: Of the 193 respondents, 158 (81.9%) were women. The population consisted of 148 RA and 45 OA patients. RA patients were younger (mean age, 65.8 years) in comparison with those in the OA group (mean age, 72.8 years; P < 0.001). All criteria for RLS were met by 27.7% of RA patients and by 24.4% of OA patients. A previous diagnosis of RLS was reported by 2.6% of patients., Conclusions: A quarter of all our patients met the 2003 IRLSSG criteria, in both RA and OA groups; however, only 2.6% of study patients reported a previous diagnosis of RLS. As RLS can significantly affect quality of life, increased awareness with improvement in surveillance, recognition, and treatment would be beneficial to patient care. We advocate screening for symptoms of sleep disorders to be incorporated into the routine rheumatologic history for all patients with RA and OA.

Objective: To determine how frequently treatments had been offered to patients with suspected diagnoses of carpal tunnel syndrome (CTS) who had been referred for confirmatory nerve conduction studies (NCSs) and to identify potential predictors of such treatment. A follow-up survey was conducted to determine the effect of NCS results on subsequent treatment., Design: Self-administered survey questionnaire and follow-up telephone survey., Setting: Royal University Hospital at the University of Saskatchewan in Saskatoon., Participants: Two hundred eleven patients with clinically suspected CTS who had been referred for confirmatory NCS., Main Outcome Measures: Results of NCSs, number of patients prescribed wrist splints or nonsteroidal anti-inflammatory drugs (NSAIDs) before and after NCSs, patient characteristics associated with being prescribed therapy, and reporting benefit of therapy., Results: Nerve conduction studies confirmed CTS in 121 (57.3%) of the 211 study patients. Before NCSs, wrist splints and NSAIDs had been prescribed to 33.2% and 38.8% of patients, respectively. Splints and NSAIDs were reported to alleviate symptoms by 78.3% and 74% of patients, respectively, who received such treatments. No significant differences in age, sex, body mass index, symptom duration, symptom or function scores, or subsequent NCS results were noted between patients who were and were not prescribed these therapies or between those who did or did not report improvement in symptoms. Results of the follow-up survey indicated that the number of recommendations for splints and NSAIDs had doubled after NCSs were completed and that surgical intervention had been at least discussed in most cases. Treatment recommendations, including surgery, however, were not associated with identifiable patient factors, including patients' NCS results., Conclusion: Some patients were prescribed conservative treatments before NCSs. Following NCSs, prescriptions for wrist splints or NSAIDs approximately doubled. Interestingly, NCS results did not appear to influence subsequent therapeutic decision-making for either conservative treatment or surgical options. We think these findings suggest a lack of confidence in electrodiagnostic study results. It would be interesting to evaluate a larger population of primary care patients prospectively to examine further the use of NCSs in current clinical decision-making.