Assessing the burden of musculoskeletal conditions: a joint World Health Organization–Bone and Joint Decade project

  • N Khaltaev1,

    Affiliated with

    • B Pfleger1,

      Affiliated with

      • AD Woolf2,

        Affiliated with

        • C Mathers1,

          Affiliated with

          • K Akesson3,

            Affiliated with

            • JM Hazes4 and

              Affiliated with

              • D Symmons5

                Affiliated with

                Arthritis Res Ther20035(Suppl 3):174

                DOI: 10.1186/ar805

                Published: 12 September 2003

                Introduction

                The Monitor Project of the Bone and Joint Decade (BJD) was developed to quantify the global burden of musculoskeletal conditions and to develop strategies for their prevention. Experts within the Monitor Project have been working with officers at the World Health Organization (WHO) to estimate morbidity and mortality associated with rheumatic conditions.

                Objectives

                To determine the burden of major musculoskeletal conditions and limb trauma in terms of mortality and disability.

                Methods

                A Scientific Group meeting of experts in the areas of musculoskeletal conditions and limb trauma was held in January 2000 in Geneva in order to produce a WHO Technical Report on the impact of rheumatoid arthritis (RA), osteoarthritis (OA), osteoporosis, major limb trauma, and spinal disorders (low back pain [LBP]). Data on incidence, prevalence and severity for the conditions were collected by world region, gender, and age groups. Estimates of the economic burden of each condition were also made, as were descriptions of relevant health domains and states. Epidemiological models were formed for RA, OA and LBP. Computer software was used to combine the data on incidence and/or prevalence with estimates of case fatality, case remission, and average duration to establish the number of years of life lost for each condition in agreement with mortality data. Estimates for the distribution of disabilities associated with treated and untreated forms of each condition were made to help determine the number of years living in disability for each condition.

                Results

                The work of the WHO/BJD collaboration has resulted in a WHO Technical Report (in press) as well as burden estimates for the WHO Global Burden of Disease 2000 study. Results comparing years of living with disability for 1990 data with those for 2000 data are presented in Table 1 for RA, OA, LBP, and a residual musculoskeletal condition category. The burden appears to have increased during the time period. Other results show that the impact of musculoskeletal conditions varies worldwide and is influenced by social structure, expectation, and economics.
                Table 1

                Years living with disability for musculoskeletal conditions

                 

                Global Burden of Disease 1990

                Global Burden of Disease 2000

                Condition

                Male

                Female

                Total

                Male

                Female

                Total

                RA

                859

                2309

                3168

                1205

                3092

                4297

                Osteoarthritis

                5341

                7934

                13,275

                5549

                8667

                14,216

                Low back pain

                -

                -

                -

                1180

                1045

                2225

                Other

                398

                1099

                1437

                596

                1598

                2194

                Years of life lost data not presented due to the low mortality associated with these conditions. LBP was not considered in the Global Burden of Disease 1990 study. RA, rheumatoid arthritis. Sources: [1, 2] and unpublished World Health Organization data.

                Conclusions

                The WHO/BJD collaboration has been successful in accumulating and publishing vital data describing the burden of musculoskeletal conditions and limb trauma.

                Authors’ Affiliations

                (1)
                World Health Organization
                (2)
                Royal Cornwall Hospital
                (3)
                Malmö University Hospital
                (4)
                University Hospital of Rotterdam
                (5)
                University of Manchester

                References

                1. Symmons D, Mathers C, Pfleger B, World Health Organization: Global Burden of Osteoarthritis in the Year 2000. [http://​www3.​who.​int/​whosis/​menu.​cfm?​path=​evidence,burden,burden_​gbd2000docs&​language=​english] 2003.
                2. Symmons D, Mathers C, Pfleger B, World Health Organization: The global burden of rheumatoid arthritis in the year 2000. [http://​www3.​who.​int/​whosis/​menu.​cfm?​path=​evidence,burden,burden_​gbd2000docs&​language=​english] 2003.

                Copyright

                © BioMed Central Ltd 2003

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