Exposure to silica and systemic sclerosis: A retrospective cohort study based on the Canadian Scleroderma Research Group

Muntyanu, Anastasiya; Milan, Raymond; Rahme, Elham; LaChance, Avery; Ouchene, Lydia; Cormier, Maxime; Litvinov, Ivan V.; Hudson, Marie; Baron, Murray; Netchiporouk, Elena

doi:10.3389/fmed.2022.984907

Cited by 18 publications

(10 citation statements)

References 23 publications

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“…Further research is needed on sex/gender-specific disease severity and SiO2 overexposure in both RA and SSc. Moreover, some pieces of evidence keep accumulating about the deleterious role played by SiO2 exposure in SSc male patients (42,43). Our results suggest for the first time that extraoccupational exposure to SiO2 may contribute to the onset of RA in women.…”

Section: Discussionmentioning

confidence: 57%

Crystalline silica exposure in patients with rheumatoid arthritis and systemic sclerosis: a nationwide cross-sectional survey

et al. 2022

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Objectives Develop and validate a thorough exposure questionnaire to comprehensively explore crystalline silica (SiO2) exposure in the general population (gender-specific, occupational and non-occupational) and in patients with autoimmune diseases (Rheumatoid arthritis (RA), Systemic sclerosis (SSc)). Methods Lifetime exposures to SiO2 in occupational and non-occupational settings were assessed using a thorough exposure questionnaire. The questionnaire was applied to a general population panel (N = 2,911) sampled from the French rolling census, and to unselected patients with SSc (N = 100) and RA (N = 97). Global (GES), occupational (OES) and non-occupational (NOES) exposure scores were assessed in SSc and RA patients, and compared with up to 4 controls from the general population, matched by age group, sex and tobacco consumption. Results Patients had higher GES than their matched controls (SSc: p= 0.001; RA: p< 0.0001) due to higher OES (p< 0.0001 for SSc and RA). Men had higher GES than women (SSc: p< 0.0001; RA: p= 0.002) due to higher OES (p< 0.0001 for SSc and RA). The NOES did not differ between men and women. In SSc patients: Men had higher GES than controls (p< 0.0001). Men and women with SSc had higher OES than controls (p< 0.0001). In RA patients: GES and OES were higher in both men (p= 0.00521; p< 0.0001) and women (p< 0.0001; p< 0.0001) than in their respective controls. Women had higher NOES than controls (p= 0.045). Conclusion The lifetime SiO2 exposure gap between RA and SSc patients and controls was substantially due to occupational exposure. In both diseases, men had higher exposure scores than women.

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Section: Discussionmentioning

confidence: 57%

Crystalline silica exposure in patients with rheumatoid arthritis and systemic sclerosis: a nationwide cross-sectional survey

et al. 2022

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“…A retrospective cohort study based on the Canadian scleroderma research group showed a correlation between silica exposure and systemic sclerosis. It also showed a worse prognosis concerning younger age at diagnosis, more severe organ involvement and higher mortality 10. SA-SS appears after a mean of 16.2 years of silica exposure.…”

Section: Discussionmentioning

confidence: 98%

Silica associated systemic sclerosis: an occupational health hazard

2023

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A middle-aged male working in the sandblasting and stone-cutting industry was brought to the medicine department with skin tightness, dysphagia and discolouration of the skin for the last 1 year. On examination, he had skin thickening over the face and the extremities with restricted mouth opening. His hands were cold and showed peripheral cyanosis. Systemic examination was suggestive of diffuse cutaneous systemic sclerosis, further confirmed by the antinuclear antibody testing. Further, CT of the chest showed mediastinal lymphadenopathy with eggshell calcification and interstitial fibrosis consistent with silicosis and fibrotic non-specific interstitial pneumonitis. The patient was started on pulse monthly cyclophosphamide for six cycles, and steroids were given for 4 weeks and tapered. Tadalafil and amlodipine were given for his pulmonary artery hypertension and Raynaud’s phenomenon, respectively. This case also highlights the importance of periodic screening of the workers exposed to silica dust to prevent silicosis.

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“…3 A multifactorial background is postulated in which different endogenous and exogenous triggers contribute to the development of the disease in genetically predisposed individuals. [3][4][5] With the exception of silica, which is an established risk factor for SSc, [5][6][7] the nature of these triggers and their effects on the evolution of the disease remain unclear.…”

Section: How This Study Might Affect Research Practice or Policymentioning

confidence: 99%

Untangling the relationship between smoking and systemic sclerosis: an analysis of the EUSTAR cohort

Ciaffi,

Liem,

Cannegieter

et al. 2024

RMD Open

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ObjectivesTo untangle the association between smoking and systemic sclerosis (SSc).MethodsIn the European Scleroderma Trials and Research cohort, the autoantibody status was compared between ever-smokers and never-smokers. Time until disease progression was assessed using Kaplan-Meier curves. Cox models were built to investigate the influence of smoking over 15 years of follow-up. All analyses were performed for the total cohort and stratified for sex and for positivity of anti-centromere (ACA) and anti-topoisomerase antibodies (ATA).ResultsOverall, 12 314 patients were included in the study. Of these, 10 393 were women (84%), 4637 were ACA-positive (38%), 3919 were ATA-positive (32%) and 4271 (35%) were ever-smokers. In men, but not in women, smoking was associated with mortality (HR 1.63, 95% CI 1.23 to 2.16, p=0.001). Ever-smoking women were at higher risk for skin progression (HR 1.10, 95% CI 1.00 to 1.22, p=0.046) and for ‘any organ progression’ (HR 1.07, 95% CI 1.00 to 1.13, p=0.036). In women, 34% of never-smokers were ATA-positive compared with 21% of ever-smokers (p<0.001). In the group of ever-smokers, higher exposure rates, reflected by the number of pack-years (OR 0.98, 95% CI 0.97 to 0.99, p<0.001) and by smoking duration (OR 0.96, 95% CI 0.95 to 0.97, p<0.001), were associated with lower frequency of ATA. In ACA-positive patients, the risk of mortality (HR 1.29, 95% CI 1.02 to 1.63, p=0.033), cardiac involvement (HR 1.25, 95% CI 1.03 to 1.43, p=0.001), skin progression (HR 1.21, 95% CI 1.03 to 1.42, p=0.018) and ‘any organ progression’ (HR 1.14, 95% CI 1.05 to 1.24, p=0.002) was increased among smokers. In ATA-positive smoking patients, mortality (HR 1.40, 95% CI 1.10 to 1.78, p=0.006), skin progression (HR 1.19, 95% CI 1.03 to 1.37, p=0.020) digital ulcers (HR 1.17, 95% CI 1.02 to 1.34, p=0.029) and ‘any organ progression’ (HR 1.11, 95% CI 1.00 to 1.22, p=0.048) occurred more frequently.ConclusionsOur stratified analysis demonstrates that smoking is associated with an increased risk for mortality in male SSc patients but not in women. Strikingly, smoking is associated with lower prevalence of ATA positivity, in particular in women. In both ATA-positive and ACA-positive patients, smoking is a risk factor for mortality, skin progression and ‘any organ progression’.

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Exposure to silica and systemic sclerosis: A retrospective cohort study based on the Canadian Scleroderma Research Group

Cited by 18 publications

References 23 publications

Crystalline silica exposure in patients with rheumatoid arthritis and systemic sclerosis: a nationwide cross-sectional survey

Crystalline silica exposure in patients with rheumatoid arthritis and systemic sclerosis: a nationwide cross-sectional survey

Silica associated systemic sclerosis: an occupational health hazard

Untangling the relationship between smoking and systemic sclerosis: an analysis of the EUSTAR cohort

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