Prospective Risk of Rheumatologic Disease Associated with Occupational Exposure in a Cohort of Male Construction Workers

Blanc, Paul D.; Järvholm, Bengt; Torén, Kjell

doi:10.1016/j.amjmed.2015.05.001

Cited by 61 publications

(67 citation statements)

References 27 publications

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“…Large population-based studies have confirmed these findings(16, 99, 100). Most recently, a prospective cohort study among male construction workers demonstrated an elevated risk for the development of the combined outcome of rheumatoid arthritis, SLE, systemic sclerosis, and dermatomyositis combined, after adjustment for age and smoking (RR 1.39, 95% CI, 1.17–1.64); however, this study was underpowered to assess for an association among SLE patients independently(101*). Although the evidence supports silica as a likely cause of SLE, questions remain regarding the required dose, and susceptibility factors, and SLE risk due to industrial exposures to other silicates.…”

Section: Occupational Factors and Pollutantsmentioning

confidence: 98%

Environmental exposures and the development of systemic lupus erythematosus

Barbhaiya

Costenbader²

2016

Current Opinion in Rheumatology

177

137

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Purpose of Review This review examines evidence relating environmental factors to the development of systemic lupus erythematosus (SLE). Recent findings The strongest epidemiologic evidence exists for the associations of silica, cigarette smoking, oral contraceptives, postmenopausal hormone therapy, and endometriosis, with SLE incidence. Recent studies have also provided robust evidence of the association between alcohol consumption and decreased SLE risk. There are preliminary, conflicting or unsubstantiated data that other factors, including air pollution, ultraviolet light, infections, vaccinations, solvents, pesticides, and heavy metals such as mercury, are related to SLE risk. Biologic mechanisms linking environmental exposures and SLE risk include increased oxidative stress, systemic inflammation and inflammatory cytokine upregulation, and hormonal triggers, as well as epigenetic modifications resulting from exposure that could lead to SLE. Summary Identifying the environmental risk factors related to risk of SLE is essential as it will lead to increased understanding of pathogenesis of this complex disease and will also make risk factor modification possible for those at increased risk.

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Section: Occupational Factors and Pollutantsmentioning

confidence: 98%

Environmental exposures and the development of systemic lupus erythematosus

Barbhaiya

Costenbader²

2016

Current Opinion in Rheumatology

177

137

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“…Multiple independent studies have found that occupational exposure to mineral dust is strongly associated with rheumatologic disease risk . Rheumatoid arthritis (RA) has been the condition most strongly implicated in mineral dust inhalation . The role that coal and silica dust inhalation may play in the colocation of US regions in which coal mining is concentrated and where there is a high prevalence of arthritis in males is not clear.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Arthritis and Rheumatoid Arthritis in Coal Mining Counties of the United States

Schmajuk

Trupin

Yelin

et al. 2019

Arthritis Care & Research

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Objective. Exposure to inhaled mineral dust, in particular silica, is associated with increased odds of rheumatoid arthritis (RA) and other autoimmune diseases. We studied the association of RA with work-related coal and silica exposure in the Appalachian region of the US.Methods. We carried out a random-digit dialed telephone survey in selected counties in Appalachia that had elevated coal workers' pneumoconiosis mortality. Our study cohort included men ages ≥50 with any employment history, and we assessed exposure to coal mining employment, other work-related dust, and ergonomic factors. We ascertained self-reported physician diagnosis of any arthritis and of RA with glucocorticoid treatment. We used multivariable logistic regression analysis to estimate the odds ratios (ORs) and associated population attributable fraction (PAF) estimates.Results. Among the 973 men who met study entry criteria (mean ± SD ages 66 ± 10 years; 54% ever smokers), 266 (27%) reported coal mining work and 189 (19%) reported other work-related silica exposure. There were 517 men (53%), who reported any arthritis and 112 (12%) whose disease met the study definition of RA. Adjusting for covariates, coal mining was associated with elevated odds of RA (OR 3.6 [95% confidence interval (95% CI) 2.1-6.2]), which accounted for a PAF of 33% (95% CI 26-40%) of the men studied. For any arthritis, the coal mining-associated OR was 2.3 (95% CI 1.6-3.2), with an associated PAF of 20% (95% CI 14-25%).Conclusion. In this population of older males living in a coal mining region, we estimated that 20% of arthritis and 33% of RA may be attributable to coal mining work.

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“…It is hypothesized that a similar disease mechanism could apply to other airborne exposures . There is a known association between occupational exposure to silica and RA , as well as for other rheumatic diseases . Occupational exposure to mineral oil , asbestos , textile dust , pesticides , and organic solvents are other potential occupational risk factors that have been observed to be related to RA or other autoimmune diseases.…”

Section: Introductionmentioning

confidence: 99%