Silica exposure and rheumatoid arthritis: a follow up study of granite workers 1940-81.

Klockars, Matti; Koskela, Riitta‐Sisko; Järvinen, Erkki; Kolari, P J; Rossi, A

doi:10.1136/bmj.294.6578.997

Cited by 98 publications

(66 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Long latency periods (15-25 years) have been reported between first silica exposure and the development of autoimmune diseases. However, in a 1987 study of granite workers, Klockars et al (1987) documented individuals who developed autoimmune disease in a shorter period of time. The authors published results of a followup of 35 workers exposed to silica who had developed rheumatoid arthritis.…”

Section: Discussionmentioning

confidence: 99%

Silica exposure and systemic vasculitis.

Mulloy

2003

Environ Health Perspect

View full text Add to dashboard Cite

Work in Department of Energy (DOE) facilities has exposed workers to multiple toxic agents leading to acute and chronic diseases. Many exposures were common to numerous work sites. Exposure to crystalline silica was primarily restricted to a few facilities. I present the case of a 63-year-old male who worked in DOE facilities for 30 years as a weapons testing technician. In addition to silica, other workplace exposures included beryllium, various solvents and heavy metals, depleted uranium, and ionizing radiation. In 1989 a painful macular skin lesion was biopsied and diagnosed as leukocytoclastic vasculitis. By 1992 he developed gross hematuria and dyspnea. Blood laboratory results revealed a serum creatinine concentration of 2.1 mg/dL, ethrythrocyte sedimentation rate of 61 mm/hr, negative cANCA (antineutrophil cytoplasmic antibody cytoplasmic pattern), positive pANCA (ANCA perinuclear pattern), and antiglomerular basement membrane negative. Renal biopsy showed proliferative (crescentric) and necrotizing glomerulonephritis. The patient's diagnoses included microscopic polyangiitis, systemic necrotizing vasculitis, leukocytoclastic vasculitis, and glomerulonephritis. Environmental triggers are thought to play a role in the development of an idiopathic expression of systemic autoimmune disease. Crystalline silica exposure has been linked to rheumatoid arthritis, scleroderma, systemic lupus erythematosus, rapidly progressive glomerulonephritis and some of the small vessel vasculitides. DOE workers are currently able to apply for compensation under the federal Energy Employees Occupational Illness Compensation Program (EEOICP). However, the only diseases covered by EEOICP are cancers related to radiation exposure, chronic beryllium disease, and chronic silicosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Silica exposure and systemic vasculitis.

Mulloy

2003

Environ Health Perspect

View full text Add to dashboard Cite

show abstract

“…Consequently, the role of nongenetic factors (environment, sex hormones, behavior, and age-related changes among them) in arthritis have at least the same importance as genetic factors, and lifestyle, age, certain working conditions, exercise, sex, exposure to silica, obesity, and smoking are among the well-known risk factors for RA (57)(58)(59)(60)(61)(62). The importance of nongenetic factors, such as aggressive behavior or estrogen turnover, in several mouse models of arthritis has been demonstrated as well (63,64).…”

Section: Discussionmentioning

confidence: 99%

Sex effect on clinical and immunologic quantitative trait loci in a murine model of rheumatoid arthritis

Adarichev¹,

Nesterovitch²,

Bárdos³

et al. 2003

Arthritis & Rheumatism

View full text Add to dashboard Cite

Objective. To explore the effect of sex on clinical and immunologic traits in major histocompatibility complex-matched (H-2d) F 2 hybrid mice with proteoglycan (PG)-induced arthritis and to identify how the quantitative trait locus (QTL) on the X chromosome influences the onset QTL of another chromosome.Methods. (BALB/c ؋ DBA/2)F 2 hybrid mice were immunized with cartilage PG, and a genome-wide linkage analysis was performed using >200 simple sequence-length polymorphic markers. The major clinical traits (susceptibility, onset, and severity) were assessed, and PG-specific T and B cell responses, and the production of proinflammatory and antiinflammatory cytokines (tumor necrosis factor ␣, interleukin-1 [IL-1], IL-6, interferon-␥, IL-4, IL-10, and IL-12) were measured in 133 arthritic and 426 nonarthritic female and male F 2 hybrid mice. The major clinical and immunologic traits were linked to genetic loci, and potential linkages among these QTLs and the effect of sex were analyzed.Results. Thirteen QTLs reported in previous studies were confirmed. Binary traits (susceptibility to arthritis) and disease onset were female specific and were identified on chromosomes 3, 7, 10, 11, 13, and X. QTLs for disease severity were mostly male specific and were located on chromosomes 1, 4, 5, 8, 14, 15, and 19. In addition, we identified 4 new QTLs for the onset of arthritis on chromosomes 3, 4, and 11, and 1 new QTL for severity on chromosome 14; all showed a strong gender association. A locus on the X chromosome interacted with a QTL on chromosome 10, and these 2 loci together seemed to control disease incidence and onset. Most of the clinical traits (QTLs) shared common regions with the immunologic traits and frequently showed a locus-locus interaction.Conclusion. Numerous immunologic QTLs overlap with clinical QTLs, thus providing information about possible mechanisms underlying QTL function. Disease susceptibility and onset showed predominant linkage with the female sex, under the control of a QTL on the X chromosome, while the severity QTLs were more strongly linked to the male sex.

show abstract

“…We have no epidemiological data about dukhan habits in our cohort or in Sudan in general, but it is practiced by almost all married Sudanese women. Thus, we hypothesize that dukhan might be another environmental RA risk factor acting through the lungs in a similar manner to cigarette smoking 38 , silica exposure 44,45 , traffic pollution 46 , or most recently, occupational exposure to textile dust 47 . The low prevalence of autoantibody-positive RA in our Sudanese cohort is, however, an argument against this hypothesis, because the strong association between smoking and RA has been reported to be confined to the ACPA-positive RA subset, at least among whites 38 .…”

Section: Rheumatologymentioning

confidence: 99%

Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between Sudan and Sweden

Elshafie

Elkhalifa²,

Elbagir³

et al. 2016

J Rheumatol

View full text Add to dashboard Cite

Objective.To compare clinical characteristics and treatment between simultaneously investigated Sudanese and Swedish outpatients with rheumatoid arthritis (RA).Methods.Outpatients with RA from Sudan (n = 281) and Sweden (n = 542) diagnosed according to the 1987 American College of Rheumatology criteria were recruited between December 2008 and September 2010 and compared concerning clinical presentation, treatment, and laboratory findings, including immunoglobulin M with rheumatoid factor (IgM-RF).Results.Sudanese patients had lower inclusion age (median 49 vs 68 yrs), disease duration (48 vs 107 mos), and disease onset age (43 vs 56 yrs) as compared with Swedish patients (p < 0.0001 for all). When stratified concerning the age of inclusion, Swedish patients between 41–50 years had, however, a significantly lower age of onset, with a similar trend for all age groups above 30 years. The female preponderance was higher among Sudanese patients (89.3% vs 72.5%, p < 0.0001), and smoking was nonexistent among Sudanese female patients (p < 0.0001). Erythrocyte sedimentation rate levels and number of tender joints were significantly higher among Sudanese patients. The proportion of IgM-RF positivity was lower among Sudanese patients with RA (52.4% vs 75.5%, p < 0.0001). Higher proportions of Sudanese patients with RA were treated with methotrexate (MTX) and disease-modifying antirheumatic drug combinations, but none of them used biologics. Sudanese patients used lower doses of MTX and sulfasalazine (p < 0.0001) and higher doses of prednisolone (p < 0.0001) than Swedish patients.Conclusion.Sudanese patients with RA have significantly higher disease activity and are often IgM-RF–seronegative. Together with reports from Uganda and Cameroon, our data indicate a cluster of highly active and often seronegative RA in central Africa.

show abstract

Silica exposure and rheumatoid arthritis: a follow up study of granite workers 1940-81.

Cited by 98 publications

References 24 publications

Silica exposure and systemic vasculitis.

Silica exposure and systemic vasculitis.

Sex effect on clinical and immunologic quantitative trait loci in a murine model of rheumatoid arthritis

Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between Sudan and Sweden

Contact Info

Product

Resources

About