Wegener granulomatosis is associated to exposure to silicon compounds: a case-control study

Nuyts, GD; Vlem, E Van; Vos, Ans De; Daelemans, R.; Rorive, Georges; Elseviers, Monique; Schurgers, M; Segaert, M; D’Haese, Patrick C.; Broe, Marc E. De

doi:10.1093/ndt/10.7.1162

Cited by 73 publications

(36 citation statements)

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“…Small, clinic based matched case-control studies reported statistically significant associations between silica exposure (based on job history) and Wegener's granulomatosis, 78 diseases with positive antineutrophil cytoplasmic antibody (ANCA+), 79 and ANCA+ rapidly progressive glomerulonephritis. 80 Significant associations between crystalline silica exposure and end stage renal disease (ESRD) caused by glomerulonephritis were identified in cohorts of crystalline silica exposed gold miners, 81 and workers in the industrial sand industry.…”

Section: Chronic Glomerulonephritis and Renal Failurementioning

confidence: 99%

Occupational silica exposure and risk of various diseases: an analysis using death certificates from 27 states of the United States

2003

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Background:Although crystalline silica exposure is associated with silicosis, lung cancer, pulmonary tuberculosis, and chronic obstructive pulmonary disease (COPD), there is less support for an association with autoimmune disease, and renal disease.Methods:Using data from the US National Occupational Mortality Surveillance (NOMS) system, a matched case-control design was employed to examine each of several diseases (including silicosis, lung cancer, stomach cancer, oesophageal cancer, COPD, pulmonary tuberculosis, sarcoidosis, systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, and various types of renal disease). Cases were subjects whose death certificate mentioned the disease of interest. A separate control group for each of the diseases of interest was selected from among subjects whose death certificate did not mention the disease of interest or any of several diseases reported to be associated with crystalline silica exposure. Subjects were assigned into a qualitative crystalline silica exposure category based on the industry/occupation pairing found on their death certificate. We also investigated whether silicotics had a higher risk of disease compared to those without silicosis.Results:Those postulated to have had detectable crystalline silica exposure had a significantly increased risk for silicosis, COPD, pulmonary tuberculosis, and rheumatoid arthritis. In addition, a significant trend of increasing risk with increasing silica exposure was observed for these same conditions and for lung cancer. Those postulated to have had the greatest crystalline silica exposure had a significantly increased risk for silicosis, lung cancer, COPD, and pulmonary tuberculosis only. Finally, those with silicosis had a significantly increased risk for COPD, pulmonary tuberculosis, and rheumatoid arthritis.Conclusions:This study corroborates the association between crystalline silica exposure and silicosis, lung cancer, COPD, and pulmonary tuberculosis. In addition, support is provided for an association between crystalline silica exposure and rheumatoid arthritis.

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Section: Chronic Glomerulonephritis and Renal Failurementioning

confidence: 99%

Occupational silica exposure and risk of various diseases: an analysis using death certificates from 27 states of the United States

2003

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“…sure with SSc and some of the SW with renal involvement (40)(41)(42)(43)(53)(54)(55)(56) (Table 5). Because of the low prevalence of occupational silica dust exposure in the general population (especially in women), most of these studies lacked the statistical power to detect moderate or smaller effects.…”

Section: Silica Dust and Autoimmunementioning

confidence: 99%

Occupational Exposure to Crystalline Silica and Autoimmune Disease

Parks¹,

Conrad²,

Cooper³

1999

Environmental Health Perspectives

114

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Occupational exposure to silica dust has been examined as a possible risk factor with respect to several systemic autoimmune diseases, including scleroderma, rheumatoid arthritis, systemic lupus erythematosus, and some of the small vessel vasculitidies with renal involvement (e.g., Wegener granulomatosis). Crystalline silica, or quartz, is an abundant mineral found in sand, rock, and soil. High-level exposure to respirable silica dust can cause chronic inflammation and fibrosis in the lung and other organs. Studies of specific occupational groups with high-level silica exposure (e.g., miners) have shown increased rates of autoimmune diseases compared to the expected rates in the general population. However, some clinic- and population-based studies have not demonstrated an association between silica exposure and risk of autoimmune diseases. This lack of effect may be due to the limited statistical power of these studies to examine this association or because the lower- or moderate-level exposures that may be more common in the general population were not considered. Experimental studies demonstrate that silica can act as an adjuvant to nonspecifically enhance the immune response. This is one mechanism by which silica might be involved in the development of autoimmune diseases. Given that several different autoimmune diseases may be associated with silica dust exposure, silica dust may act to promote or accelerate disease development, requiring some other factor to break immune tolerance or initiate autoimmunity. The specific manifestation of this effect may depend on underlying differences in genetic susceptibility or other environmental exposures.

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“…Several case-control studies have shown that among patients with AAV, a high percentage (20 to 45%) were previously exposed to silica [22], [23], [24], [25], [26], [27], [28], [29]. However, these studies have been difficult to interpret; factors such as small numbers of cases and diverse forms of classification for silica exposure contribute to this difficulty, as do the varying strengths of association between AAV and silica that are reported.…”

Section: Introductionmentioning

confidence: 99%

The association between silica exposure and development of ANCA-associated vasculitis: Systematic review and meta-analysis

Gómez-Puerta

Gedmintas

Costenbader

2013

Autoimmunity Reviews

137

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Background Crystalline silica is among the environmental exposures associated with increased risk of autoimmune diseases, including rheumatoid arthritis, systemic sclerosis and systemic lupus erythematosus. Silica exposure has also been related to the development of ANCA-associated vasculitides (AAV), but past studies appear to conflict as to the presence and magnitude of the associated risks of disease. We aimed to conduct a systematic review of the existing studies and meta-analysis of their results. Methods We searched EMBASE, MEDLINE and international scientific conference abstract databases for studies examining the association of silica exposure with AAV. Studies in English, French, or Spanish were included and those examining the association of silica with ANCA-positivity alone were excluded. We assessed study quality using the Newcastle-Ottawa scale. We meta-analyzed the results using random effects models and tested for heterogeneity. We performed sensitivity and subgroup analyses, examining studies that adjusted for smoking and occupational risk factors as well as studies that analyzed by subtypes of AAV. Results We identified 158 potential manuscripts and 3 abstracts related to silica exposure and risk of AAV. 147 were excluded after abstract review and 14 underwent detailed evaluation of full manuscript/abstract. After further application of exclusion criteria, 6 studies (all case-controls) remained. The studies had moderate heterogeneity in selection of cases and controls, exposure assessment, disease definition and controlling for potential confounders. We found an overall significant summary effect estimate of silica “ever exposure” with development of AAV (summary OR 2.56, 95% CI 1.51- 4.36), with moderate heterogeneity (I2=48.40%). ORs were similar for studies examining only MPA (OR 3.95, CI 95% 1.89-8.24), compared to those only studying GPA (OR 3.56, CI 95% 1.85-6.82). Conclusion Despite moderate heterogeneity among studies, the totality of the evidence after meta-analysis points to an association between silica exposure and risk for developing AAV.

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Wegener granulomatosis is associated to exposure to silicon compounds: a case-control study

Cited by 73 publications

References 0 publications

Occupational silica exposure and risk of various diseases: an analysis using death certificates from 27 states of the United States

Occupational silica exposure and risk of various diseases: an analysis using death certificates from 27 states of the United States

Occupational Exposure to Crystalline Silica and Autoimmune Disease

The association between silica exposure and development of ANCA-associated vasculitis: Systematic review and meta-analysis

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