umu.sePublications
Change search
ReferencesLink to record
Permanent link

Direct link
Prospective Risk of Rheumatologic Disease Associated with Occupational Exposure in a Cohort of Male Construction Workers
University of California, San Francisco, USA.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
2015 (English)In: American Journal of Medicine, ISSN 0002-9343, E-ISSN 1555-7162, Vol. 128, no 10, 1094-1101 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The association between occupational exposure and autoimmune disease is well recognized for silica, and suspected for other inhalants. We used a large cohort to estimate the risks of rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and dermatomyositis associated with silica and other occupational exposures.

METHODS: We analyzed data for male Swedish construction industry employees. Exposure was defined by a job-exposure matrix for silica and for other inorganic dusts; those with other job-exposure matrix exposures but not to either of the 2 inorganic dust categories were excluded. National hospital treatment data were linked for International Classification of Diseases, 10(th) Revision-coded diagnoses of rheumatoid arthritis (seronegative and positive), systemic lupus erythematosus, systemic sclerosis, and dermatomyositis. The 2 occupational exposures were tested as independent predictors of prospective hospital-based treatment for these diagnoses using age-adjusted Poisson multivariable regression analyses to calculate relative risk (RR).

RESULTS: We analyzed hospital-based treatment data (1997 through 2010) for 240,983 men aged 30 to 84 years. There were 713 incident cases of rheumatoid arthritis (467 seropositive, 195 seronegative, 51 not classified) and 128 cases combined for systemic lupus erythematosus, systemic sclerosis, and dermatomyositis. Adjusted for smoking and age, the 2 occupational exposures (silica and other inorganic dusts) were each associated with increased risk of rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and dermatomyositis combined: RR 1.39 (95% confidence interval [CI], 1.17-1.64) and RR 1.31 (95% CI, 1.11-1.53), respectively. Among ever smokers, both silica and other inorganic dust exposure were associated with increased risk of rheumatoid arthritis (RRs 1.36; 95% CI, 1.11-1.68 and 1.42; 95% CI, 1.17-1.73, respectively), while among never smokers, neither exposure was associated with statistically significant increased risk of rheumatoid arthritis.

CONCLUSION: This analysis reaffirms the link between occupational silica and a range of autoimmune diseases, while also suggesting that other inorganic dusts may also impart excess risk of such disease.

Place, publisher, year, edition, pages
Elsevier, 2015. Vol. 128, no 10, 1094-1101 p.
National Category
Environmental Health and Occupational Health
Identifiers
URN: urn:nbn:se:umu:diva-111843DOI: 10.1016/j.amjmed.2015.05.001PubMedID: 26007670OAI: oai:DiVA.org:umu-111843DiVA: diva2:873399
Available from: 2015-11-24 Created: 2015-11-24 Last updated: 2015-12-11Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Järvholm, Bengt
By organisation
Occupational and Environmental Medicine
In the same journal
American Journal of Medicine
Environmental Health and Occupational Health

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 30 hits
ReferencesLink to record
Permanent link

Direct link