Occupational exposures increase RA risk

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Occupational exposures increase RA risk

Rheumawire

Jul 5, 2004

Mann

Linkoping, Sweden - Occupational exposures to mineral dust and/or

vibrations may increase the risk for rheumatoid arthritis (RA),

according to a new study in the July 2004 issue of Occupational

Environmental Medicine [1].

Swedish researchers looked at lifelong occupational history and exposure

experiences via a postal questionnaire that was answered by 293 people

with RA and 1346 population-based controls. All 293 patients were Nordic

and aged 16 to 75 years. The new analysis also included previous data

from 422 RA patients and 858 controls.

Overall, the risk for RA increased with increasing duration of exposure

to vibrations and mineral dust, the study showed.

Specifically, men were more at risk if they had been exposed to

vibration, asphalt, asbestos, and organic and mineral dusts. Risk of

developing RA increased with longer exposures to vibration (odds ratio

[OR] 2.0 at 11-20 years and 2.5 at >20 years) and mineral (stone or

silica) dust (OR 2.3 and 2.6, respectively).

This is the first time vibrations were identified as a risk factor for

RA, but the new work confirmed other studies suggesting links between RA

and mineral and organic dusts, report researchers, led by Dr Asa Reckner

Olsson (Linkoping University, Sweden).

" Several exposures associated with RA in the present study involve

respirable particles, and for exposure to mineral dust, there was a

dose-response relation, " they write. " It is possible that inhaled agents

are antigenic per se, or they act as immunological adjuvants, enhancing

an inflammatory response to other causative factors, " the study authors

suggest.

Male conductors, freight and transport workers, farmers, and farm

workers had an increased risk of developing RA, the study found. Among

women, RA risk was higher among those who worked as printmakers and

process engravers, report Olsson et al. " Occupational factors seem to be

etiologically more important for men, and most occupations at risk

involve multiple exposures, " they conclude.

They caution that many job categories consist almost solely of people of

the same sex; therefore, few exposures can be evaluated for both sexes.

Dr Harry Fischer (Beth Israel Medical Center, New York City, NY) told

rheumawire, " In men, exposure to mineral dusts and vibration may

increase the risk of developing RA, " he says, adding that cause and

effect can be difficult to prove with such epidemiological

studies. " Nonetheless it does suggest that obtaining a

detailed/lifelongoccupational history (not just current occupation) is

an important part ofthe history in any patient being evaluated for

possible RA, " he says.

Besides smoking, there are relatively few proven environmental exposures

known to increase risk of RA, Dr K Gregersen (North Shore Long

Island Jewish Research Institute, Manhasset, NY) tells rheumawire.

" Exposure to petroleum products [and other environmental exposures] may

be rather ubiquitous risk factors and hard to detect because everyone is

exposed, " he says. " RA may be a recent disease of modern society, " he

says, as these exposures became available only in modern times.

Source

Olsson AR, Skogh T, Axelson O, and Wingren G.

Occupations and exposures in the work environment as determinants for

rheumatoid arthritis. Occup Environ Med. 2004; 61:233-238.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org