RESEARCH - Occupations and exposures in the work environment as determinants for RA

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Occupational and Environmental Medicine 2004;61:233-238

© 2004 BMJ Publishing Group Ltd

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ORIGINAL ARTICLE

Occupations and exposures in the work environment as determinants for

rheumatoid arthritis

Å Reckner Olsson1, T Skogh2, O Axelson1, G Wingren1

1 Division of Occupational and Environmental Medicine, Department of

Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping

University, SE-581 85 Linköping, Sweden

2 Division of Rheumatology, Unit for Autoimmunity and Immune

Regulation (AIR), Department of Molecular and Clinical Medicine,

Faculty of Health Sciences, Linköping University, SE-581 85 Linköping,

Sweden

ABSTRACT

Background and Aims: Several occupational categories have been

associated with rheumatoid arthritis (RA); this study was conducted to

further evaluate these associations.

Methods: Lifelong occupational history together with exposure

experiences were collected through a postal questionnaire answered by

293 incident cases and 1346 population based referents. Occupational

determinants were evaluated through stratified and multivariate

analyses; pooled analyses with previously gathered data on 422

prevalent cases and 858 referents were also performed.

Results: In both materials, significantly increased logistic odds

ratios (LORs) were seen for male conductors, freight and transport

workers (LOR 17.8, 95% CI 1.5 to 207.8 and LOR 4.7, 95% CI 1.4 to

16.3, respectively), and farmers and farm workers (LOR 2.4, 95% CI 1.1

to 5.2, and LOR 2.2, 95% CI 1.3 to 3.5, respectively). Among women,

increased LORs were seen in the separate and the pooled material for

printmakers and process engravers (LOR 5.5, 95% CI 0.9 to 32.6, and

LOR 3.0, 95% CI 0.9 to 10.3, respectively). Increased risks were seen

in both materials for men exposed to asbestos (LOR 2.5, 95% CI 1.0 to

6.8, and LOR 1.6, 95% CI 0.8 to 3.3, respectively), and vibrations

(LOR 2.0, 95% CI 0.9 to 4.4, and LOR 2.2, 95% CI 1.3 to 3.8,

respectively). The risk for RA increased with increasing duration of

exposure to vibrations and mineral dust, respectively.

Conclusions: There was evidence of a causal relation between exposures

to vibrations and mineral dust and development of RA among men.

Occupational factors seem to be aetiologically more important for men,

and most occupations at risk involve multiple exposures. Several

exposures associated with an increased risk for RA are frequent among

farmers, and some of the occupations at risk include exposure to

organic dust.

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http://oem.bmj.com/cgi/content/full/61/3/233

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