Signe Hjuler Boudigaard1, Vivi Schlünssen2,3, Jesper Medom Vestergaard1, Klaus Søndergaard4, Kjell Torén5, Susan Peters6, Hans Kromhout6, Henrik A Kolstad1. 1. Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. 2. Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark. 3. National Research Center for the Working Environment, Copenhagen, Denmark. 4. Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark. 5. Occupational and Environmental Medicine, School of Public Health and Community Medicine, Sahlgrenska Academy, University of Goteborg, Goteborg, Sweden. 6. Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
Abstract
BACKGROUND: Exposure to respirable crystalline silica is suggested to increase the risk of autoimmune rheumatic diseases. We examined the association between respirable crystalline silica exposure and systemic sclerosis, rheumatoid arthritis, systemic lupus erythematosus and small vessel vasculitis. METHODS: In a cohort study of the total Danish working population, we included 1 541 505 male and 1 470 769 female workers followed since entering the labour market 1979-2015. Each worker was annually assigned a level of respirable crystalline silica exposure estimated with a quantitative job exposure matrix. We identified cases of autoimmune rheumatic diseases in a national patient register and examined sex-specific exposure-response relations by cumulative exposure and other exposure metrics. RESULTS: We identified 4673 male and 12 268 female cases. Adjusted for age and calendar year, men exposed to high levels of respirable crystalline silica compared with non-exposed showed increased incidence rate ratio (IRR) for the four diseases combined of 1.53 [95% confidence interval (CI): 1.39-1.69], for systemic sclerosis of 1.62 (1.08-2.44) and rheumatoid arthritis of 1.57 (1.41-1.75). The overall risk increased with increasing cumulative exposure attained since entering the workforce [IRR: 1.07 (1.05-1.09) per 50 µg/m3-years]. Female workers were less exposed to respirable crystalline silica, but showed comparable risk patterns with overall increased risk with increasing cumulative exposure [IRR: 1.04 (0.99-1.10) per 50 µg/m3-years]. CONCLUSIONS: This study shows an exposure-dependent association between occupational exposure to respirable crystalline silica and autoimmune rheumatic diseases and thus suggests causal effects, most evident for systemic sclerosis and rheumatoid arthritis.
BACKGROUND: Exposure to respirable crystalline silica is suggested to increase the risk of autoimmune rheumatic diseases. We examined the association between respirable crystalline silica exposure and systemic sclerosis, rheumatoid arthritis, systemic lupus erythematosus and small vessel vasculitis. METHODS: In a cohort study of the total Danish working population, we included 1 541 505 male and 1 470 769 female workers followed since entering the labour market 1979-2015. Each worker was annually assigned a level of respirable crystalline silica exposure estimated with a quantitative job exposure matrix. We identified cases of autoimmune rheumatic diseases in a national patient register and examined sex-specific exposure-response relations by cumulative exposure and other exposure metrics. RESULTS: We identified 4673 male and 12 268 female cases. Adjusted for age and calendar year, men exposed to high levels of respirable crystalline silica compared with non-exposed showed increased incidence rate ratio (IRR) for the four diseases combined of 1.53 [95% confidence interval (CI): 1.39-1.69], for systemic sclerosis of 1.62 (1.08-2.44) and rheumatoid arthritis of 1.57 (1.41-1.75). The overall risk increased with increasing cumulative exposure attained since entering the workforce [IRR: 1.07 (1.05-1.09) per 50 µg/m3-years]. Female workers were less exposed to respirable crystalline silica, but showed comparable risk patterns with overall increased risk with increasing cumulative exposure [IRR: 1.04 (0.99-1.10) per 50 µg/m3-years]. CONCLUSIONS: This study shows an exposure-dependent association between occupational exposure to respirable crystalline silica and autoimmune rheumatic diseases and thus suggests causal effects, most evident for systemic sclerosis and rheumatoid arthritis.
Authors: Signe Hjuler Boudigaard; Karoline Kærgaard Hansen; Henrik Kolstad; Hans Kromhout; Vivi Schlünssen Journal: Ann Work Expo Health Date: 2022-04-22 Impact factor: 2.779
Authors: Ryan F Hoy; Mohamed F Jeebhay; Catherine Cavalin; Weihong Chen; Robert A Cohen; Elizabeth Fireman; Leonard H T Go; Antonio León-Jiménez; Alfredo Menéndez-Navarro; Marcos Ribeiro; Paul-André Rosental Journal: Respirology Date: 2022-03-18 Impact factor: 6.175
Authors: Anastasiya Muntyanu; Raymond Milan; Elham Rahme; Avery LaChance; Lydia Ouchene; Maxime Cormier; Ivan V Litvinov; Marie Hudson; Murray Baron; Elena Netchiporouk Journal: Front Med (Lausanne) Date: 2022-09-29
Authors: Oscar Wrangel; Pål Graff; Ing-Liss Bryngelsson; Louise Fornander; Pernilla Wiebert; Per Vihlborg Journal: J Occup Environ Med Date: 2021-11-01 Impact factor: 2.162