Smoke and dust common in the workplace may increase the risk of rheumatoid arthritis

dusty room

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According to a study published online in the Journal of Science, breathing in common workplace dust and fumes from agents such as vapors, gases, and solvents can increase the risk of developing arthritis. low form. Chronicle of rheumatism.

Furthermore, such vapors, gases and solvents appear to increase the adverse effects of smoking and genetic susceptibility to the disease, the findings showed.

Rheumatoid arthritis (RA) is a chronic autoimmune joint disorder characterized by painful and disabling inflammation. It affects 1% of the world population.

Although it is known that smoking increases the risk of developing rheumatoid arthritis, it is not known what affects breathing dust and dust in the workplace. smoke there may be.

In an attempt to find out, the researchers gathered data from the Swedish Epidemiological Survey of RA. This included 4,033 people newly diagnosed between 1996 and 2017 and another 6,485 people matched for age and sex, but without the disease (comparison group).

Personal work history was provided and used to estimate individual exposure to 32 airborne workplace agents, using a proven technique. Each participant was assigned a Genetic Risk Score (GRS), depending on whether they carried a gene that could increase their chances of developing rheumatoid arthritis.

Rheumatoid arthritis is characterized by the presence or absence of anti-citrullinated protein antibodies or ACPA for short. Positive ACPA indicates a worse prognosis with a higher incidence of erosive joint damage.

Nearly three-quarters of people with rheumatoid arthritis who test positive (73%) and negative (72%) for ACPA have been exposed to at least one dust or smoke in the workplace, compared with about two-thirds (67%) of people in the group compare corporations.

Analysis of the data shows that exposure to triggers in the workplace is not only associated with a higher risk of developing rheumatoid arthritis, but also appears to increase that risk even further due to interactions with smoking. and genetic susceptibility.

Overall, exposure to any agent in the workplace was associated with a 25% higher risk of ACPA-positive rheumatoid arthritis. And this risk rises to 40% in men.

Specifically, 17 out of 32 agents—including quartz, asbestos, diesel fumes, gasoline fumes, carbon monoxide and fungicides—are strongly associated with an increased risk of developing ACPA-positive disease. Only a few agents—quartz dust (silica), asbestos, and detergents—have been strongly associated with ACPA-negative disease.

The risk increased with the number of agents and the duration of exposure, with the strongest association seen for exposures lasting about 8-15 years. Men tend to be exposed to more and longer triggers than women.

“Triple exposure”—to a workplace agent, combined with smoking and high GRS—is associated with a very high risk of ACPA-positive disease, 16 to 68 times higher than ” no triple contact”.

In particular, the risk of developing ACPA-positive rheumatoid arthritis for a triple exposure to gasoline engine emissions was 45 times higher for gasoline engine emissions, 28 times higher for engine emissions. diesel, 68 times higher for pesticides and 32 times higher for quartz. dust (silica). The corresponding range for ACPA-negative disease was insignificant.

This was an observational study, and as such, cause cannot be established. The researchers also acknowledged some limitations to their findings: The study was based on personal memory; and although exposure estimates are obtained using validated methods, the results can be relatively rough. In addition, because many workplace triggers are often present at the same time, it can be difficult to determine which may be the cause.

However, the researchers conclude: “Occupational inhaled agents may act as important environmental agents in the development of RA and interact with genes at risk for RA and smoking. medication, leading to an increased risk of ACPA-positive RA.”

They added, “Our study highlights the importance of occupational respiratory protection measures, particularly for people who are genetically predisposed to RA.”

Dr Jeffrey Sparks, of Brigham and Women’s Hospital, Boston, USA, noted that the study results have several important implications for disease development and prevention.

“First, each occupational inhalation agent has a unique profile of how it interacts with RA risk genes and with smoking. These unique interactions suggest that if there is a relationship between effects inhalation and RA are indeed causal, they can do so through separate pathways.”

Referring to the stronger associations found for ACPA-positive status, Dr. Sparks commented that these findings reinforce the growing belief that ACPA-positive disease can be fatal. different from ACPA-negative rheumatism. arthritis.

Greater public health efforts are needed to limit the risk of development rheumatoid arthritishe concluded.

“First, environmental health initiatives will reduce the public’s exposure to ambient pollutants, including carbon monoxide and gasoline emissions. Second, occupational health initiatives should reduce occupational hazards, including cleaning agents and asbestos. Third, public health initiatives should continue to reduce smoking,” he wrote.

More information:
Occupational inhaled substances constitute the major risk factors for rheumatoid arthritis, especially in the context of genetic predisposition and smoking. Chronicle of rheumatism (2022). DOI: 10.1136/ard-2022-223286

quote: Pervasive smoke and dust in the workplace that may increase the risk of rheumatoid arthritis (2022, December 6) retrieved December 7, 2022 from 12-common-workplace-fumes-heighten-rheumatoid.html

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