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Aetiological factors of importance for the development of rheumatoid arthritis
Linköpings universitet, Institutionen för molekylär och klinisk medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet.
Linköpings universitet, Institutionen för molekylär och klinisk medicin, Reumatologi. Linköpings universitet, Hälsouniversitetet.ORCID-id: 0000-0002-0153-9249
Linköpings universitet, Institutionen för molekylär och klinisk medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet.ORCID-id: 0000-0002-8234-5461
2004 (engelsk)Inngår i: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 33, nr 5, s. 300-306Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective: To evaluate exposure to external factors associated with risk or prevention of rheumatoid arthritis (RA).

Methods: Two hundred and ninety‐three incident cases of RA and 1346 population‐based referents were included in a case‐referent study, in which previous exposure experiences were collected through a postal questionnaire.

Results: An inverse association between RA and additional schooling after compulsory school was seen for men. Current smoking was associated with significantly increased risks of RA for men and women [odds ratio (OR) 2.9, 95% confidence interval (CI) 1.4–6.4, and OR 1.8, 95% CI 1.1–2.9, respectively], as was previous smoking for men (OR 2.3, 95% CI 1.2–4.4). There were also indications of relationships between previous use of a private well and RA in both men and women.

Conclusion: Several previously published associations have been reproduced in the present study, which also generates some new hypotheses that suggest further research.

sted, utgiver, år, opplag, sider
2004. Vol. 33, nr 5, s. 300-306
Emneord [en]
aetiological factors, case‐referent study, educational level, environment, epidemiology, private well, rheumatoid arthritis, smoking
HSV kategori
Identifikatorer
URN: urn:nbn:se:liu:diva-22028DOI: 10.1080/03009740310004748Lokal ID: 1066OAI: oai:DiVA.org:liu-22028DiVA, id: diva2:242330
Tilgjengelig fra: 2009-10-07 Laget: 2009-10-07 Sist oppdatert: 2017-12-13bibliografisk kontrollert
Inngår i avhandling
1. Occupational and environmental aspects on the aetiology of rheumatoid arthritis
Åpne denne publikasjonen i ny fane eller vindu >>Occupational and environmental aspects on the aetiology of rheumatoid arthritis
2003 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Two questionnaire-based case-referent studies were performed to primarily assess the impact from occupational and environmental exposures on the aetiology of rheumatoid arthritis (RA). The two studies included prevalent and incident cases of RA, respectively. All determinants were evaluated separately for the two materials, and potential occupational risk factors were also analysed after pooling of the two studies. Most associations found between occupational exposures and RA regarded men. Increased risks for RA were seen for exposure to asphalt (OR 6.0, 95% CI 1.6-27.7), vibrations (OR 2.1, 95% CI 1.4-3.3), crops and/or forage (OR 2.0, 95% CI 1.3-3.0), mineral dust (OR 1.8, 95 % CI 1.0-3.2). and mineral oil (OR 1.5, 95 % CI 1.0-2.3 ), with dose-response relationships between RA and exposure to mineral dust and vibrations. Occupational categories at increased risk of RA among men were conductors, freight and transport workers (OR 4.6, 95 % CI 1.4-15.0), pulp and paper workers (OR 3.9, 95 % CI 1.2-12.8), and farmers (OR 2.3, 95 % CI 1.4-3.5). Regarding women, increased risks for RA were seen for exposure to meat (OR 2.2, 95 % CI 1.0-4.9), hairdressing chemicals (OR 1.7, 95 % CI 0.7-4.5), and for hairdressers (OR 1.7, 95 % CI 0.7-4.0). The results refer to the pooled material.

Regarding leisure-time activities, an increased risk was seen for mineral oil exposure among men in the study with incident cases (OR 2.0, 95 % CI 0. 7-6.2 ). In this study, an association was also seen for men for having ever used a private well (OR 1.5, 95 % CI 0.8-2.9). In the study with prevalent cases, associations were seen for both sexes for having been exposed to water from a private well at time of birth (OR 1.5, 95 % CI 0.9-2.4 for women, and OR 2.8, 95 % CI 1.5-5.2 for men). The risk of RA was increased for men with previous exposure to mould indoors (OR 4.6, 95 % CI 1,1-20.2 ), and an association was also seen for long time use of hair dyes and/or bleach among women (OR 1.9, 95 % CI 0.8-4.5). In the study with incident cases, the risk for RA was increased among men with previous use of skin lotion (OR 3.0, 95 % CI 0.9-9.8).

For both sexes, increased risks for RA were seen for current and previous smoking, with even higher ORs for seropositive cases among men. In the study with incident cases, male subjects with more than 20 pack years of smoking had an OR of 2.5 (95 % CI 1.2-5.1), corresponding to an OR of 1.6 (95% CI 0.9-3.1) among women. There was a tendency towards increasing risks with increasing number of pack years for men in both studies, with significant tests for trend in the study with prevalent cases. For both sexes, higher schooling resulted in a decreased risk for RA.

The relationship between RA and allergy was evaluated more extensively in a cross-sectional study, and negative associations between RA and certain manifestations of hay fever were found. An almost significantly decreased risk for allergy was found in the study with prevalent cases with both sexes included in the analysis (OR 0.6, 95 % CI 0.4-1.0). Regarding other comorbidity, there were positive associations between RA and self-repotted thyroid conditions (OR 3.5. 95 % CI 1.1-10.8) and previous treatment with insulin (OR 10.2, 95 % CI 1.7-60.8) among women in the study with prevalent cases. In the cross-sectional study, there was an association between RA and diabetes (OR 2.8. 95 & CI 0.9-8.9), with both sexes included in the analysis. Associations were seen between previous joint trauma and RA for women in both case-referent studies (OR 2.5, 95 % CI 1.0-6.6 in the study with prevalent cases) as well as for men in the study with incident cases (OR 2.2, 95% CI 0.6-7.1).

Altogether, the determinants conveying the risk for RA differ between sexes. RA is a condition most often affecting women. but the present studies, as well as previous research, have established that most extemal factors evaluated so far seem to be of more importance for men than women.

sted, utgiver, år, opplag, sider
Linköping: Linköpings universitet, 2003. s. 94
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 807
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-26666 (URN)11232 (Lokal ID)91-7373-494-2 (ISBN)11232 (Arkivnummer)11232 (OAI)
Disputas
2003-10-09, Aulan, Hälsans hus, Universitetssjukhuset, Linköping, 09:00 (svensk)
Opponent
Tilgjengelig fra: 2009-10-08 Laget: 2009-10-08 Sist oppdatert: 2012-10-16bibliografisk kontrollert

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