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Occupational determinants for rheumatoid arthritis
Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Molecular and Clinical Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-0153-9249
Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-8234-5461
2000 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 26, no 3, 243-249 p.Article in journal (Refereed) Published
Abstract [en]

Objectives The aim of the present study was to evaluate possible occupational determinants for rheumatoid arthritis according to lifetime occupational history.

Methods The cases were identified retrospectively from 1980 to 1995 at the University Hospital in Linköping, Sweden. The study comprised 422 cases and 859 randomly selected referents. Exposure data were collected through a postal questionnaire.

Results For men, occupations with increased, although nonsignificant, odds ratios (OR) were farmers or farm workers [OR 1.8, 95% confidence interval (95% CI) 1.0-3.5], textile workers (OR 2.0, 95% CI 0.3-16.2), asphalters (OR 14.0, 95% CI 1.2-799.0 without latency requirement), and employees at service stations (OR 2.2, 95% CI 0.5-9.5). Among the women, hairdressers and beauticians (OR 2.7, 95% CI 0.8-8.6) had an increased risk for rheumatoid arthritis, as well as those exposed to hairdressing chemicals (OR 3.0, 95% CI 1.0-9.4) and meat products (OR 2.0, 95% CI 1.0-4.0).

Conclusion Several of the findings in this study are in accordance with those of previous studies. The increased risks of rheumatoid arthritis for asphalters and employees at service stations are however new associations previously not described in the literature.

Place, publisher, year, edition, pages
2000. Vol. 26, no 3, 243-249 p.
Keyword [en]
asphalt, case-referent study, farmers, nonresponse bias, questionnaire
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-26087DOI: 10.5271/sjweh.538Local ID: 10546OAI: oai:DiVA.org:liu-26087DiVA: diva2:246635
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Occupational and environmental aspects on the aetiology of rheumatoid arthritis
Open this publication in new window or tab >>Occupational and environmental aspects on the aetiology of rheumatoid arthritis
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
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.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2003. 94 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 807
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26666 (URN)11232 (Local ID)91-7373-494-2 (ISBN)11232 (Archive number)11232 (OAI)
Public defence
2003-10-09, Aulan, Hälsans hus, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-10-16Bibliographically approved

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Reckner, ÅsaSkogh, ThomasWingren, Gun

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