Prospective study to evaluate the association between systemic sclerosis and occupational exposure and review of the literature

Marie, I; Gehanno, JF; Bubenheim, M; Duval-Modeste, AB; Joly, P; Dominique, S; Bravard, P; Noël, D; Cailleux, AF; Weber, J; Lagoutte, P; Benichou, J; Levesque, H

HERO ID

2128571

Reference Type

Journal Article

Subtype

Review

Year

2014

Language

English

PMID

24129037

HERO ID 2128571
Material Type Review
In Press No
Year 2014
Title Prospective study to evaluate the association between systemic sclerosis and occupational exposure and review of the literature
Authors Marie, I; Gehanno, JF; Bubenheim, M; Duval-Modeste, AB; Joly, P; Dominique, S; Bravard, P; Noël, D; Cailleux, AF; Weber, J; Lagoutte, P; Benichou, J; Levesque, H
Journal Autoimmunity Reviews
Volume 13
Issue 2
Page Numbers 151-156
Abstract <strong>INTRODUCTION: </strong>Systemic sclerosis (SSc) has complex pathogenesis and likely multifactorial causes. Environmental exposures have been suggested to play a role in SSc pathogenesis, including occupational exposure to pollutants and chemicals as well as use of drugs leading to modulation of immune response. Thus, this case-control study aimed to assess: the relationship between SSc and occupational exposure; and the risk of SSc related to occupational exposure in male and female patients.<br /><br /><strong>METHODS: </strong>From 2005 to 2008, 100 patients with a definite diagnosis of SSc were included in the study; 3 age, gender, and smoking habits matched controls were selected for each patient. A committee of experts evaluated blindly occupational exposure to crystalline silica, white spirit, organic solvents, ketones, welding fumes, epoxy resins, and pesticides; an occupational exposure score was calculated for all subjects. Our findings were compared with previous data in the literature.<br /><br /><strong>RESULTS: </strong>Increased ORs for SSc were found for: crystalline silica (p&lt;0.0001), white spirit (p&lt;0.0001), aromatic solvents (p=0.0002), chlorinated solvents (p=0.014), trichlorethylene (p=0.044), ketones (p=0.002) and welding fumes (p=0.021). Elevated risk associated with high final cumulative score in SSc was observed for: crystalline silica, white spirit, chlorinated solvents, trichlorethylene, aromatic solvents, any type of solvents, ketones and welding fumes. A marked association between SSc and occupational exposure was further found for: 1) crystalline silica, chlorinated solvents, trichloroethylene, white spirit, ketones and welding fumes in male patients; and 2) white spirit, aromatic solvents, any type of solvent and ketones in female patients. Finally, we did not find an association between SSc and: 1) the use of drugs that have been speculated to play a role in SSc onset (anorexigens, pentazocine, bromocriptine, l-tryptophan); 2) implants - that are prosthesis, silicone implants, and contact lenses; and 3) dyeing hair. In the literature, SSc has been associated with occupational exposure to silica and solvents, while the association between SSc and specific organic solvents and welding fumes has been anecdotally reported.<br /><br /><strong>CONCLUSION: </strong>The following occupational factors have an impact in the development of SSc: crystalline silica, white spirit, aromatic solvents, chlorinated solvents, trichlorethylene, ketones and welding fumes. The risk of SSc appears to be markedly associated with high cumulative exposure. Finally, the association between SSc and occupational exposure may be variable according to gender.
Doi 10.1016/j.autrev.2013.10.002
Pmid 24129037
Wosid WOS:000329685500012
Is Certified Translation No
Dupe Override No
Is Public Yes
Language Text English
Keyword Systemic sclerosis; Occupational factors; Crystalline silica; Solvents; Ketones; Welding fumes