scholarly journals Sarcoidosis and silica dust exposure among men in Sweden: a case–control study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038926
Author(s):  
Pål Graff ◽  
Johanna Larsson ◽  
Ing-Liss Bryngelsson ◽  
Pernilla Wiebert ◽  
Per Vihlborg

ObjectiveTo determine whether occupational exposure to silica dust is associated with an increased risk of developing sarcoidosis.DesignCase–control study of all individuals between 20 and 65 years of age diagnosed with sarcoidosis (D86) in Sweden between 2007 and 2016. Controls were matched to cases (2:1) based on age, sex and county at the time of diagnosis. A Job Exposure Matrix was used to estimate the occupational silica exposure of all cases and controls.SettingMedical and occupational data from the National Outpatient Register were used to implement a case–control analysis, while the two controls used for each case were selected from the National Register of the Total Population. Information about occupation and time of employment were collected from the Swedish Occupational Register.ParticipantsAll men and women aged 20–65 years old who were diagnosed sarcoidosis (D86) from 2007 to 2016 were included and assigned two controls.Main outcomesSilica dust exposure correlates with an increased risk of developing sarcoidosis in men.ResultsThe prevalence of silica exposure at work was statistically significantly higher among male cases than controls (OR 1.27, 95% CI 1.13 to 1.43). For men of an age of 35 years or younger the correlation seems to be stronger (OR 1.48, 95% CI 1.1 to 1.87) than in older men (OR 1.21, 95% CI 1.05 to 1.39). For men older than 35 with exposure to silica the prevalence of sarcoidosis increased with the exposure time, with an OR of 1.44 (95% CI 1.04 to 2.00) for exposure of more than 10 years.ConclusionsOccupational exposure to silica dust seems to increase the risk of sarcoidosis among men between 20 and 65 years of age. The risk is higher among exposed men 35 years or younger and older men with longer exposure (>6 years).

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A26.2-A26
Author(s):  
Per Vihlborg ◽  
Pål Graf ◽  
Ing-Liss Bryngelsson

IntroductionSarcoidosis is an inflammatory disease with unknown etiology that involves the formation of granulomas, mainly in the lungs and/or intrathoracic lymph nodes. Hypothesis about the etiology of sarcoidosis are combination of genetic and environmental factors. Previous studies have linked exposure to silica dust with increased risk of sarcoidosis.ObjectA case-control study to investigate the silica exposure among Swedish sarcoidosis cases.MethodsThe data was collected from the National non-primary outpatient care register kept by the Swedish National Board of Health and Welfare. All cases between the age of 20 and 65 with the diagnosis Sarkoidos-D86 according to the International Classification of Diseases, 10th Edition (ICD-10) was included in the study (11 772 cases). The information was matched towards the register for cause of death and the register for emigration.For each case two controls were included matched for age, sex, was resident in the same county, should not be first degree relatives to cases and not have been diagnosed with the investigated disease using the Swedish Central Bureau of Statistics (SCB) multigeneration register. Cases and controls was matched against SCBs occupational registry for work profession. The levels of silica dust exposure were estimated using NOCCA-JEM (Nordic Occupational Cancer study job-exposure matrix) a modified version of the Finnish Information System on Occupational Exposure job-exposure matrix (FINJEM) which is a well-established method of estimating exposure.ResultCases of sarcoidosis have an increased exposure to silica before diagnosis (1.19; 95%  CI 1.1 to 1.30).ConclusionThe increased exposure to silica among sarcoidosis cases suggest that silica can be an environmental factor that contribute to development of sarcoidosis.


BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034752 ◽  
Author(s):  
Albin Wallden ◽  
Pål Graff ◽  
Ing-Liss Bryngelsson ◽  
Louise Fornander ◽  
Pernilla Wiebert ◽  
...  

ObjectiveTo determine whether occupational exposure to silica dust causes an increased risk of developing Crohn’s disease (CD) and ulcerative colitis (UC).DesignCase–control study of CD (K50) and UC (K51) from 2007 through 2016. Controls were matched to cases (2:1) based on age, sex and county at the time of diagnosis. A job exposure matrix was used to estimate the occupational silica exposure of all cases and controls.SettingMedical and occupational data from the National Outpatient Register were used to implement a case–control analysis, while the two controls used for each case were selected from the National Register of the Total Population.ParticipantsAll men and women aged 20–65 years old who were diagnosed with CD (K50) and UC (K51) during the years of study were included and assigned two controls, resulting in 58 136 cases and 116 272 controls.Main outcomesSilica dust exposure correlates with an increased risk of developing UC in men and CD in women.ResultsThe prevalence of UC was significantly higher in the group exposed to silica dust (OR 1.13, 95% CI 1.06 to 1.21) than in controls, particularly in individuals with over 5 years exposure. When stratified by sex, a significantly increased OR was detected for men (OR 1.33, 95% CI 1.05 to 1.22). This trend was also consistent with longer exposure times. The prevalence of UC was not increased in exposed women. The prevalence of CD was significantly increased among exposed women (OR 1.29, 95% CI 1.01 to 1.65), but not for exposed men.ConclusionsSilica dust exposure correlates with an increased risk of developing UC, especially in men, and the risk seems to increase with the duration and degree of exposure. Conversely, silica dust exposure correlates positively with the risk of developing CD in women.


2015 ◽  
Vol 75 (6) ◽  
pp. 997-1002 ◽  
Author(s):  
Chun Lai Too ◽  
Nor Asiah Muhamad ◽  
Anna Ilar ◽  
Leonid Padyukov ◽  
Lars Alfredsson ◽  
...  

ObjectivesLung exposures including cigarette smoking and silica exposure are associated with the risk of rheumatoid arthritis (RA). We investigated the association between textile dust exposure and the risk of RA in the Malaysian population, with a focus on women who rarely smoke.MethodsData from the Malaysian Epidemiological Investigation of Rheumatoid Arthritis population-based case–control study involving 910 female early RA cases and 910 female age-matched controls were analysed. Self-reported information on ever/never occupationally exposed to textile dust was used to estimate the risk of developing anti-citrullinated protein antibody (ACPA)-positive and ACPA-negative RA. Interaction between textile dust and the human leucocyte antigen DR β-1 (HLA-DRB1) shared epitope (SE) was evaluated by calculating the attributable proportion due to interaction (AP), with 95% CI.ResultsOccupational exposure to textile dust was significantly associated with an increased risk of developing RA in the Malaysian female population (OR 2.8, 95% CI 1.6 to 5.2). The association between occupational exposure to textile dust and risk of RA was uniformly observed for the ACPA-positive RA (OR 2.5, 95% CI 1.3 to 4.8) and ACPA-negative RA (OR 3.5, 95% CI 1.7 to 7.0) subsets, respectively. We observed a significant interaction between exposure to occupational textile dust and HLA-DRB1 SE alleles regarding the risk of ACPA-positive RA (OR for double exposed: 39.1, 95% CI 5.1 to 297.5; AP: 0.8, 95% CI 0.5 to 1.2).ConclusionsThis is the first study demonstrating that textile dust exposure is associated with an increased risk for RA. In addition, a gene–environment interaction between HLA-DRB1 SE and textile dust exposure provides a high risk for ACPA-positive RA.


2018 ◽  
Vol 75 (5) ◽  
pp. 328-336 ◽  
Author(s):  
Régis Colin ◽  
Michel Grzebyk ◽  
Pascal Wild ◽  
Guy Hédelin ◽  
Ève Bourgkard

ObjectivesTo assess the relationship between occupational exposure to metalworking fluids (MWFs) in the steel-producing industry and bladder cancer incidence.MethodsA nested case–control study on bladder cancer was set up in a cohort of workers from six French steel-producing factories. Three controls were randomly selected for each incident bladder cancer case diagnosed from 2006 to 2012. Controls were matched to cases on age at diagnosis and counter-matched on a surrogate measure of exposure to MWFs derived from a job-exposure matrix. Cases (n=84) and controls (n=251) were face-to-face interviewed. Experts assessed occupational exposure to MWFs (straight, soluble and synthetic) using questionnaires and reports from factory visits. Occupational exposures were based on three metrics: duration, frequency-weighted duration and cumulative exposure index. Conditional multiple logistic regressions were used to determine ORs and 95% CIs, taking non-occupational and occupational exposure into account.ResultsIn the 25 years before diagnosis, ORs increased significantly with duration of exposure to straight MWFs (OR=1.13 (1.02–1.25)) and increased with frequency-weighted duration of exposure to straight MWFs (OR=1.44 (0.97–2.14)). These results remained valid after adjusting for duration of smoking, average number of cigarettes smoked per day, time since smoking cessation and exposure to polycyclic aromatic hydrocarbons (PAHs). ORs also increased with soluble MWFs but not significantly. No significant association was found with older exposures to MWFs or with exposure to synthetic MWFs.ConclusionThe increased risk of bladder cancer observed among workers exposed to straight MWFs and to a lesser extent to soluble MWFs may be explained by the presence of carcinogens (such as PAH) in mineral oils component of straight and soluble oils. Prevention therefore remains necessary in sectors using MWFs.


2019 ◽  
Vol 76 (3) ◽  
pp. 169-174 ◽  
Author(s):  
Minjie Chu ◽  
Shuangshuang Wu ◽  
Wei Wang ◽  
Yuhui Yu ◽  
Mingjiong Zhang ◽  
...  

ObjectivesIn a genome-wide association study, we discovered chromosome 12q15 (defined as rs73329476) as a silica-related pneumoconiosis susceptibility region. However, the causal variants in this region have not yet been reported.MethodsWe systematically screened eight potentially functional single-neucleotide polymorphism (SNPs) in the genes near rs73329476 (carboxypeptidase M (CPM) and cleavage and polyadenylation specific factor 6 (CPSF6)) in a case–control study including 177 cases with silicosis and 204 healthy controls, matched to cases with years of silica dust exposure. We evaluated the associations between these eight SNPs and the development of silicosis. Luciferase reporter gene assays were performed to test the effects of selected SNP on the activity of CPM in the promoter. In addition, a two-stage case–control study was performed to investigate the expression differences of the two genes in peripheral blood leucocytes from a total of 64 cases with silicosis and 64 healthy controls with similar years of silica dust exposure as the cases.ResultsWe found a strong association between the mutant rs12812500 G allele and the susceptibility of silicosis (OR=1.45, 95% CI 1.03 to 2.04, p=0.034), while luciferase reporter gene assays indicated that the mutant G allele of rs12812500 is strongly associated with increased luciferase levels compared with the wild-type C allele (p<0.01). Moreover, the mRNA (peripheral blood leucocytes) expression of the CPM gene was significantly higher in subjects with silicosis compared with healthy controls.ConclusionsThe rs12812500 variant of the CPM gene may increase silicosis susceptibility by affecting the expression of CPM, which may contribute to silicosis susceptibility with biological plausibility.


RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e000978 ◽  
Author(s):  
Anna Ilar ◽  
Lars Klareskog ◽  
Saedis Saevarsdottir ◽  
Pernilla Wiebert ◽  
Johan Askling ◽  
...  

ObjectiveAirborne agents including cigarette smoke associate with an increased risk of rheumatoid arthritis (RA). We analysed to which extent occupational exposure to asbestos and silica confers an increased risk of developing serologically defined subsets of RA.MethodsThis Swedish population-based case-control study enrolled incident RA cases between 1996 and 2013 (n=11 285), identified through national public authority and quality registers, as well as from the Epidemiological Investigation of Rheumatoid Arthritis (EIRA) Study. Controls (n=1 15 249) were randomly selected from Sweden’s population register and matched on sex, age, index year and county. Occupational histories were obtained from national censuses. Exposure to asbestos and silica was assessed by job-exposure matrices. Logistic regression was used to calculate ORs adjusted for age, sex, county, index year, alcohol use and smoking.ResultsResults showed that male workers exposed to asbestos had higher risk of seropositive RA (OR=1.2, 95% CI 1.0 to 1.4) and seronegative RA (OR=1.2, 95% CI 1.0 to 1.5) compared with unexposed workers. The risk was highest among workers exposed to asbestos from 1970, before a national ban was introduced. Male workers exposed to silica also had higher risk of RA (seropositive RA: OR=1.4, 95% CI 1.2 to 1.6; seronegative RA: OR=1.3, 95% CI 1.0 to 1.5). For the largest subset, seropositive RA, the OR increased with the number of years exposed to silica, up to OR=2.3 (95% CI 1.4 to 3.8, p for trend <0.0001). Women overall had lower ORs than men, but the duration and intensity of their exposure were lower.ConclusionsIn conclusion, we observed an association between asbestos exposure and risk of developing RA and extended previous findings of an association between silica exposure and RA risk, where a dose-response relationship was observed.


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