Amount of smoking, duration of smoking cessation and their interaction with silica exposure in the risk of rheumatoid arthritis among males: results from the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study

Zeng, Pingling; Chen, Zuomei; Klareskog, Lars; Alfredsson, Lars; Bengtsson, Camilla; Jiang, Xia

doi:10.1136/annrheumdis-2017-212145

Cited by 17 publications

(11 citation statements)

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“…Thus, silica exposure has been identified as a risk factor both for RA as a whole (before appropriate subdivisions into subsets was done) [76] and later found to be restricted mainly but not exclusively to the seropositive (RF and/or ACPA-positive) subsets [77][78][79]. Interestingly, a significant interaction between the two environmental exposures smoking and silica exposure was observed in providing risk for ACPApositive RA [77,81]. An additional exposure with possible effects both in airways and elsewhere was observed in textile workers in Malaysia, where an increased risk was seen both for anti-CCP-positive and anti-CCP-negative patients [80].…”

Section: Smoking and Other Airway Exposuresmentioning

confidence: 99%

The importance of differences; On environment and its interactions with genes and immunity in the causation of rheumatoid arthritis

et al. 2020

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Section: Smoking and Other Airway Exposuresmentioning

confidence: 99%

The importance of differences; On environment and its interactions with genes and immunity in the causation of rheumatoid arthritis

et al. 2020

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“…Further support for this aetiological hypothesis comes from the observations that occupations related to manufacturing, construction and production, which include airborne exposure to inorganic dusts, are associated with an increased risk of RA 4–7. Exposure to one such agent, silica, has been shown to increase the risk of RA,8–10 and interact with cigarette smoking in conferring an increased risk for seropositive RA 11. It is thus of interest to investigate if other airborne agents are also associated with an increased risk for RA.…”

Section: Introductionmentioning

confidence: 99%

Occupational exposure to asbestos and silica and risk of developing rheumatoid arthritis: findings from a Swedish population-based case-control study

et al. 2019

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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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“…Interestingly, a high risk of ACPA-positive RA was observed among silica-exposed current smokers (OR = 7.36, 95% CI 3.31–16.38), suggesting an interaction between these exposures [ 46 ]. Few other studies supported such silica–smoking interaction [ 48 , 72 ]. These results must be taken with caution because smoking duration or intensity was not taken into account.…”

Section: Inhaled Exposures Other Than Smokingmentioning

confidence: 99%

Environment and Lifestyle: Their Influence on the Risk of RA

Salliot

Nguyen

Boutron‐Ruault

et al. 2020

JCM

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Background: Rheumatoid arthritis (RA) is a complex disease in which environmental agents are thought to interact with genetic factors that lead to triggering of autoimmunity. Methods: We reviewed environmental, hormonal, and dietary factors that have been suggested to be associated with the risk of RA. Results: Smoking is the most robust factor associated with the risk of RA, with a clear gene–environment interaction. Among other inhalants, silica may increase the risk of RA in men. There is less evidence for pesticides, pollution, and other occupational inhalants. Regarding female hormonal exposures, there is some epidemiological evidence, although not consistent in the literature, to suggest a link between hormonal factors and the risk of RA. Regarding dietary factors, available evidence is conflicting. A high consumption of coffee seems to be associated with an increased risk of RA, whereas a moderate consumption of alcohol is inversely associated with the risk of RA, and there is less evidence regarding other food groups. Dietary pattern analyses (Mediterranean diet, the inflammatory potential of the diet, or diet quality) suggested a potential benefit of dietary modifications for individuals at high risk of RA. Conclusion: To date, smoking and silica exposure have been reproducibly demonstrated to trigger the emergence of RA. However, many other environmental factors have been studied, mostly with a case-control design. Results were conflicting and studies rarely considered potential gene–environment interactions. There is a need for large scale prospective studies and studies in predisposed individuals to better understand and prevent the disease and its course.

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Amount of smoking, duration of smoking cessation and their interaction with silica exposure in the risk of rheumatoid arthritis among males: results from the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study

Cited by 17 publications

References 10 publications

The importance of differences; On environment and its interactions with genes and immunity in the causation of rheumatoid arthritis

The importance of differences; On environment and its interactions with genes and immunity in the causation of rheumatoid arthritis

Occupational exposure to asbestos and silica and risk of developing rheumatoid arthritis: findings from a Swedish population-based case-control study

Environment and Lifestyle: Their Influence on the Risk of RA

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