Exposure to Solvents in Female Patients with Scleroderma

Abstract

The role of exposure to solvents was investigated in female patients with connective tissue disease and Raynaud's phenomenon using a questionnaire. Sixteen out of the 63 patients with systemic sclerosis had been exposed to solvents. A borderline significance was demonstrated compared to matched female controls (P < 0.05). Fourteen out of the 66 patients with undifferentiated connective tissue disease, 18/86 of patients with Raynaud's phenomenon, 6/45 with systemic lupus erythematosus, 1/16 with dermatopolymyositis, 1/15 with rheumatoid arthritis and 0/13 with primary Sjögren's syndrome had been exposed to solvents. None of these groups of patients showed a statistical significance compared to matched controls. Our present findings indicate that, at least in certain areas of the world, exposure to solvents may be a provoking factor in female scleroderma, but it must be emphasised that only a borderline significance was found between the scleroderma patients and controls. A large multicenter study seems to be required to clarify the importance of solvents as provoking factors of scleroderma. Furthermore, exposure to solvents does not seem to be a provoking factor among females for the other connective tissue diseases.

Raynaud’s Phenomenon in Medical Laboratory Workers Who Work with Solvents

“…Exposures may have been higher and workplace practices different in earlier years. The findings are consistent with the increased rates of RP with solvent use found in other studies 6,8 . This study found higher rates of severe RP for those who had worked with xylene or toluene and acetone, a ketone, or chlorinated solvents.…”

“…Another systematic review reported a metaanalysis of 11 of these studies, with a publication-bias adjusted OR of 1.8 (95% CI 1.2-2.5) 5 . Two case-control studies have found increased relative risks of undifferentiated connective tissue disease from solvent exposure 6,7 . A case-control study of 25 patients with primary RP and 61 patients with secondary RP (RP as the sole predominant clinical symptom and either antinuclear antibody positivity, scleroderma capillary pattern, or pitting ulcerations/gangrene, but no internal organ manifestation) found an OR of 2.1 (95% CI 0.9-5.5) for solvent exposure 6 .…”

“…Two case-control studies have found increased relative risks of undifferentiated connective tissue disease from solvent exposure 6,7 . A case-control study of 25 patients with primary RP and 61 patients with secondary RP (RP as the sole predominant clinical symptom and either antinuclear antibody positivity, scleroderma capillary pattern, or pitting ulcerations/gangrene, but no internal organ manifestation) found an OR of 2.1 (95% CI 0.9-5.5) for solvent exposure 6 . A population survey found higher rates of simple and more severe RP in people exposed to solvents, with OR of 1.9 (95% CI 1.7-2.2) and 2.7 (95% CI 2.2-3.1), respectively 8 .…”

Primary Sjögren's syndrome and occupational risk factors: A case–control study

“…Indeed, solvents have already been reported to be associated with autoimmune diseases, such as systemic lupus erythematosus, systemic sclerosis and rheumatoid arthritis [16,17,20,21]. In a retrospective analysis, L. Czirjak and G. Kumanovics studied the association between exposure to solvents and autoimmune diseases [22]. They included 63 female patients with scleroderma, 66 female patients with undifferentiated connective tissue disease, 45 female patients with systemic lupus erythematosus, 16 females with dermatopolymyositis, 15 cases with rheumatoid arthritis, and 13 patients with pSS.…”

Effect of glutathione S‐TRANSFERASE polymorphisms and proximity to hazardous waste sites on time to systemic lupus erythematosus diagnosis: Results from the roxbury lupus project

“…Exposure to organic solvents, petroleum, and related by-products may play a role in susceptibility to SLE (17)(18)(19)(20)(21)(22). Solvent exposure has been associated with the risk of other autoimmune diseases, including scleroderma (23)(24)(25)(26), rheumatoid arthritis (27), and undifferentiated connective tissue disease (28), a chronic disease that shares clinical characteristics of SLE. A volatile organic solvent, trichloroethylene, has been linked with the presence of low-titer antinuclear antibodies (17,21).…”