Occupation and Risk of Developing Rheumatoid Arthritis: Results From a Population-Based Case-Control Study
Occupation and Risk of Developing Rheumatoid Arthritis: Results From a Population-Based Case-Control Study
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DOI：
10.1002/acr.23321
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发表时间：
2018-04-01
影响因子：
4.7
通讯作者：
Bengtsson, Camilla
中科院分区：
文献类型：
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作者：
Ilar, Anna;Alfredsson, Lars;Bengtsson, Camilla
环境因素对类风湿关节炎（RA）的病因学具有重要意义，但有关不同职业危害因素的贡献仍不清楚。我们探讨了职业与抗瓜氨酸蛋白抗体（ACPA）+ RA或ACPA- RA.MethodsWe的风险之间的关联分析了3,522例和5,580例对照瑞典人群为基础的流行病学调查风湿性关节炎病例对照研究。调查问卷被用来获得有关工作史和生活方式因素的信息。抽取血样进行血清学分析。采用非条件Logistic回归分析计算RA与入选研究前最后一个职业相关的比值比（OR）。对已知的环境暴露和生活方式因素进行了调整，包括吸烟、饮酒、体重指数和教育。（OR 2.9，95%置信区间[95% CI] 1.4-5.7），物料搬运操作员（OR 2.4，95% CI 1.3-4.4），电气和电子工作者（OR 2.1，95% CI 1.1-3.8）患ACPA+ RA的风险增加。对于ACPA-RA，砌砖工和混凝土工人（OR 2.4，95%CI 1.0-5.7）以及电气和电子工人（OR 2.6，95%CI 1.3-5.0）的风险增加。在女性中，助理护士和护理人员有中度增加的风险ACPA+ RA（OR 1.3，95% CI 1.1-1.6）。没有职业与ACPA- RA之间women.ConclusionMainly与潜在的有害空气传播剂相关的职业与ACPA+或ACPA- RA的风险增加有关，调整以前已知的混杂因素后。
ObjectiveEnvironmental factors are of importance for the etiology of rheumatoid arthritis (RA), but much remains unknown concerning the contributions from distinct occupational hazards. We explored the association between occupation and the risk of anti-citrullinated protein antibody (ACPA)+ RA or ACPA- RA.MethodsWe analyzed 3,522 cases and 5,580 controls from the Swedish population-based Epidemiological Investigation of Rheumatoid Arthritis case-control study. A questionnaire was used to obtain information on work history and lifestyle factors. Blood samples were drawn for serologic analyses. Unconditional logistic regression was used to calculate the odds ratio (OR) of RA associated with the last occupation before study inclusion. Analyses were performed with adjustments for known environmental exposures and lifestyle factors, including pack-years of cigarette smoking, alcohol use, body mass index, and education.ResultsAmong men, bricklayers and concrete workers (OR 2.9, 95% confidence interval [95% CI] 1.4-5.7), material handling operators (OR 2.4, 95% CI 1.3-4.4), and electrical and electronics workers (OR 2.1, 95% CI 1.1-3.8) had an increased risk of ACPA+ RA. For ACPA- RA, bricklayers and concrete workers (OR 2.4, 95% CI 1.0-5.7) and electrical and electronics workers (OR 2.6, 95% CI 1.3-5.0) had an increased risk. Among women, assistant nurses and attendants had a moderately increased risk of ACPA+ RA (OR 1.3, 95% CI 1.1-1.6). No occupations were significantly associated with ACPA- RA among women.ConclusionMainly occupations related to potential noxious airborne agents were associated with an increased risk of ACPA+ or ACPA- RA, after adjustments for previously known confounders.