Session Information
Session Title: Epidemiology and Public Health (ACR): Rheumatoid Arthritis Pathogenesis and Treatment
Session Type: Abstract Submissions (ACR)
Background/Purpose
The role of environmental factors in the etiology of rheumatoid arthritis (RA) is still fairly unknown. Finding occupations associated with the risk of disease could generate knowledge about occupational hazards that might be involved in disease development. The objective was to study the association between different occupations and the risk of developing anti-citrullinated protein antibodypositive (ACPA+) RA or anti-citrullinated protein antibody-negative (ACPA-) RA in men and women.
Methods
The Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study is a population-based case-control study, which enrolls newly diagnosed cases of RA in defined geographical areas of Sweden. Participants were 18-70 years of age. In total, 3,295 cases and 4,912 controls participated in the study. A questionnaire was collected to obtain information on environmental/lifestyle factors, including occupational history. Blood samples were taken for serologic analyses. Occupations were coded according to the Nordic Classification of Occupations and divided into 69 occupational groups. We compared the last occupation before onset of disease symptoms with the rest of the workforce for occupations with at least 5 controls by calculating odds ratios (ORs) together with 95% confidence intervals (CIs) for ACPA+ RA or ACPA- RA, respectively, by means of logistic regression with adjustment for age and county. Potential confounding from smoking was also considered.
Results
Among women, Nurses had a reduced risk (OR: 0.7, 95 % CI 0.5–1.0) whereas Assistant nurses & attendants in psychiatric care (OR: 1.4, 95 % CI: 1.2–1.6) and Rubber & plastic workers (OR: 2.9, 95 % CI: 1.1–7.4) had an increased risk of ACPA+ RA.
Among men, Technical, Physical & biological workers (OR: 0.7, 95 % CI: 0.5–1.0) and Clerical workers (OR: 0.7, 95 % CI: 0.5–1.0) had a reduced risk whereas Smelters & metal foundry workers (OR: 2.8, 95 % CI: 1.0–7.4), Bricklayers & concrete workers (OR: 2.6, 95 % CI: 1.3–4.9) , Material handling & related equipment operators (OR: 2.5, 95 % CI: 1.4–4.3) and Electrical & electronics workers (OR: 1.8, 95 % CI: 1.0–3.1) had an increased risk of ACPA+ RA.
For ACPA- RA, male Administrators & managers had a reduced risk (OR: 0.3, 95 % CI: 0.2–0.8), while Shop managers & assistants (OR: 1.9, 95 % CI: 1.2–3.1) and Electrical & electronics workers had an increased risk (OR: 2.1, 95 % CI: 1.1–4.0). Adjustment for smoking had a small effect on the estimates and mainly reduced the risk of ACPA+ RA.
Conclusion
The study found associations between several occupations and onset of RA. Among women, mainly occupations within the health care sector were associated with RA, whereas increased risks among men were detected in mechanical and technical occupations.
Disclosure:
A. Ilar,
None;
P. Wiebert,
None;
L. Klareskog,
None;
L. Alfredsson,
None;
C. Bengtsson,
None.
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