Date: Sunday, November 5, 2017
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Occupational exposure to silica dust has been associated with increased risk of developing ACPA positive Rheumatoid arthritis (RA)1,2,3. Little is known about non-occupational exposure, as there are no available tools to assess it in clinical practice.
The Dust Exposure Life-Course Questionnaire (DELCQ) longitudinally quantifies lifetime occupational and non-occupational (e.g. body care; hobbies such as DIY, woodworking, stone cutting etc.. ).
The DELCQ, developed within a European Research Council Advanced Grant, provides clinical research with a tool derived from social sciences .In the DELCQ, the identification of situations likely to put people at risk of exposure is grounded on an extensive list of products and activities summed up by the International Agency on Research on Cancer IARC4 and on a wide overview of the literature that in medicine, epidemiology and industrial hygiene has been addressing silica exposure and silica-related (or suspected-to-be-related) diseases.
The aim of this study was to use this novel tool to explore occupational and non-occupational silica exposure in a series of consecutive RA patients and to explore the association of quantified silica dust exposure with major disease features (ACPA positivity) or outcomes (erosive disease).
The DELCQ was administered to 97 consecutive RA patients (77F, 20M, mean age 59.1+/- 13.3 yrs.,75 ACPA positives, 66 with erosive disease) attending the department of rheumatology of the Avicenne teaching Hospital (Bobigny, FRANCE).The DELQQC scores of patients were compared to those of 261 controls, matched for sex, age and smoking status, from a 825-subject national cohort, representative of the general French population (ELIPSSilice). Within RA subjects, the association of the scores with ACPA positivity and with erosive disease was assessed after adjustment for tobacco exposure.
RA patients had higher scores of total (median [Q1, Q3]: 25 [13, 36] vs. 9 [4, 19]), occupational (10 [0, 17] vs. 0 [0, 4]) and non-occupational (15 [8, 20] vs. 7 [0, 15]) exposure vs. controls (p<0.0001 for all comparisons). Amongst RA patients, male vs. female patients had higher occupational scores of exposure (12 [2, 18] vs. 0 [0, 3] p<0.005), while non-occupational exposure was not significantly different (12 [3, 25] vs. 8[4, 15]). After adjusting for smoking (ever smokers vs. nonsmokers), neither professional of non-professional scores were associated with erosive disease, despite a strong negative interaction with tobacco exposure.
By using a tool developed in collaboration of social sciences, this work shows for the first time that RA patients have higher nonprofessional lifetime exposure to silica dust compared to age and sex-matched subjects from the general population. Moreover, higher occupation exposure in RA is confirmed, in accordance with previous literature. Neither occupational nor non-occupational exposure was associated with ACPA positivity or erosive disease, likely due to the high prevalence of ACPA positivity and severe disease in the patient series.
To cite this abstract in AMA style:Semerano L, Cavalin C, Macchi O, El Rharras S, Petit M, Decker P, Andre E, Rosental PA, Boissier MC. Patients with Rheumatoid Arthritis Have Higher Lifetime Professional and Non-Professional Exposure to Silica Dust Particles Compared to General Population [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/patients-with-rheumatoid-arthritis-have-higher-lifetime-professional-and-non-professional-exposure-to-silica-dust-particles-compared-to-general-population/. Accessed November 18, 2019.
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