RA risk by job

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Takeaway

  • 4 occupations, 3 involving noxious airborne substances, were associated with an increased risk for rheumatoid arthritis (RA) in this large case-control study.

Why this matters

  • Previous studies of RA and occupation did not adjust for environmental or lifestyle risk factors or stratify patients by positive or negative anticitrullinated protein antibodies (ACPAs) status.

Key results

  • 3522 patients with RA and 5580 control patients with complete data.
  • Adjusted, elevated RA risk in men in the following occupational groups:
  • —Electrical/electronics workers (OR, 2.1 for ACPA+; OR, 2.6 for ACPA).
  • —Bricklayers, concrete workers (OR, 2.9 for ACPA+; OR, 2.4 for ACPA).
  • —Material handling operators (OR, 2.4 for ACPA+).
  • —ORs slightly lower after adjustment for silica exposure.
  • Adjusted, elevated RA risk in women in the following occupations:
  • —Assistant nurses/attendants (OR, 1.3 for ACPA+).

Study design

  • Population-based case-control study of adults with newly diagnosed RA (n=3724) and age-, sex-, and residential area-matched control participants (n=5935).
  • Participants were checked for ACPA status, asked about their occupation in the previous year.
  • Analyses were adjusted for matching variables plus smoking, alcohol use, BMI, education.
  • Funding: Swedish Research Council for Health, Working Life, and Welfare; AFA Insurance.

Limitations

  • Study possibly underpowered to detect other occupational associations.
  • Bias potential from group differences, selection bias.