Occupational and Hobby Exposures Associated With Myositis Phenotypes in a National Myositis Patient Registry

IF 3.7 2区医学 Q1 RHEUMATOLOGY

Arthritis Care & Research Pub Date : 2024-11-12 DOI:10.1002/acr.25461

Christine G. Parks, Jesse Wilkerson, Kathryn M. Rose, Abdullah Faiq, Payam Noroozi Farhadi, Nastaran Bayat, Adam Schiffenbauer, Hermine I. Brunner, Bob Goldberg, Dale P. Sandler, Frederick W. Miller, Lisa G. Rider

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引用次数: 0

Abstract

Objective

The objective of this study was to investigate occupational and hobby exposures to silica, solvents, and heavy metals and the odds of having the idiopathic inflammatory myopathy (IIM) phenotypes dermatomyositis (DM) and polymyositis (PM) versus inclusion body myositis (IBM), lung disease plus fever or arthritis (LD+), and systemic autoimmune rheumatic disease–associated overlap myositis (OM).

Methods

The sample included 1,390 patients (598 with DM, 409 with PM, and 383 with IBM) aged ≥18 years from a national registry. Of these, 218 (16%) were identified with LD+, and 166 (12%) with OM. Of these, 218 (16%) were identified with LD+, and 166 (12%) with OM. We calculated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) and explored joint effects with smoking.

Results

High silica exposure was associated with increased odds of having DM (OR 2.02, 95% CI 1.18–3.46, compared to no exposure; P trend = 0.004), LD+ (OR 1.75, 95% CI 1.10–2.78, vs no LD; P trend = 0.005), and OM (OR 2.07, 95% CI 1.19–3.61, P trend = 0.020). Moderate to high heavy metals exposure was associated with greater odds of having LD+ (OR 1.49, 95% CI 1.00–2.14, P trend = 0.026) and OM (OR 1.59, 95% CI 0.99–2.55, P trend = 0.051). Greater odds of having LD+ were seen among smokers with moderate to high silica exposure versus nonsmokers with low or no exposure (high-certainty assessment OR 2.53, 95% CI 1.31–4.90, P interaction = 0.061).

Conclusion

These findings, based on a systematic exposure assessment, suggest that occupational and hobby exposures to silica and heavy metals contribute to adult IIM phenotypes, including DM, OM, and LD+, a possible marker for antisynthetase syndrome or other autoantibody-associated lung diseases.

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全国肌炎患者登记中与肌炎表型相关的职业和嗜好暴露

目的调查职业和业余接触二氧化硅、溶剂和重金属与特发性炎症性肌炎（IIM）表型、皮肌炎（DM）和多发性肌炎（PM）与包涵体肌炎（IBM）、肺部疾病加发热或关节炎（LD+）以及系统性自身免疫性风湿病-重叠性肌炎（OM）的几率：样本包括来自全国登记处的1390名年龄≥18岁的患者（598名DM患者、409名PM患者和383名IBM患者）。其中，218人（16%）被确认为LD+，即自我报告的肺部疾病伴有发热和/或关节炎，166人（12%）被确认为OM。我们采用基于规则的方案和专家对矽尘、溶剂和重金属暴露的评估，对诊断前的工作、业余爱好和暴露的问卷数据进行了评估。我们计算了调整后的几率比（OR）和95%置信区间（CI），并探讨了与吸烟的联合效应：与无接触相比，接触大量二氧化硅会增加患 DM（OR=2.02；95%CI 1.18-3.46；p-trend=0.004）、LD+（1.75；1.10-2.78；p-trend=0.005，与无 LD 相比）和 OM（2.07；1.19-3.61；p-trend=0.020）的几率。中度至高度重金属暴露与更高的 LD+ （1.49；1.00-2.14；p-trend=0.026）和 OM （1.59；0.99-2.55；p-trend=0.051）几率相关。中度至高度二氧化硅暴露的吸烟者与低度或无暴露的非吸烟者相比，LD+的几率更大（高确定性评估，2.53；1.31-4.90；p-交互作用=0.061）：这些基于系统暴露评估的研究结果表明，职业和业余暴露于二氧化硅和重金属会导致成人 IIM 表型，包括 DM、OM 和 LD+，而 LD+ 可能是抗合成酶或其他自身抗体相关肺病的标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arthritis Care & Research RHEUMATOLOGY-

CiteScore

9.40

自引率

6.40%

发文量

368

审稿时长

3-6 weeks

期刊介绍： Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.