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Exposure to Occupational Inhalable Agents Could Increase RA Risk

Markedly elevated risk seen for ACPA-positive RA with exposure to any occupational inhalable agents, smoking, high genetic risk score

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Dec. 7, 2022 (HealthDay News) — Exposure to occupational inhalable agents is associated with an increased risk for anticitrullinated protein antibodies (ACPA)-positive rheumatoid arthritis (RA), according to a study published online Dec. 6 in the Annals of the Rheumatic Diseases.

Bowen Tang, from the Karolinska Institutet in Stockholm, and colleagues used data from the Swedish Epidemiological Investigation of RA, including 4,033 incident RA cases and 6,485 matched controls to examine the effects of occupational inhalable exposures on RA development. Exposure to 32 inhalable agents was estimated based on retrieval of occupational histories, combined with a Swedish national job-exposure matrix.

The researchers found the risk for ACPA-positive RA was increased in association with exposure to any occupational inhalable agents (odds ratio, 1.25). As the number of exposed agents increased or duration of exposure elongated, the risk increased. When jointly considering exposure to any occupational inhalable agents, smoking, and high genetic risk score, those who were triple-exposed had a markedly elevated risk for ACPA-positive RA compared with those not exposed to any (odds ratio, 18.22). In ACPA-positive RA, significant interactions were identified between occupational inhalable agents and smoking/genetic factors.

“Our data provide a novel and quite dramatic emphasis on the role of occupational exposures in the etiology of seropositive RA, calling for extended measures to reduce these exposures as part of international collaborative efforts to reduce morbidities due to working life,” the authors write.

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