Systematic Review and Meta-analysis on the Association of Occupational Exposure to Free Crystalline Silica and Rheumatoid Arthritis

Key messages • Occupational exposure to free crystalline silica and tobacco smoking are associated with an increased risk rheumatoid arthritis, with the evidence of an interaction in seropositive subjects . • Further studies in the field are needed to support such association We carried out a system...

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Published in:Clinical reviews in allergy & immunology 2022-04, Vol.62 (2), p.333-345
Main Authors: Morotti, A., Sollaku, I., Franceschini, F., Cavazzana, I., Fredi, M., Sala, E., De Palma, G.
Format: Article
Language:English
Subjects:
Allergology
Analysis
Arthritis
Arthritis, Rheumatoid - etiology
Autoantibodies
Autoimmunity
B cells
Epidemiology
Humans
Immunology
Internal Medicine
Internet/Web search services
Medicine
Medicine & Public Health
Meta-analysis
Occupational exposure
Occupational Exposure - adverse effects
Occupational health and safety
Rheumatoid arthritis
Rheumatoid factor
Risk Factors
Silica
Silicon Dioxide - adverse effects
Smoking
Tobacco smoking
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Summary:Key messages • Occupational exposure to free crystalline silica and tobacco smoking are associated with an increased risk rheumatoid arthritis, with the evidence of an interaction in seropositive subjects . • Further studies in the field are needed to support such association We carried out a systematic search for all published epidemiological studies concerning the association between occupational exposure to free crystalline silica (FCS) and subsequent development of rheumatoid arthritis (RA). A meta-analysis was conducted on relevant studies. We searched PubMed and Embase, search engines, for original articles published (from 1960 to November 2019) in any language. In addition, we also searched reference lists of included studies manually for additional relevant articles. Finally, twelve studies were included in the meta-analysis (seven case-control cases and five cohort studies). The odds risks and 95% confidence interval (CI) were calculated using a random effect meta-analysis. A primary meta-analysis (using a random effect model)—regarding RA risk in subjects exposed to FCS—yelled to an overall OR of 1.94 (95% CI 1.46–2.58). We also conducted three further meta-analysis, taking into account the presence of autoantibodies (anti-RF or anti-ACPA) and smoking habits and found a significant association between FCS and RA in both seropositive and seronegative subjects (OR 1.74, 95% CI 1.35–2.25 and OR 1.23, 95% CI 1.06–1.4, respectively) and in seropositive subjects which were smokers (OR 3.30, 95% CI 2.40–4.54). The studies that have investigated the association between RA and occupatational exposure to FCS are still scarce and the heterogeneity between the studies remains high. Some critical limitations have been identified within studies, among which, the methods for assessing exposure stand out. Although with due caution, our results confirm the hypothesis of an association between occupational exposure to FCS and RA development. There was an interaction between FCS and tobacco smoking in RA seropositive workers.
ISSN:1559-0267
1080-0549
1559-0267
DOI:10.1007/s12016-021-08846-5