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

AbstractKey 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 associationWe 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 i n 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 ...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research