Background The etiology of rheumatoid arthritis (RA) is still fairly unknown. Finding occupations associated with the risk of disease could generate knowledge about occupational hazards that might be involved in disease development.
Objectives The study explored the association between occupation and the risk of developing anti-citrullinated protein antibody-positive (ACPA+) RA or anti-citrullinated protein antibody-negative (ACPA-) RA in men and women.
Methods The Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study is a population-based case-control study, which enrolls newly diagnosed cases of RA in defined geographic areas of Sweden. Participants were 18-70 years of age. In total, 2,886 cases and 4,072 controls participated in the study. A questionnaire was collected to obtain information on occupational history and lifestyle factors. Blood samples were taken for serologic analyses. Logistic regression was used to calculate the odds ratio (OR) of RA due to last occupation before onset of disease symptoms in men and women separately.
Results Among women, nurses had a reduced risk whereas assistant nurses, retail salesmen and machine fitters & assemblers had an increased risk of ACPA+ RA. Female attendants in psychiatric care had an increased risk while social workers had a reduced risk of ACPA- RA. Female business administrators had a reduced risk of RA, independent of ACPA status.
Among men, wholesalers & retailers had a reduced risk whereas construction machine operators had an increased risk of ACPA+ RA. Men who worked as systems analysts had a decreased risk, while architects & engineers & technical workers, cargo & van drivers and machine & engine repairers had an increased risk of ACPA- RA. Male electricians were associated with an increased risk, whereas business administrators and advertisement workers had reduced point estimates in RA independent of ACPA status.
Adjusting for smoking mainly affected the risk of developing ACPA+ RA.
Conclusions This study found associations between several occupations and onset of RA. Considering sex and ACPA status were of considerable relevance. Differences were detected between men and women, where elevated risks among women were mainly seen in the health care sector, whereas increased risks among men were detected in mechanical and technical occupations.
Disclosure of Interest : None declared
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