Rheumatoid Arthritis and Pneumoconiosis

Details

• Personal Author:
  Rosenman, Kenneth D.
• Description:
  To the Editor: The article by Olson and colleagues presented interesting statistics on mortality for rheumatoid arthritis-associated interstitial lung disease (RA-ILD) (1). However, no mention was made in the article of the well-known association between interstitial fibrosis caused by asbestos, coal, or silica and either rheumatoid arthritis or positive serum rheumatoid factor (2-6). The methodology of Olson and coworkers, as noted in their discussion of limitations, was based on the accuracy of the diagnoses reported on death certificates. Given the known association between the pneumoconioses and rheumatoid arthritis it is likely that some percentage of the decedents identified with RA-ILD actually had interstitial disease from mineral exposure and also had rheumatoid arthritis, or that some had interstitial lung disease from mineral dust exposure and had a positive rheumatoid factor without rheumatoid arthritis rather than RA-ILD. Data in the article by Olson and coworkers that would be consistent with the possibility of misdiagnosis include: 1.Mortality rates for RA-ILD decreased in men while they increased in women. Men are more likely to have pneumoconiosis, and mortality rates for silicosis, and for coal workers' pneumoconiosis are declining. 2.The occurrence of RA-ILD was higher in men than women (9.8% versus 6.8%), even though rheumatoid arthritis is more common in women. This difference between men and women is consistent with the increased incidence of pneumoconiosis in men versus women. Further work that examines the occurrence and trends in RA-ILD should consider what role interstitial disease from exposure to mineral dust confounds the diagnosis and recognition of RA-ILD. Studies that involve more strict criteria for determining the presence of interstitial disease and rheumatoid arthritis would benefit from the inclusion of occupational histories/exposures in their case definitions. [Description provided by NIOSH]
• Subjects:
  Asbestos Dust Fibrosis Minerals Occupational Exposure Occupational Health Safety Sex Characteristics Silicon Dioxide
• Keywords:
  Asbestos Dust Coal Dust Gender Factors Mineral Dusts Mineral Processing Occupational Exposure Pneumoconiosis Rheumatoid Disorders Silica Dusts
• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Michigan ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  185
• Issue:
  9
• NIOSHTIC Number:
  nn:20054266
• Citation:
  Am J Respir Crit Care Med 2012 May; 185(9):1024
• CAS Registry Number:
  Asbestos (CAS RN 1332-21-4) ; Silica (CAS RN 7631-86-9)
• Federal Fiscal Year:
  2012
• Performing Organization:
  Michigan State University
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:40d21d9ef06cbd4c36d61f32d027ecc1a9938dc83b1229739169ea661d6e8817b6fb91149fd98937d4144e70dd8f38ffcc9ef6b09b7aca4da974fbb5702b795c
• Download URL:
  https://stacks.cdc.gov/view/cdc/216865/cdc_216865_DS1.pdf
• File Type:
  [PDF - 39.62 KB ]