Dusty trades and associated rheumatoid arthritis in a population-based study in the coal mining counties of Appalachia.

Details

• Personal Author:
  Blanc PD ; Schmajuk G ; Trupin L ; Yelin EH
• Description:
  Objectives: We previously showed increased coal mining-associated risk of rheumatoid arthritis (RA). Using additional survey data, we sought to delineate this risk further. Methods: We used data from two cross-sectional, random-digit-dial, population-based surveys (males; greater than or equal to 50 years) in selected counties in the Appalachian region of the inland, mid-Atlantic USA with elevated pneumoconiosis mortality. Surveys ascertained age, smoking, coal mining and non-coal silica exposure jobs. In a subset, we surveyed ergonomic exposures, scored by intensity. We queried diagnosis of RA, corticosteroid use, and, in a subset, use of disease modifying antirheumatic drugs (DMARDs). Multivariable logistic regression modelled RA risk (defined by glucocorticoid or DMARDs use) associated with coal mining employment, other silica exposure, smoking status, and age and ergonomic exposures. Results: We analysed data for 2981 survey respondents (mean age 66.6 years; 15% current, 44% ex-smokers). The prevalence of glucocorticoid-treated and DMARD-treated RA was 11% and 4%, respectively. Glucocorticoid-treated RA was associated with coal mining (OR 3.5; 95% CI 2.5 to 4.9) and non-coal mining silica exposure (OR 3.2; 95% CI 2.4 to 4.4). For DMARD-treated RA, the odds associated with coal mining and other silica remained elevated: OR 2.3 (95% CI 1.18, 4.5) and OR 2.7 (95% CI 1.51, 5.0), respectively. In the same model, the highest intensity ergonomic exposure also was associated with increased odds of RA (OR 4.3; 95% CI 1.96 to 9.6). Conclusions: We observed a strong association between coal mining and other silica-exposing dusty trades and RA. Clinicians and insurers should consider occupational histories in the aetiology of RA. [Description provided by NIOSH]
• Subjects:
  Aging Coal Coal Mining Dust Environmental Exposure Ergonomics Men Mining Morbidity Mortality Occupational Health Risk Assessment Risk Factors Safety Silicon Dioxide Smokers

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• Keywords:
  Dusts; Dust exposure; Rheumatoid disorders; Coal mining; Underground mines; Underground mining; Exposure levels; Risk factors; Humans; Men; Age groups; Pneumoconiosis; Morbidity rates; Mortality rates; Smoking; Silica; Ergonomics; Corticosteroids; Drugs; Statistical analysis; Models
• ISSN:
  1351-0711
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  308-314
• Volume:
  79
• Issue:
  5
• NIOSHTIC Number:
  nn:20064987
• Citation:
  Occup Environ Med 2022 May; 79(5):308-314
• Contact Point Address:
  Professor Paul D Blanc, Medicine, Veterans Health Administration, San Francisco, CA
• Email:
  paul.blanc@ucsf.edu
• CAS Registry Number:
  Silica (CAS RN 7631-86-9)
• Federal Fiscal Year:
  2022
• Performing Organization:
  University of California, Berkeley
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Occupational and Environmental Medicine
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:686f4c5debb6091b341110dd390f79055022586a2414080d2d4c01bc17e7f2f68d864cb836b22731d5f0a87b966007750fb1517fc9c2e62298e0931e65f3b57c
• Download URL:
  https://stacks.cdc.gov/view/cdc/248873/cdc_248873_DS1.pdf
• File Type:
  [PDF - 525.90 KB ]