Occupational risk factors for the development of systemic lupus erythematosus.
OBJECTIVE
There have been few studies of occupational exposures and systemic lupus erythematosus (SLE). We examined the association between the risk of SLE and occupational exposures (mercury, solvents, and pesticides), specific jobs (ever worked in teaching, healthcare, and cosmetology), and working night or rotating shifts.


METHODS
Patients with recently diagnosed SLE (n = 265) were recruited through 4 university based and 30 community based rheumatology practices in North Carolina and South Carolina, USA. Controls (n = 355) were identified through driver's license records and were frequency matched to patients by age, sex, and state. Data collection included an in-person interview with detailed farming and work histories.


RESULTS
Associations were seen with self-reported occupational exposure to mercury (OR 3.6, 95% CI 1.3, 10.0), mixing pesticides for agricultural work (OR 7.4, 95% CI 1.4, 40.0), and among dental workers (OR 7.1, 95% CI 2.2, 23.4). Although these associations were fairly strong and statistically significant, the prevalence of these exposures was very low and thus these estimates are based on a small number of exposed cases and controls. Weaker associations were seen between SLE and shift work (OR 1.6, 95% CI 0.99, 2.7) and among healthcare workers with patient contact (OR 1.7, 95% CI 0.99, 2.9). There was no association of SLE with use of solvents or among teachers or cosmetologists.


CONCLUSIONS
This study reveals the potential contribution of occupational exposures to the development of SLE, and highlights some exposures and experiences that should be examined in other studies using more extensive exposure assessment techniques and in experimental studies of autoimmunity.
Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina 27709, USA. copper1@niehs.nih.gov
Glinda S
GS
Cooper
Christine G
CG
Parks
Edward L
EL
Treadwell
E William
EW
St Clair
Gary S
GS
Gilkeson
Mary Anne
MA
Dooley
D016022:Case-Control Studies; D004651:Employment; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology*; D008628:Mercury / Q000009:adverse effects; D009657:North Carolina; D016273:Occupational Exposure / Q000009:adverse effects; D012307:Risk Factors; D012997:Solvents / Q000009:adverse effects; D013022:South Carolina
D012997:Solvents; D008628:Mercury