title: Systemic sclerosis and occupational risk factors: role of solvents and cleaning products.
abstract: OBJECTIVE
  To analyze occupational and non-occupational exposure factors suspected of being associated with scleroderma (SSc), with a view to inculpating or excluding certain potentially toxic substances (e.g., solvents), thereby contributing to the recognition of such toxins in the field of occupational health.
  
  
  METHODS
  The study comprised 10 men and 83 women diagnosed with SSc between 1995 and 1999 (American College of Rheumatology criteria) and early SSc, and 206 age and sex matched controls. The SSc registry is all-inclusive in the French administrative departments of Isere and Savoie so controls were randomly selected from the general population (using telephone directories) in these departments to ensure full representation. Exposure factors were analyzed for each subject by a personal questionnaire, and an individual evaluation was carried out by an industrial expert. Data were analyzed by conditional logistical regression adjusting for educational level.
  
  
  RESULTS
  Construction workers were at significantly higher risk of contracting SSc; odds ratio (OR) = 4.01 (95% confidence interval 1.14-14.09). Analysis by industrial experts identified exposure to certain toxic substances regularly used by these same workers as risk factors for SSc: cleaning products: OR = 1.66 (0.90-3.08) (both sexes) and OR = 1.71 (0.92-3.20) (women only); solvents: OR = 3.23 (1.58-6.63) (both sexes) and OR = 2.80 (1.28-6.11) (women only); synthetic adhesives: OR 25.36 (1.36-472.28) (on 3 exposed cases).
  
  
  CONCLUSIONS
  Exposure to either cleaning products or solvents emerged as a risk factor for SSc. Exposure factors should be characterized and results of all studies compared to implement appropriate preventive measures in relevant workplaces.
authors.affiliation: Environnement et Prédiction de la Santé Des Populations-Laboratoire, Faculté de Médecine, Domaine de la Merci, 38706 La Tronche, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Maître
authors.forename: Martine
authors.initials: M
authors.lastname: Hours
authors.forename: Vincent
authors.initials: V
authors.lastname: Bonneterre
authors.forename: Joëlle
authors.initials: J
authors.lastname: Arnaud
authors.forename: Marie Tülin
authors.initials: MT
authors.lastname: Arslan
authors.forename: Patrick
authors.initials: P
authors.lastname: Carpentier
authors.forename: Alain
authors.initials: A
authors.lastname: Bergeret
authors.forename: Régis
authors.initials: R
authors.lastname: de Gaudemaris
mesh_terms: D000328:Adult; D017677:Age Distribution; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006795:Household Products / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D018570:Risk Assessment; D012595:Scleroderma, Systemic / Q000139:chemically induced* / Q000453:epidemiology*; D012720:Severity of Illness Index; D017678:Sex Distribution; D012997:Solvents / Q000009:adverse effects*
chemical_list: D012997:Solvents