Relationship between occupational risk factors and severity markers of systemic sclerosis.
OBJECTIVE
To investigate a potential association between occupational risk factors and severity markers of systemic sclerosis (SSc) defined by diffuse cutaneous extent, pulmonary involvement, and immunologic profile, i.e., presence of antitopoisomerase I antibody (anti-topo I).


METHODS
Occupational exposures were assessed in 105 patients with SSc from 1998 to 2002. Exposures to silica dust, welding fumes, solvents, and epoxy resins were investigated. A group of 39 exposed SSc patients and a group of 66 unexposed ones were identified and compared according to severity markers of SSc. The stage of cutaneous extent was defined according to the classification of Leroy, as limited scleroderma (lSSc) or diffuse scleroderma (dSSc). Respiratory status was defined by pulmonary function tests and high resolution computed tomography. Immunological profile was determined by the presence of anti-topo I or anticentromere antibodies (ACA). Statistical relationships between occupational exposures and severity markers of SSc were evaluated using a multiple correspondence analysis and Fisher's exact test.


RESULTS
Diffuse scleroderma affected mainly patients exposed during their occupational life to toxic agents. There were significant or close to significant associations between toxic exposure and dSSc (p = 0.06), pulmonary involvement (p = 0.10), and negative ACA (p = 0.03). The most incriminated products seemed to be epoxy resins (p = 0.06), white spirit (p = 0.07), aromatic solvents (p = 0.07), and silica coupled to welding fumes (p = 0.10).


CONCLUSIONS
Our results indicate that occupational toxic factors have an influence on the severity of SSc.
Magnant
Julie
J
Groupe de Pneumologie, INSERM U618, IFR 135, Service de Médecine Interne B, Institut de Médecine du Travail du Val de Loire, France.
de Monte
Michèle
M
Guilmot
Jean-Louis
JL
Lasfargues
Gérard
G
Diot
Patrice
P
Asquier
Elisabeth
E
Degenne
Danielle
D
Boissinot
Eric
E
Diot
Elisabeth
E
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000974:Antibodies, Antinuclear / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016273:Occupational Exposure / Q000009:adverse effects*; D011336:Probability; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012594:Scleroderma, Localized / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D012595:Scleroderma, Systemic / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D012720:Severity of Illness Index; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed
D000974:Antibodies, Antinuclear; D015415:Biomarkers