title: Occupational silica and solvent exposures and risk of systemic lupus erythematosus in urban women.
abstract: OBJECTIVE
  To assess the risk of systemic lupus erythematosus (SLE) associated with occupational exposure to silica dust and organic solvents in an urban population.
  
  
  METHODS
  Women with SLE were identified through both community screening and hospital databases in 4 predominantly African American neighborhoods in Boston. Female control patients were volunteers from the same communities and were screened for the absence of connective tissue disease. Demographic factors, smoking history, and a detailed occupational history, including exposures to specific chemicals, were obtained by in-person interviews. The exposure assessment was based on independent evaluation of the occupational history by 2 reviewers who were blinded to each subject's disease status. The risks associated with exposure to silica and solvents were analyzed using multivariate conditional logistic regression models, adjusted for potential confounders.
  
  
  RESULTS
  Ninety-five patients and 191 age- and race-matched controls were included in this analysis. Exposure to silica for longer than 1 year was associated with SLE (odds ratio [OR] 4.3, 95% confidence interval [95% CI] 1.7-11.2). An exposure-response effect was seen for longer duration of exposures to silica (P for trend = 0.01). The association between occupational exposure to organic solvents and SLE was not statistically significant (OR 1.04, 95% CI 0.34-3.2).
  
  
  CONCLUSIONS
  Silica exposure from a variety of industrial occupations in urban areas is associated with an increased risk of SLE. A longer duration of exposure to silica dust is associated with greater risks. This study provides further impetus for additional research into the influence of modifiable exposures on the pathogenesis of SLE.
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. afinckh@post.harvard.edu
authors.forename: Axel
authors.initials: A
authors.lastname: Finckh
authors.forename: Glinda S
authors.initials: GS
authors.lastname: Cooper
authors.forename: Lori B
authors.initials: LB
authors.lastname: Chibnik
authors.forename: Karen H
authors.initials: KH
authors.lastname: Costenbader
authors.forename: Julie
authors.initials: J
authors.lastname: Watts
authors.forename: Helen
authors.initials: H
authors.lastname: Pankey
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Fraser
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Karlson
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001900:Boston / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced / Q000453:epidemiology*; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology*; D016273:Occupational Exposure; D012307:Risk Factors; D012822:Silicon Dioxide / Q000009:adverse effects*; D012997:Solvents / Q000009:adverse effects*; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D012997:Solvents; D012822:Silicon Dioxide