title: Occupational exposures and risk of systemic lupus erythematosus: a review of the evidence and exposure assessment methods in population- and clinic-based studies.
abstract: Epidemiologic and experimental research suggests a potential role of occupational exposures in the development of systemic lupus erythematosus (SLE). A plausible association has been identified in studies of occupational silica exposure and SLE, complemented by experimental studies in lupus-prone mice exploring potential mechanisms related to apoptosis and immune dysregulation. Experimental studies of the solvent trichloroethylene in lupus-prone mice provide evidence of effects on immune function, including increased production of autoantibodies and activation of CD4+ T cells. However, few studies of occupational solvent exposure and SLE have been conducted, and those that are available show little evidence of an association. There is some suggestion from the available studies of the potential influence of pesticides on SLE, but as with solvents, the specific type of pesticides that may be implicated is not known. Our understanding of the role of occupational exposures in SLE could be advanced by the development of larger, multisite or parallel studies that utilize similar questionnaire and exposure evaluation methods. Multiple studies using comparable exposure measures are needed to provide sufficient sample size for examining gene-environment interactions. We provide a general overview of data requirements and methods available for the assessment and evaluation of occupational exposures in clinical and population-based studies of SLE.
authors.affiliation: Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute of Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV 26505, USA. cop8@cdc.gov
authors.forename: C G
authors.initials: CG
authors.lastname: Parks
authors.forename: G S
authors.initials: GS
authors.lastname: Cooper
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D002986:Clinical Trials as Topic / Q000379:methods / Q000639:trends; D019317:Evidence-Based Medicine; D006801:Humans; D007107:Immune System / Q000187:drug effects; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology* / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects*; D010575:Pesticides / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D012822:Silicon Dioxide / Q000009:adverse effects; D012997:Solvents / Q000009:adverse effects
chemical_list: D010575:Pesticides; D012997:Solvents; D012822:Silicon Dioxide