title: Organic solvents as risk factor for autoimmune diseases: a systematic review and meta-analysis.
abstract: BACKGROUND
  Genetic and epigenetic factors interacting with the environment over time are the main causes of complex diseases such as autoimmune diseases (ADs). Among the environmental factors are organic solvents (OSs), which are chemical compounds used routinely in commercial industries. Since controversy exists over whether ADs are caused by OSs, a systematic review and meta-analysis were performed to assess the association between OSs and ADs.
  
  
  RESULTS
  The systematic search was done in the PubMed, SCOPUS, SciELO and LILACS databases up to February 2012. Any type of study that used accepted classification criteria for ADs and had information about exposure to OSs was selected. Out of a total of 103 articles retrieved, 33 were finally included in the meta-analysis. The final odds ratios (ORs) and 95% confidence intervals (CIs) were obtained by the random effect model. A sensitivity analysis confirmed results were not sensitive to restrictions on the data included. Publication bias was trivial. Exposure to OSs was associated to systemic sclerosis, primary systemic vasculitis and multiple sclerosis individually and also to all the ADs evaluated and taken together as a single trait (OR: 1.54; 95% CI: 1.25-1.92; p-value<0.001).
  
  
  CONCLUSIONS
  Exposure to OSs is a risk factor for developing ADs. As a corollary, individuals with non-modifiable risk factors (i.e., familial autoimmunity or carrying genetic factors) should avoid any exposure to OSs in order to avoid increasing their risk of ADs.
authors.affiliation: Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia.
authors.forename: Carolina
authors.initials: C
authors.lastname: Barragán-Martínez
authors.forename: Cesar A
authors.initials: CA
authors.lastname: Speck-Hernández
authors.forename: Gladis
authors.initials: G
authors.lastname: Montoya-Ortiz
authors.forename: Rubén D
authors.initials: RD
authors.lastname: Mantilla
authors.forename: Juan-Manuel
authors.initials: JM
authors.lastname: Anaya
authors.forename: Adriana
authors.initials: A
authors.lastname: Rojas-Villarraga
mesh_terms: D001327:Autoimmune Diseases / Q000209:etiology*; D016022:Case-Control Studies; D006801:Humans; D009930:Organic Chemicals / Q000009:adverse effects*; D012196:Review Literature as Topic; D012307:Risk Factors; D012997:Solvents / Q000009:adverse effects*
chemical_list: D009930:Organic Chemicals; D012997:Solvents