title: Primary Sjögren's syndrome and occupational risk factors: A case-control study.
abstract: OBJECTIVE
  A case-control study was carried out to investigate the relation between primary Sjögren's syndrome (pSS) and occupational exposure.
  
  
  METHODS
  One hundred seventy five cases of pSS followed up into the internal medicine departments of three French university hospitals from 2010 to 2013 were included. For each case, two age and gender matched controls were selected during the same period in the same departments. Occupational exposure was assessed retrospectively by industrial hygienists and occupational practitioners. Exposure to occupational factors such as organic solvents or silica was investigated using semiquantitative estimates of exposure. An exposure score was calculated for each subject based on probability, intensity, daily frequency, and duration of exposure for each period of employment. The final cumulative exposure score was obtained, taking into account all periods of employment.
  
  
  RESULTS
  Significant associations with pSS were observed for dichloromethane (OR 9.28, 95%CI 2.60-33.03), perchlorethylene (OR 2.64, 95%CI 1.20-5.77) chlorinated solvents (OR 2.95, 95%CI 1.77-4.93), benzene (OR 3.30, 95%CI 1.07-10.26), toluene (OR 4.18 95%CI 1.41-12.43), white spirit (OR 3.60, 95%CI 1.39-9.33), aromatic solvents (OR 3.03, 95%CI 1.41-6.50) and any types of solvents (OR 2.76, 95%CI 1.70-4.47). Risk of pSS was significantly associated with a high cumulative exposure score of occupational exposure to toluene (OR 4.69, 95%CI 1.42-15.45), white spirit (OR 3.30, 95%CI 1.07-10.26), aromatic solvents (OR 2.50, 95%CI 1.06-5.91) and any types of solvents (OR 2.25, 95%CI 1.20-4.22).
  
  
  CONCLUSIONS
  This work suggests the influence of occupational risk factors in the occurrence of pSS.
authors.affiliation: CHRU de Tours, Service de Médecine Interne, Université François-Rabelais de Tours, France. Electronic address: benjamin.chaigne@hotmail.fr.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Chaigne
authors.affiliation: Institut de Santé au travail de Paris-Est, Université Paris-Est Créteil, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Lasfargues
authors.affiliation: CHRU de Rouen, Service de Médecine Interne, Rouen, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Marie
authors.affiliation: CHRU de Tours, Service de Stomatologie et de Chirurgie Maxillo-Faciale, Tours, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Hüttenberger
authors.affiliation: CHRU d'Angers, Service de Médecine Interne, Angers, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Lavigne
authors.affiliation: CHRU de Tours, Service de Pneumologie, Université François-Rabelais de Tours, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Marchand-Adam
authors.affiliation: CHRU de Tours, Service de Médecine Interne, Université François-Rabelais de Tours, France.
authors.forename: François
authors.initials: F
authors.lastname: Maillot
authors.affiliation: CHRU de Tours, Service de Médecine Interne, Université François-Rabelais de Tours, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Diot
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006838:Hydrocarbons / Q000009:adverse effects; D008297:Male; D008752:Methylene Chloride / Q000009:adverse effects; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors; D012822:Silicon Dioxide / Q000009:adverse effects*; D012859:Sjogren's Syndrome / Q000453:epidemiology*; D012997:Solvents / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D013750:Tetrachloroethylene / Q000009:adverse effects; D014050:Toluene / Q000009:adverse effects
chemical_list: D006838:Hydrocarbons; D012997:Solvents; D014050:Toluene; D008752:Methylene Chloride; C013089:ligroin; D012822:Silicon Dioxide; D013750:Tetrachloroethylene
keywords: Occupational risk factors; Organic solvent; Primary Sjögren syndrome