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Prevalence of connective tissue disease in silicosis (1985-2006): a report from the state of Michigan surveillance system for silicosis.

Authors
Makol-A; Reilly-MJ; Rosenman-KD
Source
Am J Ind Med 2011 Apr; 54(4):255-262
NIOSHTIC No.
20038680
Abstract
Background: The risk of developing clinical connective tissue disease (CTD) has been reported to be increased among individuals with silica exposure. Methods: We reviewed the medical records of individuals reported to the Michigan Silicosis Surveillance system from 1985 to 2006 to confirm the diagnosis of silicosis and determine the presence of CTDs. Results: From 1985 to 2006, 1,022 cases were confirmed to have silicosis. Medical records of 790 cases were available. Thirty-three individuals had rheumatoid arthritis (RA) [prevalence 4.2% (prevalence ratio (RR) ranged from 2.26, 95% CI: 1.57-3.25 to 6.96, 95% CI: 2.93-16.53) depending on the reference rate used], two had scleroderma [prevalence 0.3% (RR 28.3, 95% CI: 6.09-129.98)], one had systemic lupus erythematosus [prevalence 0.1% (RR 2.53, 95% CI: 0.30-21.64)], two had Sjogrens syndrome [prevalence 0.3% (RR 0.42, 95% CI: 0.09-2.08)], and six had anti-neutrophil cytoplasm antibody (ANCA) vasculitis [prevalence 0.8% (RR 25.3, 95% CI: 6.34-101.04)]. There was no difference between those with and without CTD with respect to age, race, industry type, history of tuberculosis, application for workers' compensation, or severity of fibrotic changes on chest X-ray. Conclusions: A two- to eight-fold risk for RA and systemic lupus erythematosus, with a greater than 24-fold risk for scleroderma and ANCA vasculitis was found in individuals with silicosis. The most common CTD among silicotics in the Michigan disease registry was RA. Though not classically included in the category of CTD, ANCA-associated vasculitis was found to have a much greater prevalence amongst silicosis patients than the general population.
Keywords
Connective-tissue-disorders; Connective-tissue; Rheumatoid-disorders; Silica-dusts; Silicosis; Employee-exposure; Surveillance-programs; Medical-care; Medical-research; Information-retrieval-systems; Immune-system-disorders; Neutrophils; Antibody-response; Demographic-characteristics; Author Keywords: silicosis; connective tissue disease; scleroderma; systemic lupus erythematosus; rheumatoid arthritis
Contact
Kenneth D. Rosenman, 117 West Fee Hall, Department of Medicine, Michigan State University, East Lansing, MI 48824
CODEN
AJIMD8
CAS No.
7631-86-9; 14808-60-7
Publication Date
20110401
Document Type
Journal Article
Email Address
rosenman@msu.edu
Funding Type
Cooperative Agreement
Fiscal Year
2011
NTIS Accession No.
NTIS Price
Identifying No.
Cooperative-Agreement-Number-U60-OH-008466
Issue of Publication
4
ISSN
0271-3586
Source Name
American Journal of Industrial Medicine
State
MI
Performing Organization
Michigan State University
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