Rheumatoid arthritis and occupational exposure
本研究分析了芬兰人群中不同职业的类风湿关节炎发病率差异，发现采矿、纺织、农业等职业风险较高，并识别出冷湿、粉尘等可能诱发疾病的职业暴露因素。
<h3>Objectives</h3> The aim was to find out occupational differences in the incidence of rheumatoid arthritis (RA) in the Finnish population and to detect exposures in occupations with a high risk of RA. <h3>Methods</h3> The employed persons of 15–64 years of age receiving specially compensated medicines because of RA for the period of 1971–2000 were linked with the 5-year periodical census data. The incidence rates were calculated by sex, occupation and region. Occupational and exposure history, and confounding factors were studied via a questionnaire sent to a sample of 5 000 RA patients and 5 000 matched referents with hypertension. <h3>Results</h3> The highest age- and region-adjusted incidence rate ratios (RR; 95% CI; reference administrative work) were observed for men in mining and quarrying work (2.1; 1.6–2.8), textile work (1.7; 1.3–2.2), iron and metalware work (1.4; 1.3–1.5), road transport work (1.3; 1.2–1.4), and for women in agricultural and horticultural work, animal husbandry (1.4; 1.3–1.5), postal work (1.3; 1.2–1.5), iron and metalware work (1.3; 1.1–1.5), laundering, and pressing work (1.3; 1.1–1.6). The RA patients noticed cold, humidity, draft (p<0.001), and vibration (p<0.01) more often in their work than the referents. Also different dusts: clay minerals, synthetic mineral fibres, carbonate minerals (p>0.01), and concrete (p<0.001) were reported by the RA patients more frequently. As other harmful exposures were mentioned, for example, insects, animal epithelium, and strenuous work. <h3>Conclusions</h3> The variation in occupational incidences of RA cannot be explained by regional factor. The results indicate that occupational exposures have contributed to RA.