Among modifiable environmental variables, occupational inhalants like silica dust, mineral oils, pesticides, textile fibers, and metal vapors have received attention for their possible role in RA etiology. Inhalation of these chemicals can cause airway inflammation, protein citrullination, and immunological dysregulation in the lung, which is a critical location for the start of RA-related autoimmunity. Epidemiological studies continue to correlate occupational airborne exposures to an increased incidence of RA, particularly seropositive illness.
Understanding these relationships is critical for identifying early risk factors, implementing preventative workplace interventions, and better understanding of the environmental processes that contribute to the development of rheumatoid arthritis. Thus, this study thoroughly analyzed the available data regarding the relationship between occupational inhalants and the risk of getting RA.
This research used PRISMA criteria, searching Medline, Embase, and Web of Science from the database's establishment to November 20, 2024. Eligible studies employed cross-sectional, case-control, or cohort designs, were population-based, and published original data on occupational inhalant exposures and RA.
The study also quantified exposures, included a comparison group, and used valid RA assessment methodologies and also, omitted studies that relied exclusively on self-reported RA or focused on therapy, prognosis, sick leave, or death. Cohort and case-control studies underwent random-effects meta-analyses using relative risk, and heterogeneity was assessed using the I2 statistic.
31 research satisfied the inclusion criteria, with 25 being included in meta-analyses spanning 10 categories of occupational inhalants. Significant correlations with RA risk were found for asbestos, silica, solvents, animal dust, pesticides, fertilizers, and motor exhaust (relative risks ranged from 1.25 to 1.49). 7 meta-analyses revealed heterogeneity ranging from moderate to high.
Overall, this study indicates a strong relationship between the employment environment and the development of rheumatoid arthritis. Inhaling certain toxins on the job, like silica, asbestos, pesticides, solvents, fertilizers, animal dust, and vehicle exhaust, may make a person more susceptible to an autoimmune disorder.
Source:
Liu, Q., Song, X., Mauro, E., Jiang, Y., Shchetynsky, K., Klareskog, P., Alfredsson, L., & Jiang, X. (2025). Exposure to occupational inhalants and the risk of developing rheumatoid arthritis: A systematic review and meta-analysis. Arthritis & Rheumatology, art.43446. https://doi.org/10.1002/art.43446
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