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

Ashima Makol, Mary Jo Reilly, Kenneth D. Rosenman

Research output: Contribution to journalArticle

47 Citations (Scopus)

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 eightfold 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.

Original languageEnglish (US)
Pages (from-to)255-262
Number of pages8
JournalAmerican Journal of Industrial Medicine
Volume54
Issue number4
DOIs
StatePublished - Apr 2011
Externally publishedYes

Fingerprint

Silicosis
Connective Tissue Diseases
Vasculitis
Rheumatoid Arthritis
Cytoplasm
Neutrophils
Systemic Lupus Erythematosus
Medical Records
Antibodies
Workers' Compensation
Sjogren's Syndrome
Silicon Dioxide
Registries
Industry
Tuberculosis
Thorax
X-Rays
Population

Keywords

  • Connective tissue disease
  • Rheumatoid arthritis
  • Scleroderma
  • Silicosis
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Prevalence of connective tissue disease in silicosis (1985-2006)-a report from the state of michigan surveillance system for silicosis. / Makol, Ashima; Reilly, Mary Jo; Rosenman, Kenneth D.

In: American Journal of Industrial Medicine, Vol. 54, No. 4, 04.2011, p. 255-262.

Research output: Contribution to journalArticle

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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 eightfold 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.",
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