Skip to main content
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2002 Aug;59(8):545–549. doi: 10.1136/oem.59.8.545

Systemic sclerosis and occupational risk factors: a case–control study

E Diot 1, V Lesire 1, J Guilmot 1, M Metzger 1, R Pilore 1, S Rogier 1, M Stadler 1, P Diot 1, E Lemarie 1, G Lasfargues 1
PMCID: PMC1740346  PMID: 12151611

Abstract

Aims: A case–control study was carried out between 1998 and 2000 to investigate the relation between systemic sclerosis and occupational exposure.

Methods: Eighty cases of systemic sclerosis admitted consecutively to the Department of Internal Medicine at the University Hospital of Tours from 1998 to 2000 were included. For each case, two age, gender, and smoking habits matched controls hospitalised during the same period in the same department were selected. A committee of experts was set up retrospectively to assess occupational exposure. Exposure to silica dust and organic solvents (such as trichlorethylene and other chlorinated solvents, and benzene and other aromatic solvents) 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 SS were observed for crystalline silica, trichlorethylene, chlorinated solvents, toluene, aromatic solvents, ketones, white spirit, epoxy resins, and welding fumes. Risk of SS was significantly associated with a high final cumulative exposure score of occupational exposure to crystalline silica, trichlorethylene, chlorinated solvents, welding fumes, and any types of solvents.

Conclusion: Results confirm the influence of occupational risk factors in the occurrence of SS in both men and women. The link is not only with silica but also with other compounds such as solvents.

Full Text

The Full Text of this article is available as a PDF (106.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bottomley W. W., Sheehan-Dare R. A., Hughes P., Cunliffe W. J. A sclerodermatous syndrome with unusual features following prolonged occupational exposure to organic solvents. Br J Dermatol. 1993 Feb;128(2):203–206. doi: 10.1111/j.1365-2133.1993.tb15152.x. [DOI] [PubMed] [Google Scholar]
  2. Bovenzi M., Barbone F., Betta A., Tommasini M., Versini W. Scleroderma and occupational exposure. Scand J Work Environ Health. 1995 Aug;21(4):289–292. doi: 10.5271/sjweh.40. [DOI] [PubMed] [Google Scholar]
  3. Czirják L., Bokk A., Csontos G., Lörincz G., Szegedi G. Clinical findings in 61 patients with progressive systemic sclerosis. Acta Derm Venereol. 1989;69(6):533–536. [PubMed] [Google Scholar]
  4. ERASMUS L. D. Scleroderma in goldminers on the Witwatersrand with particular reference to pulmonary manifestations. S Afr J Lab Clin Med. 1957 Sep;3(3):209–231. [PubMed] [Google Scholar]
  5. Haustein U. F., Herrmann K. Environmental scleroderma. Clin Dermatol. 1994 Jul-Sep;12(3):467–473. doi: 10.1016/0738-081x(94)90299-2. [DOI] [PubMed] [Google Scholar]
  6. Khan M. F., Kaphalia B. S., Prabhakar B. S., Kanz M. F., Ansari G. A. Trichloroethene-induced autoimmune response in female MRL +/+ mice. Toxicol Appl Pharmacol. 1995 Sep;134(1):155–160. doi: 10.1006/taap.1995.1179. [DOI] [PubMed] [Google Scholar]
  7. LeRoy E. C., Black C., Fleischmajer R., Jablonska S., Krieg T., Medsger T. A., Jr, Rowell N., Wollheim F. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol. 1988 Feb;15(2):202–205. [PubMed] [Google Scholar]
  8. Lundberg I., Alfredsson L., Plato N., Sverdrup B., Klareskog L., Kleinau S. Occupation, occupational exposure to chemicals and rheumatological disease. A register based cohort study. Scand J Rheumatol. 1994;23(6):305–310. doi: 10.3109/03009749409099278. [DOI] [PubMed] [Google Scholar]
  9. Nietert P. J., Sutherland S. E., Silver R. M., Pandey J. P., Knapp R. G., Hoel D. G., Dosemeci M. Is occupational organic solvent exposure a risk factor for scleroderma? Arthritis Rheum. 1998 Jun;41(6):1111–1118. doi: 10.1002/1529-0131(199806)41:6<1111::AID-ART19>3.0.CO;2-J. [DOI] [PubMed] [Google Scholar]
  10. Preliminary criteria for the classification of systemic sclerosis (scleroderma). Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Arthritis Rheum. 1980 May;23(5):581–590. doi: 10.1002/art.1780230510. [DOI] [PubMed] [Google Scholar]
  11. Rodnan G. P., Benedek T. G., Medsger T. A., Jr, Cammarata R. J. The association of progressive systemic sclerosis (scleroderma) with coal miners' pneumoconiosis and other forms of silicosis. Ann Intern Med. 1967 Feb;66(2):323–334. doi: 10.7326/0003-4819-66-2-323. [DOI] [PubMed] [Google Scholar]
  12. Shopp G. M., Jr, Sanders V. M., White K. L., Jr, Munson A. E. Humoral and cell-mediated immune status of mice exposed to trans-1,2-dichloroethylene. Drug Chem Toxicol. 1985;8(5):393–407. doi: 10.3109/01480548509041066. [DOI] [PubMed] [Google Scholar]
  13. Silman A. J., Jones S. What is the contribution of occupational environmental factors to the occurrence of scleroderma in men? Ann Rheum Dis. 1992 Dec;51(12):1322–1324. doi: 10.1136/ard.51.12.1322. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Sluis-Cremer G. K., Hessel P. A., Nizdo E. H., Churchill A. R., Zeiss E. A. Silica, silicosis, and progressive systemic sclerosis. Br J Ind Med. 1985 Dec;42(12):838–843. doi: 10.1136/oem.42.12.838. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Steenland K., Goldsmith D. F. Silica exposure and autoimmune diseases. Am J Ind Med. 1995 Nov;28(5):603–608. doi: 10.1002/ajim.4700280505. [DOI] [PubMed] [Google Scholar]
  16. VIGLIANI E. C., PERNIS B. Immunological aspects of silicosis. Bibl Tuberc. 1963;17:230–279. [PubMed] [Google Scholar]
  17. deShazo R. D. Current concepts about the pathogenesis of silicosis and asbestosis. J Allergy Clin Immunol. 1982 Jul;70(1):41–49. doi: 10.1016/0091-6749(82)90200-7. [DOI] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES