Abstract
Background:Rheumatoid arthritis (RA) is a systemic, inflammatory disease with an estimated global prevalence of 0.3–1.0%. An unexplained association exists between low formal education and the development of RA independent of smoking. It is established that RA is initiated in the lungs and that various occupations associated with dust, fume and metal inhalation can increase the risk of RA development.Objective:The objective of this review is to evaluate published clinical reports related to occupations associated with RA development. We highlight the concept of a “double-hit” phenomenon involving adsorption of toxic metals from cigarette smoke by dust residing in the lung as a result of various work exposures. We discuss the relevant pathophysiological consequences of these inhalational exposures in relation to RA associated autoantibody production.Method:A thorough literature search was performed using available databases including Pubmed, Embase, and Cochrane database to cover all relative reports, using combinations of keywords: rheumatoid arthritis, rheumatoid factor, anti-citrullinated peptide antibody silica, dust, fumes, metals, cadmium, cigarette smoking, asbestos, mining, bronchial associated lymphoid tissue, heat shock protein 70, and adsorption.Conclusion:We postulate that the inhalation of dust, metals and fumes is a significant trigger factor for RA development in male patients and that male RA should be considered an occupational disease. To the best of our knowledge, this is the first review of occupations as a risk factor for RA in relation to the potential underlying pathophysiology.
Highlights
It is established that Rheumatoid arthritis (RA) is initiated in the lungs and that various occupations associated with dust, fume and metal inhalation can increase the risk of RA development
We postulate that the inhalation of dust, metals and fumes is a significant trigger factor for RA development in male patients and that male RA should be considered an occupational disease
To the best of our knowledge, this is the first review of occupations as a risk factor for RA in relation to the potential underlying pathophysiology
Summary
Background Rheumatoid arthritis (RA) is a common autoimmune inflammatory disease with an estimated global prevalence of. The overall cost to the individual with RA as a consequence of fatigue, joint inflammation and the subsequent development of joint deformities are impaired physical. The overall economic cost of RA to society is substantial. Studies identifying potential causes of RA that are avoidable and are of huge importance to at risk individuals and wider society. Rheumatoid arthritis (RA) is a systemic, inflammatory disease with an estimated global prevalence of 0.3–1.0%. It is established that RA is initiated in the lungs and that various occupations associated with dust, fume and metal inhalation can increase the risk of RA development
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