Environmental Epidemiology and Risk Factors for Autoimmune Disease

M. A. Dooley, MD, MPH, S. L. Hogan, PhD, MPH


Curr Opin Rheumatol. 2003;15(2) 

In This Article

Occupational Exposures

Exposure to occupational crystalline silica has been identified as a strong risk factor for developing autoimmune disease[2*] and was a strong risk factor associated with SLE in the CLU study.[20*] The CLU study provided rigorous attention to the definitions and assignments of silica exposure. Occupational silica exposure is most frequently associated with dusty, nonfarming related jobs. This study included an assessment of these types of occupational exposures by industrial hygienists, but also included a detailed assessment of farm-related silica exposures using both a dust-exposure matrix for specific farming tasks and soil system maps for specific farm locations. In previous studies of silica exposure and autoimmune disease, mostly men have been studied, and farming exposures have not been considered. Farming exposures were of particular importance in this eastern North Carolina and South Carolina study location. Furthermore, the farming exposures accounted for much of the silica exposure among women, who often worked in part-time or seasonal farming jobs. In a disease such as SLE that predominantly affects females, it is critical to pay careful attention to variations in opportunities for occupational exposures. The CLU study has set a new precedent for careful attention to issues that are critical to understanding risk factors for women in any disease setting.


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