Epidemiology of Systemic Sclerosis

Incidence, Prevalence, Survival, Risk Factors, Malignancy, and Environmental Triggers

Jammie Barnes; Maureen D. Mayes


Curr Opin Rheumatol. 2012;24(2):165-170. 

In This Article

Environmental Triggers

In the past, multiple environmental exposures have been studied in relation to susceptibility to SSc and SSc-like illnesses with varying results. These have silica, solvents, vinyl chloride, toxic oil, tryptophan, gadolinium, bleomycin, and pentazocine.

Because of the association of cigarette smoking with susceptibility to rheumatoid arthritis, Chaudhary et al. [28•] compared SSc cases to age-matched controls but did not find tobacco smoking to be a risk factor for development of SSc. However, they reported that smoking may impact disease severity.

Makol et al.[29] reported the prevalence of connective tissue disease among 1022 cases of confirmed silicosis from the Michigan Silicosis Surveillance System from 1985 to 2006. Of those cases, 44 were found to have connective tissue disease of which only two had SSc. The authors calculated a significantly increased risk of developing SSc which was 28-fold higher than the general population with a wide 95% CI ranging from 6.09 to 129.98.

In addition, McCormic et al.[30] performed a meta-analysis of silica exposure identifying articles dating from 1949 to 2009. Although there was significant heterogeneity among studies, they found that silica exposure appeared to be a risk factor for developing SSc in men. The relative risk estimate was significant for men at 3.02 (95% CI 1.24–7.35) but not significant for women at 1.03 (95% CI 0.74– 1.44).

In a systematic review of the possible association of silicone breast implants and SSc, Lipworth et al.[31] confirmed that there was no association.


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