Maître Anne, Hours Martine, Bonneterre Vincent, Arnaud Joëlle, Arslan Marie Tülin, Carpentier Patrick, Bergeret Alain, de Gaudemaris Régis
Environnement et Prédiction de la Santé Des Populations-Laboratoire, Faculté de Médecine, Domaine de la Merci, 38706 La Tronche, France.
J Rheumatol. 2004 Dec;31(12):2395-401.
To analyze occupational and non-occupational exposure factors suspected of being associated with scleroderma (SSc), with a view to inculpating or excluding certain potentially toxic substances (e.g., solvents), thereby contributing to the recognition of such toxins in the field of occupational health.
The study comprised 10 men and 83 women diagnosed with SSc between 1995 and 1999 (American College of Rheumatology criteria) and early SSc, and 206 age and sex matched controls. The SSc registry is all-inclusive in the French administrative departments of Isere and Savoie so controls were randomly selected from the general population (using telephone directories) in these departments to ensure full representation. Exposure factors were analyzed for each subject by a personal questionnaire, and an individual evaluation was carried out by an industrial expert. Data were analyzed by conditional logistical regression adjusting for educational level.
Construction workers were at significantly higher risk of contracting SSc; odds ratio (OR) = 4.01 (95% confidence interval 1.14-14.09). Analysis by industrial experts identified exposure to certain toxic substances regularly used by these same workers as risk factors for SSc: cleaning products: OR = 1.66 (0.90-3.08) (both sexes) and OR = 1.71 (0.92-3.20) (women only); solvents: OR = 3.23 (1.58-6.63) (both sexes) and OR = 2.80 (1.28-6.11) (women only); synthetic adhesives: OR 25.36 (1.36-472.28) (on 3 exposed cases).
Exposure to either cleaning products or solvents emerged as a risk factor for SSc. Exposure factors should be characterized and results of all studies compared to implement appropriate preventive measures in relevant workplaces.
分析怀疑与硬皮病（SSc）相关的职业和非职业暴露因素，以便归责或排除某些潜在有毒物质（如溶剂），从而有助于在职业健康领域识别此类毒素。
该研究纳入了1995年至1999年间根据美国风湿病学会标准诊断为SSc和早期SSc的10名男性和83名女性，以及206名年龄和性别匹配的对照。SSc登记册涵盖了法国伊泽尔省和萨瓦省的所有地区，因此对照是从这些地区的普通人群（使用电话簿）中随机选择的，以确保全面代表性。通过个人问卷分析每个受试者的暴露因素，并由一名工业专家进行个体评估。数据通过条件逻辑回归分析，并对教育水平进行了校正。
建筑工人患SSc的风险显著更高；优势比（OR）=4.01（95%置信区间1.14 - 14.09）。工业专家的分析确定，这些工人经常接触的某些有毒物质是SSc的危险因素：清洁产品：OR = 1.66（0.90 - 3.08）（男女均有）和OR = 1.71（0.92 - 3.20）（仅女性）；溶剂：OR = 3.23（1.58 - 6.63）（男女均有）和OR = 2.80（1.28 - 6.11）（仅女性）；合成粘合剂：OR = 25.36（1.36 - 472.28）（基于3例暴露病例）。
接触清洁产品或溶剂是SSc的一个危险因素。应明确暴露因素，并比较所有研究结果，以便在相关工作场所实施适当的预防措施。
