Occupational, smoking and biomass fuel exposure in a cohort of Mexican patients with IgG4-related disease.

OBJECTIVES

To assess work history, occupational exposure, smoking, and biomass fuel use in a Mexican IgG4-related disease (IgG4-RD) cohort.

METHODS

We conducted a cross-sectional study among patients with IgG4-RD. A standardised questionnaire was used to collect data on occupational, smoking, and biomass fuel exposure. The International Standard Classification of Occupations (ISCO88) categorised patients into white-collar (ISCO88 groups 0-5) and blue-collar (ISCO88 groups 6-9) work.

RESULTS

We included 95 patients, with a mean age of 53.8±15.8 years, and 50.5% were male. Seventy-eight (82.1%) had paid work: 63 (66.3%) in white-collar and 15 (15.8%) in blue-collar occupations. Of those who had no paid work, 13 (13.7%) did household work and 4 (4.2%) were students. White-collar jobs were more common than blue-collar jobs, both including (66.3% vs. 29.5%) and excluding (66.3% vs. 15.8%) unpaid household work. Pancreatobiliary involvement was not more frequent among blue-collar workers. Occupational exposure was reported by 31.6% of patients. White-collar workers had more lung involvement (29% vs. 7.1%, p=0.02) and less biomass exposure (19% vs. 64.3%, p<0.001). Occupational exposures were associated with the proliferative phenotype (OR 3.5, 95% CI 1.08-11.36). History of smoking was linked to increased lung involvement (OR 3.2, 95% CI 1.1-9.4), while biomass exposure was associated with the Mikulicz/systemic phenotype (OR 2.6, 95% CI 1.03-6.9).

CONCLUSIONS

This study shows that there are different patterns of occupational exposure among Mexican IgG4-RD patients, with fewer blue-collar jobs compared to other cohorts. Smoking and biomass fuel exposure may be more significant risk factors for IgG4-RD in this population, warranting further investigation.