Inhaling fumes and dust common in an office setting could double the risk of developing rheumatoid arthritis, a new study suggests.

The study published in the journal Annals of the Rheumatic Diseases found that the risks were even higher when the number of agents exposed to the employees was elevated or the time of exposure was prolonged. In addition, men were found to be at higher risk of developing the disease when compared to women.

Rheumatoid arthritis is a chronic autoimmune disease that causes pain, swelling, and stiffness in the joint and affects roughly 0.3 percent to 1 percent of the world’s population. While it has been established that smoking cigarettes could contribute to the onset of rheumatoid arthritis, little is known about the impact associated with breathing in fumes circulating at work. 

The researchers set out to investigate this and at the same time take smoking and the genetic constitution of the individual into consideration.

To do that, the team looked at data from the Swedish Epidemiological Investigation of Rheumatoid Arthritis. The study encompassed a total of 4,033 people newly diagnosed with RA who partook in the project between 1966 to 2017 and 6,485 people who were free of the disease standing in as the control group.

They questioned participants on details about their job background and quantified their exposure to 32 inhalable agents using standard procedures. No exposure was done for the control group. Participants were then allocated a Genetic Risk Score (GRS) to determine whether or not they were carriers of the gene that could potentially increase their odds of developing rheumatoid arthritis. 

Generally, the presence of anti-citrullinated protein antibodies or ACPA denotes rheumatoid arthritis. Those with ACPA-positive rheumatoid arthritis have a worse prognosis and tend to experience increased levels of damage due to wear and tear on their joints.

Roughly 73 percent of people that tested positive for ACPA and 72 percent that tested negative for ACPA were exposed to these workplace fumes in higher amounts when compared to 67 percent of participants in the control group.

From their analysis, it turned out that those who were exposed to workplace fumes or dust were associated with a 25 percent higher risk of ACPA-positive rheumatoid arthritis overall. Beyond that, they also found that men were at a 40 percent higher risk of developing the disease than women. More specifically, 17 of these 32 agents including quartz dust, asbestos, diesel fumes, gasoline fumes, carbon monoxide, and fungicides were strongly linked to a higher risk of developing ACPA-positive disease. Conversely, quartz dust (silica), asbestos, and detergents were the only few agents strongly linked to ACPA-negative RA.

The team also analyzed for triple exposure. This group included people who smoked, had a high genetic risk for RA, and were exposed to any airborne agent all at once. Here, they found that participants in the ‘triple exposure’ group had an incredibly high chance—up to 16 to 68 times higher—of developing rheumatoid arthritis compared to those who weren’t exposed to the 3 factors at all.

All things considered, this study sheds light on the role of workplace fumes in the origin of rheumatoid arthritis. The study authors emphasize that protective measures especially for those genetically at risk for RA are essential.

Although the fact that its an observational study and therefore the ability to establish a cause is limited, the study authors highlight the following needs for preventive measures:

“First, environmental health initiatives should reduce public exposure to ambient pollutants, including carbon monoxide and gasoline exhaust. Second, occupational health initiatives should mitigate occupational hazards, including detergents and asbestos. Third, public health initiatives should continue to reduce cigarette smoking.”

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