Inorganic Dust Exposure During Military Service as a Predictor of Rheumatoid Arthritis and Other Autoimmune Conditions
Open Access
- 4 June 2021
- journal article
- research article
- Published by Wiley in ACR Open Rheumatology
- Vol. 3 (7), 466-474
- https://doi.org/10.1002/acr2.11273
Abstract
Objective Rheumatoid arthritis (RA) and other autoimmune (AI) conditions are associated with inorganic dust exposure. Many military activities are likely to entail inorganic dust exposures. We wished to identify associations between prior military dust exposure and RA and other AI conditions. Methods We studied persons from a roster of Army, Navy, Air Force, or Marine Corps personnel who had served in Operation Enduring Freedom and Operations Iraqi Freedom and New Dawn. We linked military occupational codes to a job exposure matrix assigning dust exposure likelihood. We used the Veterans Affairs Health Care System (VAHCS) electronic health care records to identify cases of RA, systemic lupus erythematosus (SLE), systemic sclerosis (SSc), vasculitis, and inflammatory myositis. Generalized estimating equations modeled risk of RA and other AI conditions associated with dust exposure, taking into account military service branch, age at first VAHCS encounter, sex, race/ethnicity, smoking status, and years of military service. Results Of 438 086 veterans (68% ever-smokers), 44% were classified with likely or somewhat likely dust exposure. Cases included 1139 cases with RA, 467 cases with SLE, and 180 cases with other AI diseases (SSc, vasculitis, or inflammatory myositis). Military dust exposure was associated with increased odds of RA (odds ratio [OR] = 1.10; 95% confidence interval [CI] = 1.003-1.20) and increased odds of SSc, vasculitis, or inflammatory myositis (OR = 1.23; 95% CI = 1.14-1.34) but was protective for SLE (OR = 0.81; 95% CI = 0.76-0.88). Conclusion Dust exposure during past military service comprises an occupational and environmental risk factor for RA and other AI diseases. This is potentially relevant for prevention activities.Keywords
Funding Information
- National Institutes of Health (T32 5T32AR007304)
- U.S. Department of Veterans Affairs (Merit CX001548‐01A2)
This publication has 36 references indexed in Scilit:
- A systematic review of validated methods for identifying systemic lupus erythematosus (SLE) using administrative or claims dataVaccine, 2013
- Underestimation of the Reliability of Codes for Rheumatoid Arthritis Within Administrative Data: Comment on the Article by Ng et alArthritis Care & Research, 2012
- Newly Reported Lupus and Rheumatoid Arthritis in Relation to Deployment Within Proximity to a Documented Open-Air Burn Pit in IraqJournal of Occupational and Environmental Medicine, 2012
- Identification of rheumatoid arthritis patients using an administrative database: A Veterans Affairs studyArthritis Care & Research, 2012
- A Prospective Study of Lupus and Rheumatoid Arthritis in Relation to Deployment in Support of Iraq and Afghanistan: The Millennium Cohort StudyAutoimmune Diseases, 2011
- Silica exposure among male current smokers is associated with a high risk of developing ACPA-positive rheumatoid arthritisAnnals Of The Rheumatic Diseases, 2009
- Performance of self-reported occupational exposure compared to a job-exposure matrix approach in asthma and chronic rhinitisOccupational and Environmental Medicine, 2009
- Bringing the War Back HomeArchives of Internal Medicine, 2007
- Silica exposure is associated with increased risk of developing rheumatoid arthritis: results from the Swedish EIRA studyAnnals Of The Rheumatic Diseases, 2005
- Radiation Exposure, Socioeconomic Status, and Brain Tumor Risk in the US Air Force: A Nested Case-Control StudyAmerican Journal of Epidemiology, 1996