The risk of developing anti-citrullinated protein antibody-positive rheumatoid arthritis is high among current smokers exposed to silica (OR 7.5, 95% CI 4.2–13.2), with the two risk factors having a synergistic effect, according to findings from the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study. The additive interaction between silica exposure and smoking increased with pack-years of smoking, with the highest attributable proportion due to interaction (AP) seen with ≥28 pack-years of smoking (AP 0.7, 95% CI 0.4–0.9).
References
Zeng, P. et al. Amount of smoking, duration of smoking cessation and their interaction with silica exposure in the risk of rheumatoid arthritis among males: results from the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study. Ann. Rheum. Dis. http://dx.doi.org/10.1136/annrheumdis-2017-212145 (2017)
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Onuora, S. Risk from silica exposure influenced by smoking. Nat Rev Rheumatol 13, 632 (2017). https://doi.org/10.1038/nrrheum.2017.170
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DOI: https://doi.org/10.1038/nrrheum.2017.170