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Childhood agricultural and adult occupational exposures to organic dusts in a population-based case–control study of systemic lupus erythematosus

Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA, parks1{at}mail.nih.gov

GS Cooper

United States Environmental Protection Agency, Washington, District of Columbia, USA

MA Dooley

Division of Rheumatology, University of North Carolina, Chapel Hill, North Carolina, USA

MM Park

Division of Rheumatology, University of North Carolina, Chapel Hill, North Carolina, USA

EL Treadwell

Department of Medicine, East Carolina University School of Medicine, Greenville, North Carolina, USA

GS Gilkeson

Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, South Carolina, USA

Organic dust exposure can influence the development and symptoms of immune-related diseases such as atopy and asthma, but has rarely been examined in relation to systemic autoimmunity. The present analyses explore the association of lifetime farm and occupational organic dust exposures with systemic lupus erythematosus (SLE) in recently diagnosed patients (n = 265) compared with controls (n = 355) frequency matched by age, sex and state. Questionnaire data included childhood farm residence, childhood and adult experience with specific crops, and adult work in textiles, hog or poultry processing and paper or furniture manufacture. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression models including age, sex, state, race, education and silica exposure. Overall childhood or adult farm contact and childhood farm residence were not associated with SLE. Farm contact with livestock was inversely associated with SLE (OR = 0.55, 95% CI 0.35, 0.88). This effect was most pronounced among those with childhood farm residence and both childhood and adult livestock exposure (OR = 0.19; 95% CI 0.06, 0.63), but was difficult to separate from adult exposure to grains or corn. Other adult occupational exposures were not associated with SLE risk overall, regardless of childhood farm residence or livestock exposure, although an inverse association was seen among non-smokers (OR = 0.59; 95% CI 0.33, 1.1), particularly for textile work (OR = 0.34; 95% CI 0.19, 0.64). These exploratory findings support the development of studies to specifically investigate the effects of organic dust exposure on SLE risk, with particular attention to exposure assessment and characterization of demographics, smoking and other occupational exposures.

Key Words: systemic lupus erythematosus • endotoxins • hygiene hypothesis • occupational exposure • livestock • epidemiology

Lupus, Vol. 17, No. 8, 711-719 (2008)
DOI: 10.1177/0961203308089436


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