https://www.medpagetoday.com/rheumatology/arthritis/67750
Interesting....yes it's RA not CFS...I should have worked the night shift....
Interesting....yes it's RA not CFS...I should have worked the night shift....
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RA Risk Tied to Occupational Factors
- Thread starter jaybee00
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Daffodil
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it keeps asking me to register before I can read the article ughhh I hate that lol
they have drawn a link between cold climates and autoimmune conditions many times....they always thought it had to do with kids being under exposed to pathogens in northern countries with more hygiene etc....
they have drawn a link between cold climates and autoimmune conditions many times....they always thought it had to do with kids being under exposed to pathogens in northern countries with more hygiene etc....
Here is the article...
RA Risk Tied to Occupational Factors
Working in the cold, shift work influenced arthritis risk
Individuals who work in cold environments and those who do shift work are at increased risk for developing rheumatoid arthritis (RA), Swedish researchers found.
In one study, individuals who had ever worked in a cold environment had an odds ratio of 1.5 (95% CI 1.4-1.7) for developing RA compared with those who had never done so, according to Pingling Zeng, MD, of the Karolinska Institute in Stockholm, and colleagues.And in a second study, a 30% increased risk for the subset of RA characterized by seropositivity for anticitrullinated peptide antibodies (ACPA) was seen in patients with rotating shift work (OR 1.3, 95% CI 1-1.6) and those with day-oriented shift work (OR 1.3, 95% CI 1-1.7), reported Anna Karin Hedström, MD, and colleagues, also from the Karolinska Institute.
Both studies were reported online in RMD Open: Rheumatic & Musculoskeletal Diseases.
Cold Environment and Risk
Environmental factors such as exposure to tobacco smoke are recognized as playing an etiologic role in the development of RA, and although for centuries patients with the disease have reported an association with cold environments, evidence to support this has been lacking.
Zeng's group examined the potential link between cold exposure and RA among patients enrolled in the Swedish Epidemiologic Investigation of Rheumatoid Arthritis (EIRA) population-based study from 1996 to 2014.
A total of 3,659 cases and 5,925 controls completed questionnaires asking whether they worked in the cold, whether this was indoors or outdoors, and for how many hours per week. Only exposures up until the year when RA symptoms first appeared were included in the analysis.
Potential confounders were age, sex, residence, BMI, smoking, education, alcohol use, exposure to silica, and type of occupation.
The increased RA risk was seen for both indoor cold environments (OR 1.7, 95% CI 1.4-2.1) and outdoor environments (OR 1.5, 95% CI 1.3-1.7), and also for ACPA-positive disease (OR 1.6, 95% CI 1.4-1.8) and ACPA-negative disease (OR 1.4, 95% CI 1.2-1.6).
For women, the increased risk was seen for only ACPA-positive RA, while for men, the risk was increased for both ACPA-positive and negative RA.
There also was a "dose response," with greater risks being associated with more exposure. For instance, with less than 10 years of cold environment work, the OR was a nonsignificant 1.3 (95% CI 0.9-1.8), whereas for 20 years or more the OR was 2 (95% CI 1.2-2.4, P<0.001).
Similarly, for less than 10 hours of exposure per week, the OR was again nonsignificant, at 1 (95% CI 0.7-1.5), while for 20 or more hours per week, the OR rose to 1.8 (95% CI 1.2-2.6, P<0.001).
The dose-response relationship was only seen for cold indoor environment and ACPA-positive disease.
An additional association was seen for work that involved repetitive hand and finger movements (OR 1.4, 95% CI 1.1-1.8, P<0.001) though not for activities involving bending/turning or carrying more than 10 kg (about 22 lbs).
Limitations of the study included reliance on participants' self-report of cold exposure, and a lack of information about other potentially relevant factors such as humidity and barometric pressure.
Shift Work and Risk
Increasing evidence has linked shift work with various health problems including autoimmune thyroid disease, diabetes, multiple sclerosis, and cardiovascular disease.
RA is strongly influenced by circadian rhythm, for both clinical symptoms such as morning stiffness and immune processes such as cytokine release. Therefore, to examine whether alterations in circadian rhythm resulting from shift work might affect the risk of developing RA, Hedström's group also used EIRA data, focusing on patients enrolled from 1996 to 2006.
Participants completed a questionnaire on demographics and socioeconomics, hereditary and lifestyle factors, and occupational exposures.
The analysis included 1,951 individuals who had a history of day-oriented shift work, rotating shift work, or permanent night shift work, along with 2,225 controls. Mean age was 50.5.
Unlike for day shift or rotating shift work, permanent night shift work was inversely associated with developing both ACPA-positive (OR 0.7, 95% CI 0.6-0.9, P=0.005) and ACPA-negative RA (OR 0.8, 95% CI 0.6-1, P=0.03).
In addition, longer duration of night shift work was associated with decreased risk. Among those with a history of night shift work less than 5 years, the OR of developing ACPA-positive RA was 0.8 (95% CI 0.6-1, P=0.06), while for those with longer than 10 years, the OR was 0.6 (95% CI 0.4-0.9, P=0.005). For ACPA-negative RA, the OR decreased from 0.9 (95% CI 0.7-1.2) for less than 5 years to 0.7 (95% CI 0.4-1, P=0.06) for longer than 10 years.
The authors noted that sleep restriction may be an underlying mechanism to explain the association between shift work and RA, through disturbances of the functional rhythm of T cells and the upregulation of proinflammatory cytokines such as tumor necrosis factor, interleukin (IL)-16, and in particular, IL-17, which has been implicated in the induction of autoimmunity.
And as to the inverse relationship observed between night shift work and RA risk, they suggested that decreased melatonin may be involved. "Permanent night shift work, but not other kinds of shift work, decreases the production of melatonin, a hormone produced by the pineal gland which may have a disease-promoting role in RA pathogenesis," they wrote.
"Compared with healthy controls, patients with RA have altered levels of circulating melatonin with higher nocturnal serum levels of melatonin and an altered temporal profile with a more rapid increase at the start of the night and an earlier peak," they explained.
Future studies should further explore the potential role of melatonin, measuring levels and investigating the effects on symptoms, they concluded.
A possible limitation was the possibility of selection bias among controls.
RA Risk Tied to Occupational Factors
Working in the cold, shift work influenced arthritis risk
- by Nancy Walsh, Senior Staff Writer, MedPage TodaySeptember 07, 2017
Individuals who work in cold environments and those who do shift work are at increased risk for developing rheumatoid arthritis (RA), Swedish researchers found.
In one study, individuals who had ever worked in a cold environment had an odds ratio of 1.5 (95% CI 1.4-1.7) for developing RA compared with those who had never done so, according to Pingling Zeng, MD, of the Karolinska Institute in Stockholm, and colleagues.And in a second study, a 30% increased risk for the subset of RA characterized by seropositivity for anticitrullinated peptide antibodies (ACPA) was seen in patients with rotating shift work (OR 1.3, 95% CI 1-1.6) and those with day-oriented shift work (OR 1.3, 95% CI 1-1.7), reported Anna Karin Hedström, MD, and colleagues, also from the Karolinska Institute.
Both studies were reported online in RMD Open: Rheumatic & Musculoskeletal Diseases.
Cold Environment and Risk
Environmental factors such as exposure to tobacco smoke are recognized as playing an etiologic role in the development of RA, and although for centuries patients with the disease have reported an association with cold environments, evidence to support this has been lacking.
Zeng's group examined the potential link between cold exposure and RA among patients enrolled in the Swedish Epidemiologic Investigation of Rheumatoid Arthritis (EIRA) population-based study from 1996 to 2014.
A total of 3,659 cases and 5,925 controls completed questionnaires asking whether they worked in the cold, whether this was indoors or outdoors, and for how many hours per week. Only exposures up until the year when RA symptoms first appeared were included in the analysis.
Potential confounders were age, sex, residence, BMI, smoking, education, alcohol use, exposure to silica, and type of occupation.
The increased RA risk was seen for both indoor cold environments (OR 1.7, 95% CI 1.4-2.1) and outdoor environments (OR 1.5, 95% CI 1.3-1.7), and also for ACPA-positive disease (OR 1.6, 95% CI 1.4-1.8) and ACPA-negative disease (OR 1.4, 95% CI 1.2-1.6).
For women, the increased risk was seen for only ACPA-positive RA, while for men, the risk was increased for both ACPA-positive and negative RA.
There also was a "dose response," with greater risks being associated with more exposure. For instance, with less than 10 years of cold environment work, the OR was a nonsignificant 1.3 (95% CI 0.9-1.8), whereas for 20 years or more the OR was 2 (95% CI 1.2-2.4, P<0.001).
Similarly, for less than 10 hours of exposure per week, the OR was again nonsignificant, at 1 (95% CI 0.7-1.5), while for 20 or more hours per week, the OR rose to 1.8 (95% CI 1.2-2.6, P<0.001).
The dose-response relationship was only seen for cold indoor environment and ACPA-positive disease.
An additional association was seen for work that involved repetitive hand and finger movements (OR 1.4, 95% CI 1.1-1.8, P<0.001) though not for activities involving bending/turning or carrying more than 10 kg (about 22 lbs).
Limitations of the study included reliance on participants' self-report of cold exposure, and a lack of information about other potentially relevant factors such as humidity and barometric pressure.
Shift Work and Risk
Increasing evidence has linked shift work with various health problems including autoimmune thyroid disease, diabetes, multiple sclerosis, and cardiovascular disease.
RA is strongly influenced by circadian rhythm, for both clinical symptoms such as morning stiffness and immune processes such as cytokine release. Therefore, to examine whether alterations in circadian rhythm resulting from shift work might affect the risk of developing RA, Hedström's group also used EIRA data, focusing on patients enrolled from 1996 to 2006.
Participants completed a questionnaire on demographics and socioeconomics, hereditary and lifestyle factors, and occupational exposures.
The analysis included 1,951 individuals who had a history of day-oriented shift work, rotating shift work, or permanent night shift work, along with 2,225 controls. Mean age was 50.5.
Unlike for day shift or rotating shift work, permanent night shift work was inversely associated with developing both ACPA-positive (OR 0.7, 95% CI 0.6-0.9, P=0.005) and ACPA-negative RA (OR 0.8, 95% CI 0.6-1, P=0.03).
In addition, longer duration of night shift work was associated with decreased risk. Among those with a history of night shift work less than 5 years, the OR of developing ACPA-positive RA was 0.8 (95% CI 0.6-1, P=0.06), while for those with longer than 10 years, the OR was 0.6 (95% CI 0.4-0.9, P=0.005). For ACPA-negative RA, the OR decreased from 0.9 (95% CI 0.7-1.2) for less than 5 years to 0.7 (95% CI 0.4-1, P=0.06) for longer than 10 years.
The authors noted that sleep restriction may be an underlying mechanism to explain the association between shift work and RA, through disturbances of the functional rhythm of T cells and the upregulation of proinflammatory cytokines such as tumor necrosis factor, interleukin (IL)-16, and in particular, IL-17, which has been implicated in the induction of autoimmunity.
And as to the inverse relationship observed between night shift work and RA risk, they suggested that decreased melatonin may be involved. "Permanent night shift work, but not other kinds of shift work, decreases the production of melatonin, a hormone produced by the pineal gland which may have a disease-promoting role in RA pathogenesis," they wrote.
"Compared with healthy controls, patients with RA have altered levels of circulating melatonin with higher nocturnal serum levels of melatonin and an altered temporal profile with a more rapid increase at the start of the night and an earlier peak," they explained.
Future studies should further explore the potential role of melatonin, measuring levels and investigating the effects on symptoms, they concluded.
A possible limitation was the possibility of selection bias among controls.