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Prevalence of Arthritis and Rheumatoid Arthritis in Coal Mining Counties of the U.S

Author

Schmajuk G1, Trupin L2, Yelin E3, Blanc PD4. Arthritis Care Res (Hoboken). 2019 Mar 15. doi: 10.1002/acr.23874. [Epub ahead of print]

Author Information

1 Division of Rheumatology and Philip R Lee Institute for Health Policy Studies, University of California San Francisco and the San Francisco Veterans Affairs Health Care System. 

2 Division of Rheumatology, University of California, San Francisco.

3 Division of Rheumatology, Russell/Engleman Rheumatology Research Center, and Philip R Lee Institute for Health Policy Studies, University of California, San Francisco.

4 Division of Occupational and Environmental Medicine, University of California San Francisco and the San Francisco Veterans Affairs Health Care System.

Abstract

OBJECTIVE: 

Exposure to inhaled mineral dust, in particular silica, is associated with increased odds of rheumatoid arthritis (RA) and other autoimmune diseases. We studied the association of RA with work-related coal and silica exposure in the Appalachian region of the U.S.

MATERIALS AND METHODS: 

We carried out a random-digit-dial telephone survey in selected counties in Appalachia with elevated coal workers' pneumoconiosis mortality. We studied males, age ≥50, with any employment history, assessing exposure to coal mining employment, other work-related dusts, and ergonomic factors. We ascertained self-reported physician diagnosis of any arthritis and of RA with glucocorticoid treatment. We used multivariable logistic regression analysis to estimate the odds ratios (ORs) and associated population attributable fraction (PAF) estimates.

RESULTS: 

Among the 973 men meeting study entry criteria (age 66±10 years; 54% ever smokers), 266 (27%) reported coal mining work and 189 (19%) reported other work-related silica exposure. There were 517 (53%) reporting any arthritis and 112 (12%) meeting the study definition of RA. Adjusting for covariates, coal mining was associated with elevated odds of RA (OR 3.6; 95% CI 2.1, 6.2) accounting for a PAF of 33% (95% CI 26, 40%) of the men studied. For any arthritis, the coal-associated OR was 2.3 (95% CI 1.6, 3.2) and the associated PAF 20% (95% CI 14, 25%).

CONCLUSIONS: 

In this population of older males living in a coal mining region, we estimated that 20% of arthritisand 33% of RA may be attributable to coal mining work.