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Autoimmun Rev. 2017 Mar;16(3):223-230. doi: 10.1016/j.autrev.2017.01.004. Epub 2017 Jan 27.

Systemic sclerosis and exposure to heavy metals: A case control study of 100 patients and 300 controls.

Author information

1
Department of Internal Medicine, CHU Rouen, and INSERM U 905, University of Rouen IFRMP, Institute for Biochemical Research, F-76000 Rouen, France. Electronic address: isabelle.marie@chu-rouen.fr.
2
Department of Occupational Medicine, CHU Rouen, Rouen, France.
3
Department of Biostatistics, CHU Rouen, Rouen, France.
4
Department of Dermatology, CHU Rouen, Rouen, France.
5
Department of Pneumology, CHU Rouen, Rouen, France.
6
Department of Dermatology, CHG Le Havre, Le Havre, France.
7
Department of Internal Medicine, CHG Elbeuf, Elbeuf, France.
8
Clinical Investigation Center, CIC 0204-INSERM, Institute for Biomedical Research, CHU Rouen, Rouen, France.
9
Department of Epidemiology, CHU Rouen, Rouen, France.
10
Department of Internal Medicine, CHU Rouen, and INSERM U 905, University of Rouen IFRMP, Institute for Biochemical Research, F-76000 Rouen, France.
11
Laboratory of Toxicology, CHG Le Havre, Le Havre, France.

Abstract

OBJECTIVE:

This case control study assessed: 1) the relationship of systemic sclerosis (SSc) related to exposure to heavy metals; and 2) the risk of SSc related to occupational exposure in male and female patients.

METHODS:

From 2005 to 2008, 100 patients with a definite diagnosis of SSc were included in the study; 3 age, gender, and smoking habit matched controls were selected for each patient. All SSc patients and controls underwent detection and quantification of heavy metal traces in hair samples, using multi-element inductively coupled plasma mass spectrometry (ICP-MS).

RESULTS:

SSc patients exhibited higher median levels of the following metals: antimony (p=0.001), cadmium (p=0.0003), lead (p=0.02), mercury (p=0.02), molybdenum (p=0.04), palladium (p<0.0001) and zinc (p=0.0003). A marked association between SSc and occupational exposure was further found for: 1) antimony (p=0.008) and platinum (p=0.04) in male patients; and 2) antimony (p=0.02), cadmium (p=0.001), lead (p=0.03), mercury (p=0.03), palladium (p=0.0003) and zinc (p=0.0001) in female patients CONCLUSION: The results show the impact of occupational risk factors in the development of SSc for: antimony, cadmium, lead, mercury, molybdenum, palladium and zinc. Thus, occupational exposure should be systematically checked in all SSc patients at diagnosis. Finally, the association between SSc and occupational exposure may be variable according to patients' gender.

KEYWORDS:

Crystalline silica; Environmental factors; Heavy metals; Occupational factors; Solvents; Systemic sclerosis

PMID:
28137480
DOI:
10.1016/j.autrev.2017.01.004
[Indexed for MEDLINE]

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