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Prevalence of Arthritis and Rheumatoid Arthritis in Coal Mining Counties of the United States
Author(s) -
Schmajuk Gabriela,
Trupin Laura,
Yelin Edward,
Blanc Paul D.
Publication year - 2019
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23874
Subject(s) - medicine , rheumatoid arthritis , odds ratio , pneumoconiosis , confidence interval , population , arthritis , logistic regression , coal mining , demography , coal , environmental health , pathology , sociology , engineering , waste management
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 US . Methods We carried out a random‐digit dialed telephone survey in selected counties in Appalachia that had elevated coal workers’ pneumoconiosis mortality. Our study cohort included men ages ≥50 with any employment history, and we assessed exposure to coal mining employment, other work‐related dust, 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 ( OR s) and associated population attributable fraction ( PAF ) estimates. Results Among the 973 men who met study entry criteria (mean ± SD ages 66 ± 10 years; 54% ever smokers), 266 (27%) reported coal mining work and 189 (19%) reported other work‐related silica exposure. There were 517 men (53%), who reported any arthritis and 112 (12%) whose disease met the study definition of RA . Adjusting for covariates, coal mining was associated with elevated odds of RA ( OR 3.6 [95% confidence interval (95% CI ) 2.1–6.2]), which accounted for a PAF of 33% (95% CI 26–40%) of the men studied. For any arthritis, the coal mining–associated OR was 2.3 (95% CI 1.6–3.2), with an associated PAF of 20% (95% CI 14–25%). Conclusion In this population of older males living in a coal mining region, we estimated that 20% of arthritis and 33% of RA may be attributable to coal mining work.