Risky jobs?

Clinical Brief – August 14th

The Brief

A new study finds that being exposed to “noxious airborne agents” on the job were linked to a higher risk of rheumatoid arthritis (aka RA) for men.

More research is needed to see if avoiding such jobs could lower the risk.

What do you mean?

RA is a condition where the body gets confused and attacks the joints like they do bacteria. We don’t know what causes RA, so the next best thing is to point out potential risk factors.

In a bid to find links between lifestyle and work history and the risk of RA, a new Swedish study looked at about 9,100 people, matching roughly every two people with RA to three healthy individuals.

They found that for men, the odds of getting RA was higher for certain jobs:

  • Bricklayers and concrete workers: 2.4-2.9 times higher vs office clerks
  • Electrical and electronics workers: 2.1-2.4 times higher vs office clerks

Their findings for women were relatively weak.

Their conclusion was that “mainly occupations related to potential noxious airborne agents were associated with an increased risk of RA”.

In an earlier study published in 2008, another group in Sweden found a similar trend.

Do these jobs increase the risk of RA?

I always cringe at headlines supported by risk studies, like this one on Medscape“Occupational Exposures Increase Rheumatoid Arthritis Risk”.

The lead author even said this in a press release“It is important that findings on preventable risk factors are spread to employees, employers, and decision-makers in order to prevent disease by reducing or eliminating known risk factors”…which implied that avoiding such jobs may somehow lower the risk of RA.

Frankly, the study showed no such thing. Taking a job as a concrete worker may not increase someone’s risk, and avoiding such a job may not lower the risk either.

This was a simple observation, that within this group of people surveyed, those who had particular jobs had higher odds of getting RA than those who were office clerks. It’s like tossing a trick coin. We see heads are coming up 7 times out of 10, but we have no clue how it’s loaded.

Bottom line

Let’s not get into an academic debate. At the end of the day, I want to bring medical research that everyone can use. So how do we use these results?

Going back to the coin analogy, if we toss the same coin again, we should expect to see heads more often than tails.

What this means is that for people who work in construction or electronics, say they have joint pain. They may consider RA as one of the many causes of the pain and ask their doctors about it.

For doctors, knowing that their patient’s occupation is linked to a higher risk of RA may prompt them to include RA in the differential so that at least it’s considered and can be ruled out.

For more on symptoms and other basic info on RA, check out my RA101 series.

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