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O18-6 Occupational exposure to textile dust increases the risk of RA: results from a malaysian population-based case-control study
  1. Lars Alfredsson1,2,
  2. Chun Lai Too3,
  3. Anna Ilar1,
  4. Leonid Padyukov4,
  5. Lars Klareskog4,
  6. Shahnaz Murad3,
  7. Camilla Bengtsson1
  1. 1Karolinska Insititutet, Stockholm, Sweden, Stockholm, Sweden
  2. 2Centre for Occupational and Envirionmental Health, Stocholm County Council, Stockhom, Sweden, Stockholm, Sweden
  3. 3Allergy and Immunology Research Centre, Institute of Medical Research, Kuala Lumpur, Malaysia, Kuala Lumpur, Malaysia
  4. 4Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Stockholm, Sweden, Stockholm, Sweden


Objectives Lung exposures including cigarette smoking and silica exposure are associated with the risk of rheumatoid arthritis (RA). We investigated the association between textile dust exposure and the risk of RA in the Malaysian population, with a focus on women who rarely smoke.

Methods Data from the Malaysian Epidemiological Investigation of Rheumatoid Arthritis (MyEIRA) population-based case-control study involving 910 female early RA cases and 910 female age-matched controls were analysed. Self-reported information on ever/never occupationally exposed to textile dust was used to estimate the risk of developing anti-citrullinated protein antibody (ACPA)-positive and ACPA-negative RA. Interaction between textile dust and the HLA-DRB1 shared epitope (SE) was evaluated by calculating the attributable proportion due to interaction (AP), with 95% CI.

Results Occupational exposure to textile dust was significantly associated with an increased risk of developing RA in the Malaysian female population (OR 2.8, 95% CI: 1.6–5.2). The association between occupational exposure to textile dust and risk of RA was uniformly observed for the ACPA-positive RA (OR 2.5, 95% CI: 1.3–4.8) and ACPA-negative RA (OR 3.5, 95% CI: 1.7–7.0) subsets, respectively. We observed a significant interaction between exposure to occupational textile dust and HLA-DRB1 SE alleles regarding the risk of ACPA-positive RA (OR for double exposed: 39.1, 95% CI: 5.1–297.5; AP: 0.8, 95% CI: 0.5–1.2).

Conclusions This is the first study demonstrating that textile dust exposure is associated with an increased risk for RA. In addition a gene-environment interaction between HLA-DRB1 SE and textile dust exposure provides a high risk for ACPA-positive RA.

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