RT Journal Article
SR Electronic
T1 Occupational trichloroethylene exposure and antinuclear antibodies: a cross-sectional study in China
JF Occupational and Environmental Medicine
JO Occup Environ Med
FD BMJ Publishing Group Ltd
SP oemed-2022-108266
DO 10.1136/oemed-2022-108266
A1 Mark Purdue
A1 Luoping Zhang
A1 Roel Vermeulen
A1 Martyn T Smith
A1 Wei Hu
A1 Jongeun Rhee
A1 Cuiju Wen
A1 Yongshun Huang
A1 Xiaojiang Tang
A1 Sonja I Berndt
A1 Ashley A Frazer-Abel
A1 Kevin D Deane
A1 Nathaniel Rothman
A1 Qing Lan
YR 2022
UL http://oem.bmj.com/content/early/2022/05/02/oemed-2022-108266.abstract
AB Objectives There has been concern over the possible risk of autoimmune diseases from exposure to trichloroethylene (TCE), an industrial solvent and common pollutant near hazardous waste sites. Studies of TCE-exposed lupus-prone mouse strains have reported increases in serum antinuclear antibodies (ANAs), a marker of autoimmunity, and autoimmune pathologic changes, while epidemiologic studies have provided limited support for an association between TCE exposure and scleroderma. To investigate exposure-related biologic evidence of autoimmunity in humans, we measured ANA levels in sera from a cross-sectional study of TCE-exposed (n=80) and TCE-unexposed (n=96) workers in Guangdong, China.Methods Full-shift personal air exposure measurements for TCE were taken prior to blood collection. Serum ANAs were detected by immunofluorescence on HEp-2 cells. We calculated ORs and 95% CI relating levels of TCE exposure (categorised using tertiles as cut-points) and ANA positivity (1+ intensity at 1:320 dilution) using multivariable logistic regression.Results Samples from 16 of 176 participants were ANA-positive. We found higher levels of TCE exposure (concentrations>17.27 ppm) to be associated with an elevated odds of ANA positivity (OR 4.7, 95% CI 1.3 to 16.8) compared with unexposed controls. This association remained after excluding two subjects with diagnosed autoimmune disease (OR 4.5, 95% CI 1.2 to 16.2). We did not observe an association with ANAs at lower exposure levels.Conclusions Our findings, to our knowledge the first direct human evidence of an association between TCE exposure and systemic autoimmunity, provide biologic plausibility to epidemiologic evidence relating TCE and autoimmune disease.Data are available upon reasonable request.