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

• Published in: Autoimmunity reviews Vol. 16; no. 3; pp. 223 - 230
• Main Authors: Marie, I., Gehanno, J-F., Bubenheim, M., Duval-Modeste, A-B., Joly, P., Dominique, S., Bravard, P., Noël, D., Cailleux, A-F., Benichou, J., Levesque, H., Goullé, J-P.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2017; Elsevier
• Subjects: Allergy and Immunology; Case-Control Studies; Crystalline silica; Environmental Exposure - adverse effects; Environmental factors; Female; Heavy metals; Humans; Life Sciences; Male; Metals, Heavy - adverse effects; Occupational Exposure - adverse effects; Occupational factors; Risk Factors; Scleroderma, Systemic - etiology; Solvents; Systemic sclerosis; Occupational factors; Solvents; Environmental factors; Crystalline silica; Systemic sclerosis; Heavy metals
• ISSN: 1568-9972; 1568-9972; 1873-0183
• DOI: 10.1016/j.autrev.2017.01.004

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. 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). 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 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.