Occupational trichloroethylene exposure and antinuclear antibodies: a cross-sectional study in China. Issue 10 (3rd May 2022)

• Record Type: Journal Article
• Authors: Purdue, Mark; Zhang, Luoping; Vermeulen, Roel; Smith, Martyn T; Hu, Wei; Rhee, Jongeun; Wen, Cuiju; Huang, Yongshun; Tang, Xiaojiang; Berndt, Sonja I; Frazer-Abel, Ashley A; Deane, Kevin D; Rothman, Nathaniel; Lan, Qing
• Is Part Of: Occupational and environmental medicine. Volume 79:Issue 10(2022)
• Page Start: 717
• Page End: 720
• Publication Date: 2022-05-03
• Subjects: Epidemiology -- Solvents -- Autoimmune Diseases -- Cross-Sectional Studies; Medicine, Industrial -- Periodicals; Environmental health -- Periodicals; 616.980305
• DOI: 10.1136/oemed-2022-108266
• Languages: English
• ISSNs: 1351-0711

Abstract

Abstract : 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.