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Overlap syndrome with Sjögren’s syndrome and systemic sclerosis in a steel rolling mill worker: a case report
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Min-Kee Yi, Won-Jun Choi, Sung-Woo Han, Seng-Ho Song, Dong-Hoon Lee, Sun Young Kyung, Sang-Hwan Han
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Ann Occup Environ Med 2016;28:24. Published online June 2, 2016
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DOI: https://doi.org/10.1186/s40557-016-0106-3
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Abstract
PDFPubReaderePub
- Background
There are few reports about work-related factors associated with Sjögren’s syndrome. We report a case of overlap syndrome with Sjögren’s syndrome and systemic sclerosis. Case presentationA 54-year-old man was admitted due to dyspnea on exertion. The results of physical examination and laboratory findings were compatible with Sjögren’s syndrome with systemic sclerosis. The patient had no pre-existing autoimmune disease, and denied family history of autoimmune disease. The patient worked in the large-scale rolling department of a steel manufacturing company for 25 years. Hot rolling is a rolling process performed at between 1100 °C and 1200 °C, generating a high temperature and a large amount of fumes, involving jet-spraying of water throughout the process to remove the instantaneously generated oxide film and prevent the high generation of fumes. In this process, workers could be exposed to silica produced by thermal oxidation. Other potential toxic substances including nickel and manganese seemed to be less likely associated with the patient’s clinical manifestations. ConclusionsOccupational exposure to silica seemed to be associated with the patient’s clinical manifestations of overlap syndrome with Sjögren’s syndrome and systemic sclerosis. Although the underlying mechanism is still unclear, autoimmune disease including Sjögren’s syndrome affects women more often than men and there was no family history of autoimmune disease. These suggested that there was an association between occupational silica exposure and the disease of the patient. Future research about the association between long-term low dose exposure to silica and the development of autoimmune diseases should be encouraged.
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Citations
Citations to this article as recorded by
- Environmental pollutants and phosphoinositide signaling in autoimmunity
Chang Ren, Noah D. Carrillo, Vincent L. Cryns, Richard A. Anderson, Mo Chen Journal of Hazardous Materials.2024; 465: 133080. CrossRef - Silicosis y síndrome de Sjögren
Miguel Martín Asenjo, Javier Miguel Martín Guerra, Claudia Iglesias Pérez, José María Prieto de Paula Archivos de Bronconeumología.2019; 55(10): 536. CrossRef - Silicosis and Sjögren's Syndrome
Miguel Martin Asenjo, Javier Miguel Martín Guerra, Claudia Iglesias Pérez, José Maria Prieto de Paula Archivos de Bronconeumología (English Edition).2019; 55(10): 536. CrossRef - Systemic sclerosis due to crystalline silica exposure among jewelry workers in Korea: two case reports
Jae Yoon Kim, Sang Yoon Do, Young Hoon Moon, Chul Gab Lee, Yun Sung Kim, Byung Soon Choi, Eun-A Kim, Han Soo Song Annals of Occupational and Environmental Medicine.2017;[Epub] CrossRef
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Acute respiratory symptoms and evacuation-related behavior after exposure to chlorine gas leakage
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Sung-Woo Han, Won-Jun Choi, Min-Kee Yi, Seng-Ho Song, Dong-Hoon Lee, Sang-Hwan Han
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Ann Occup Environ Med 2016;28:29. Published online July 4, 2016
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DOI: https://doi.org/10.1186/s40557-016-0115-2
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Abstract
PDFPubReaderePub
- Background
A study was performed on the accidental chlorine gas leakage that occurred in a factory of printed circuit boards manufactured without chlorine. Health examination was performed for all 52 workers suspected of exposure to chlorine gas, and their evacuation-related behaviors were observed in addition to analyzing the factors that affected the duration of their acute respiratory symptoms. MethodsBehavioral characteristics during the incidence of the accidental chlorine gas leakage, the estimated time of exposure, and the duration of subjective acute respiratory symptoms were investigated. In addition, clinical examination, chest radiography, and dental erosion test were performed. As variables that affected the duration of respiratory symptoms, dose group, body weight, age, sex, smoking, work period, and wearing a protective gear were included and analyzed by using the Cox proportional hazard model. ResultsOf 47 workers exposed to chlorine gas, 36 (77 %) developed more than one subjective symptom. The duration of the subjective symptoms according to exposure level significantly differed, with a median of 1 day (range, 0–5 days) in the low-exposure group and 2 days (range, 0–25 days) in the high-exposure group. Among the variables that affected the duration of the acute respiratory symptoms, which were analyzed by using the Cox proportional hazard model, only exposure level was significant (hazard ratio 2.087, 95 % CI = 1.119, 3.890). Regarding the evacuation-related behaviors, 22 workers (47 %) voluntarily evacuated to a safety zone immediately after recognizing the accidental exposure, but 25 workers (43 %) delayed evacuation until the start of mandatory evacuation (min 5, max 25 min). ConclusionsThe duration of the subjective acute respiratory symptoms significantly differed between the low- and high-exposure groups. Among the 27 workers in the high-exposure group, 17 misjudged the toxicity after being aware of the gas leakage, which is a relatively high number.
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Citations
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- Migration behavior of chlorine and sulfur during gasification and combustion of biomass and coal
Yuefeng Wang, Yuhong Qin, Stanislav V. Vassilev, Chong He, Christina G. Vassileva, Yuexing Wei Biomass and Bioenergy.2024; 182: 107080. CrossRef - Acute chlorine poisoning caused by an accident at a swimming pool
Wu Na, Yiran Wang, An Li, Xiaoli Zhu, Changjiang Xue, Qiao Ye Toxicology and Industrial Health.2021; 37(9): 513. CrossRef - Removal of gaseous elemental mercury by hydrogen chloride non-thermal plasma modified biochar
Jinjing Luo, Mingchang Jin, Lurong Ye, Yinan Cao, Yonggui Yan, Rupeng Du, Ryo Yoshiie, Yasuaki Ueki, Ichiro Naruse, ChinJung Lin, YiYuan Lee Journal of Hazardous Materials.2019; 377: 132. CrossRef
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The association between shift work and hyperuricemia in steelmaking male workers
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Jae-Seok Oh, Won-Jun Choi, Min-Kee Lee, Sung-Woo Han, Seung-Ho Song, Jong-Wan Yun, Sang-Hwan Han
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Ann Occup Environ Med 2014;26:42. Published online November 4, 2014
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DOI: https://doi.org/10.1186/s40557-014-0042-z
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Abstract
PDFPubReaderePub
- Objectives
The aim of this study was to examine the association between shift work and hyperuricemia among steel company workers. MethodsWe examined 1,029 male workers at a Korean steel company between June 6 and June 28, 2013. We conducted anthropometric measurements, questionnaire surveys, and blood tests. Hyperuricemia was defined as a serum uric acid concentration of ≥7.0 mg/dL. Logistic regression analyses were performed. In the full model, analysis was adjusted for covariates including age, body mass index, lifestyle factors, and comorbidities. The odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated for all models. ResultsThe participants included 276 daytime workers and 753 shift workers. Among daytime workers, 72 (26.1%) individuals had hyperuricemia, as did 282 (37.5%) individuals among shift workers (p <0.001). There was a statistically significant association between shift work and hyperuricemia. In the unadjusted model, the OR of shift work was 1.70 (95% CI 1.25-2.31) for hyperuricemia. In the full model, the OR of shift work was also statistically significant after adjustment for covariates (OR 1.41, 95% CI 1.02-1.96). ConclusionsAmong male steel workers, a significant association between shift work and hyperuricemia was observed.
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- Influence of occupational exposure on hyperuricemia in steelworkers: a nested case–control study
Yuanyu Chen, Yongzhong Yang, Ziwei Zheng, Hui Wang, Xuelin Wang, Zhikang Si, Rui Meng, Guoli Wang, Jianhui Wu BMC Public Health.2022;[Epub] CrossRef - Serum uric acid concentration is associated with hyperhomocysteinemia in hypertensive Chinese adults
Wen Wang, Qian Wang, Nan Yang Blood Pressure Monitoring.2022; 27(3): 147. CrossRef - An association of smoking with serum urate and gout: A health paradox
Niamh Fanning, Tony R. Merriman, Nicola Dalbeth, Lisa K. Stamp Seminars in Arthritis and Rheumatism.2018; 47(6): 825. CrossRef
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The Relevance of Hyperuricemia and Metabolic Syndrome and the Effect of Blood Lead Level on Uric Acid Concentration in Steelmaking Workers
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Deul Lee, Won-Jun Choi, Jae-Seok Oh, Min-Kee Yi, Sung-Woo Han, Jong-Wan Yun, Sang-Hwan Han
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Ann Occup Environ Med 2013;25:27-27. Published online October 25, 2013
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DOI: https://doi.org/10.1186/2052-4374-25-27
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Abstract
PDFPubReaderePub
- Objectives
Uric acid concentration is known to increase the prevalence of metabolic syndrome by affecting its components, resulting in increased risk of cerebrovascular and cardiovascular diseases, and long-term lead exposure is known to affect this serum uric acid level. In this study, we aimed to examine the association between the causes of hyperuricemia and metabolic syndrome, and to determine whether an increased blood lead level affects hyperuricemia. MethodAnthropometric measurements, surveys, and blood tests were conducted between May and June 2012 in 759 men working in the steelmaking process at a domestic steel company. Workers were divided into 2 groups according to the presence or absence of hyperuricemia, and an analysis was performed to examine its association with metabolic syndrome. In addition, the workers were divided into 3 groups according to the blood lead level to analyze the association between blood lead and hyperuricemia. ResultsThe geometric mean (standard deviation) of the blood lead levels in the hyperuricemia group was significantly higher than that of the healthy group (3.8 [1.8] vs. 3.3 [1.8] μg/dL). The adjusted odds ratio for metabolic syndrome of the hyperuricemia group increased significantly to 1.787 (1.125–2.839) compared with the healthy group. In addition, the adjusted odds ratios for the occurrence of hyperuricemia in the tertile 2 (2.61–4.50 μg/dL) and tertile 3 groups (>4.50 μg/dL) according to blood lead level significantly increased to 1.763 (1.116–2.784) and 1.982 (1.254–3.132), respectively, compared with the tertile 1 group (< 2.61 μg/dL). ConclusionHyperuricemia is believed to function as an independent risk factor for metabolic syndrome, while lead seems to increase the serum uric acid level even at a considerably low blood level. Therefore, attention should be given to patients with hyperuricemia and metabolic syndrome who are prone to lead exposure, and a prospective study should be conducted to identify their causal relationship.
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- A systematic review and meta-analysis of the hyperuricemia risk from certain metals
Tingting Gu, Guorong Cao, Miao Luo, Nannan Zhang, Ting Xue, Rongchun Hou, Min Leng Clinical Rheumatology.2022; 41(12): 3641. CrossRef - Environmental factors and risk of gout
Zheng-Dong Wu, Xiao-Ke Yang, Yi-Sheng He, Jing Ni, Jie Wang, Kang-Jia Yin, Ji-Xiang Huang, Yue Chen, Ya-Ting Feng, Peng Wang, Hai-Feng Pan Environmental Research.2022; 212: 113377. CrossRef - Association of hyperuricemia and metabolic syndrome in type 2 diabetes mellitus patients in Dakar
Oumou Kesso Barry Nènè, Djite Moustapha, Matar Kandji Pape, Hadji Malick Ndour El, Assane Ndour Michel, Diedhiou Demba, Fatou Gueye-Tall, Palanga Koboyo Alix, Marieme Thioune Ndeye, Fatou Coly Najah, Doupa Dominique, Ndour Mbaye Maimouna, Cisse Aynina, Am African Journal of Biochemistry Research.2021; 15(3): 43. CrossRef - Frequency of daily tooth brushing and subsequent cardiovascular events
Daiki Kobayashi, Atsushi Mizuno, Rie Mitsui, Takuro Shimbo Coronary Artery Disease.2020; 31(6): 545. CrossRef - Occupational exposure to inorganic dust and risk of gout: a population-based study
Valgerdur Sigurdardottir, Lennart Jacobsson, Linus Schiöler, Anna Svärd, Mats Dehlin, Kjell Toren RMD Open.2020; 6(2): e001178. CrossRef - Associations between blood lead, cadmium, and mercury levels with hyperuricemia in the Korean general population: A retrospective analysis of population‐based nationally representative data
Wonkil Jung, Yunkyung Kim, Hoseob Lihm, Jihun Kang International Journal of Rheumatic Diseases.2019; 22(8): 1435. CrossRef - The role of cadmium in obesity and diabetes
Alexey A. Tinkov, Tommaso Filippini, Olga P. Ajsuvakova, Jan Aaseth, Yordanka G. Gluhcheva, Juliana M. Ivanova, Geir Bjørklund, Margarita G. Skalnaya, Eugenia R. Gatiatulina, Elizaveta V. Popova, Olga N. Nemereshina, Marco Vinceti, Anatoly V. Skalny Science of The Total Environment.2017; 601-602: 741. CrossRef
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