Exposure to Occupational Inhalants and the Risk of Developing Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.

Although smoking is a well-established risk factor for RA, the role of occupational inhalants in RA development is less well recognized.

尽管吸烟是已知的RA风险因素，但职业吸入物在RA发展中的作用尚未得到广泛认可。

This study aimed to systematically review and synthesize existing evidence on the association between occupational inhalants and the risk of developing RA.

本研究旨在系统回顾和综合现有证据，探讨职业吸入物与类风湿性关节炎（RA）发病风险之间的关联。

Methods

We conducted a systematic reviewand meta-analysisfollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching MEDLINE, Embase, and Web of Science from database inception to November 20, 2024.

我们遵循系统综述和荟萃分析的首选报告项目（PRISMA）指南，对MEDLINE、Embase和Web of Science数据库从创建之初到2024年11月20日进行了系统综述和荟萃分析。

Eligible studies were cross-sectional, were case-control and cohort designs, were population-based, reported original data on occupational inhalant exposures and RA, measured exposures, included a comparison group, and used reliable RA ascertainment methods.

符合条件的研究是横断面研究、病例对照研究和队列研究设计，是基于人群的研究，报告了关于职业吸入暴露和类风湿关节炎的原始数据，测量了暴露情况，包括了对照组，并使用了可靠的类风湿关节炎确诊方法。

Studies relying solely on self-reported RA or focusing on treatment, prognosis, sick leave, or death were excluded.

仅依赖自我报告的类风湿关节炎或专注于治疗、预后、病假或死亡的研究被排除在外。

Two reviewers independently conducted literature screening, data extraction, and risk-of-bias assessment using the Newcastle-Ottawa Scale.

两位评审员独立进行文献筛选、数据提取和使用纽卡斯尔-渥太华量表进行偏倚风险评估。

Random-effects meta-analyses with relative risk were performed for cohort and case-control studies, and heterogeneity was assessed using the I2 statistic.

对队列研究和病例对照研究进行了相对风险的随机效应荟萃分析，并使用I2统计量评估异质性。

Results

In total, 31 studies met inclusion criteria, and 25 were included in meta-analyses across 10 types of occupational inhalants.

共有31项研究符合纳入标准，其中25项研究被纳入了针对10种职业吸入物的荟萃分析。

Significant associations with RA risk were observed for exposure to silica, asbestos, solvents, pesticides, fertilizers, animal dust, and engine exhaust (relative risks ranging from 1.25 to 1.49).

对于矽尘、石棉、溶剂、农药、化肥、动物粉尘和发动机废气的暴露与类风湿关节炎（RA）风险显著相关（相对风险从1.25到1.49不等）。

Moderate-to-high heterogeneity was observed in seven meta-analyses.

在七项荟萃分析中观察到中到高度的异质性。

Conclusions

Occupational inhalants are associated with increased RA risk, underscoring the importance of workplace prevention strategies and further research into biologic mechanisms.

职业吸入物与增加的类风湿关节炎（RA）风险相关，强调了工作场所预防策略的重要性以及对生物机制进行进一步研究的必要性。