OP0054 OCCUPATIONAL EXPOSURE TO INORGANIC DUST – A NOVEL RISK FACTOR FOR INCIDENT GOUT?
Authors: Valgerdur Sigurdardottir, Anna Svärd, Lennart T.H. Jacobsson, Linus Schiöler, Kjell Torén, Mats Dehlin
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Hyperuricemia and factors contributing to it are strong risk factors for gout but it is still unexplained why only some individuals with hyperuricemia develop gout. Additional risk factors for gout could be genetic or related to comorbidity, lifestyle or occupation. Occupational exposure to inorganic dust has previously been linked to an increased occurrence of inflammatory rheumatic diseases such as rheumatoid arthritis and could possibly increase the risk of gout. <h3>Objectives:</h3> To evaluate if occupational exposure to inorganic dust increases the risk of incident gout. <h3>Methods:</h3> Gout was defined as having at least one ICD-10 code for gout (M10 or M14.0) in the population based health care database of the Western Swedish Health Care Region (VEGA), during the years 2006-2012, without any gout diagnosis during at least 6 years previously. Individuals with gout that were employed in the 5-year period prior to first diagnosis were included for analysis. Population controls without gout were identified in the census register by Statistics Sweden, matching up to 5 controls per case on the basis of age, sex and place of residence, excluding controls that were not employed during the predictor period. Data on occupation (coded by the ISCO-88 standard) for the 5 years prior to inclusion were collected from official registries and were used to assign exposure status using a job exposure matrix for inorganic dust previously developed.[1] Data on predefined comorbidities (psoriasis, renal disease, alcohol abuse, obesity and diuretic treatment) considered to be possibly relevant confounders for the analyses were collected from VEGA, defined by ICD-10 codes. Alcohol abuse and obesity were found to be related both to gout and exposure to inorganic dusts and were therefore adjusted for in multivariate analyses. The effect of exposure to inorganic dust on risk of gout was described with odds ratios, calculated using conditional logistic regression, for the whole population and stratified by sex. <h3>Results:</h3> 6120 gout cases and 25074 controls were included. Frequencies of exposures (n (%)) and odds ratios (OR (95% conf. int.) for association of risk factors with incident gout are shown in the table below. <h3>Conclusion:</h3> As expected, previously known risk factors for gout such as obesity and alcoholism were strongly associated with incident gout. In univariate analyses, exposure to inorganic dust was also associated with gout. After adjusting for alcohol abuse and obesity, the relationship was attenuated in men but remained in women, providing evidence that occupational exposure to inorganic dust might be a previously unknown risk factor for gout. <h3>Reference:</h3> [1] Lillienberg L, et al. Occupational exposure and new-onset asthma in a population-based study in Northern Europe (RHINE). Ann Occup Hyg. 2013;57:482-92. <h3>Disclosure of Interests:</h3> Valgerdur Sigurdardottir: None declared, Anna Svärd: None declared, Lennart T.H. Jacobsson Consultant for: LJ has received lecture and consulting fees from Pfizer, Abbvie, Novartis, Eli-Lily and Janssen, Linus Schiöler: None declared, Kjell Torén: None declared, Mats Dehlin: None declared