Association between occupational exposure to mineral oil and rheumatoid arthritis: results from the Swedish EIRA case–control study

The aim of the present study was to investigate the association between exposure to mineral oil and the risk of developing rheumatoid arthritis (RA), and in addition to perform a separate analysis on the major subphenotypes for the disease; namely, rheumatoid factor (RF)-positive RA, RF-negative RA, anticitrulline-positive RA and anticitrulline-negative RA, respectively. A population-based case–control study of incident cases of RA was performed among the population aged 18–70 years in a defined area of Sweden during May 1996–December 2003. A case was defined as an individual from the study base who for the first time received a diagnosis of RA according to the American College of Rheumatology criteria of 1987. Controls were randomly selected from the study base with consideration taken for age, gender and residential area. Cases (n = 1,419) and controls (n = 1,674) answered an extensive questionnaire regarding lifestyle factors and occupational exposures, including different types of mineral oils. Sera from cases and controls were investigated for RF and anticitrulline antibodies. Among men, exposure to any mineral oil was associated with a 30% increased relative risk of developing RA (relative risk = 1.3, 95% confidence interval = 1.0–1.7). When cases were subdivided into RF-positive RA and RF-negative RA, an increased risk was only observed for RF-positive RA (relative risk = 1.4, 95% confidence interval 1.0–2.0). When RA cases were subdivided according to the presence of anticitrulline antibodies, an increased risk associated with exposure to any mineral oil was observed only for anticitrulline-positive RA (relative risk = 1.6, 95% confidence interval = 1.1–2.2). Analysis of the interaction between oil exposure and the presence of HLA-DR shared epitope genes regarding the incidence of RA indicated that the increased risk associated with exposure to mineral oil was not related to the presence of shared epitope genotypes. In conclusion, our study shows that exposure to mineral oil is associated with an increased risk to develop RF-positive RA and anticitrulline-positive RA, respectively. The findings are of particular interest since the same mineral oils can induce polyarthritis in rats

Aspects of the role of mineral oil as immunological adjuvants in rheumatoid arthritis

Environmental factors are likely contributing factors in the development of Rheumatoid Arthritis (RA), an autoimmune disease, for which etiologic factors are still poorly known. Mineral oils are efficient adjuvants which increase immunological responses and are used in animal immunization and for induction of different experimental autoimmune diseases including arthritis. The relationship between environmental exposure to mineral oil and the risk of developing RA is the subject of this thesis. Both animal experimental studies and human epidemiological studies were performed in order to investigate the possible role of mineral oils in the development of arthritis. A special emphasis was devoted to investigations of whether exposure to cosmetics containing mineral oils was associated with arthritis in a similar way as exposure to the mineral oils themselves. Experimental studies using the Dark Agouti rat (DA rat) showed that five of the eight tested common, commercial cosmetic products containing mineral oil induced arthritis in DA rats after immunisation in the skin. One cosmetic product, so called baby oil, also induced a mild transient arthritis after percutaneous exposure. Two types of epidemiological studies were performed to investigate the relationship between occupational exposure to mineral oil and the risk of developing RA. First, a register-based cohort study was used to compare the cumulative incidence of RA between individuals with different occupations. The study population comprised of subjects who in 1980 lived in one of 13 Swedish counties and were born 1905-1945, and stated the same occupation in the census of 1960 and 1970. The study population was followed concerning hospital care for RA in 1981-1983 by linkage to the Swedish Hospital Discharge Register. A small increased risk of RA was observed in farmers, upholsterers, lacquerers, concrete workers and hair-dressers and in several occupations such as toolmakers, machinery and engine repairmen. Many of these occupations are associated with exposure to organic solvents and mineral oil, and this register study triggered our interest in initiating a case-control study investigating the environmental risk factors for RA, including the risk confined by mineral oil exposure. The case-control study comprised 1419 incident RA cases and 1674 controls. Men occupationally exposed to mineral oil were observed to have an increased risk of developing RA (Relative risk (RR) = 1.3, 95% confidence interval (CI) = 1.0-1.7). Mineral oil exposure was associated with a particularly high risk of developing rheumatoid factor positive RA (RR =1.4, 95% CI =1.0-2.0) and anti-citrulline positive RA (anti-CCP+RA) (RR =1.6, 95% CI=1.1-2.2). The highest risk of developing anti- CCP+RA (RR=1.7, 95% CI=1.1-2.6) was observed after exposure to hydraulic oil. The number of women occupationally exposed to mineral oils was too few to allow meaningful analyses. Association between cosmetic usage and the risk of developing RA was also investigated in the casecontrol study. However, no increased risk through use of common skin care products such as body lotions and skin creams was observed. Conclusion This thesis demonstrates that environmental exposure to mineral oil by itself, as well as being a component of cosmetics, can induce experimental arthritis in rats with certain genetic characteristics, and that occupational exposure to mineral oils is associated with an increased risk of developing RA. Our epidemiological study gave no evidence that use of cosmetics containing mineral oils was associated with an increased risk for RA

Translation and cultural influence in Norway c.1100-1600

Three major disruptions marked Norwegian literary production, style, and language: the introduction of Christianity, the Black Death, and the Reformation. The influence of foreign writing in translation was pivotal to the transition between the pagan Viking Era and the Christian Middle Ages in the 11 th and 12 th centuries and to the passage from Catholicism to Lutheranism in the 16 th century. Translation in a medieval (and to some extent Renaissance) context must be understood as transfer of knowledge, the crossing of linguistic and cultural borders, including adaptation, paraphrase, imitation, summary, and compiling. The objective of the present work is to examine Norwegian medieval and Renaissance translations in a broader European context and emphasize how the encounter with the foreign helped shape the national. For centuries, long before the official introduction of Christianity, the people of the North had been in more or less regular contact with foreign cultures through commercial travels and raids. By adopting the Christian faith, Norwegians became members of an international community with long-established literary traditions and a legal system that was being revised and enforced throughout Christianity to harmonize secular and ecclesiastical life. Translated texts helped explain and consolidate the social conventions promoted by the new religion. The need for exemplification marked textual imports of all genres and translators played an important role in the reshaping of the Old Norse mentality. Religious and devotional material preceded the secular court literature from the French-speaking territories. Hagiographic material ran parallel to heroic tales as both genres helped illustrate the virtues of Christian life and needed only minor adaptation for a Norse audience. Over time, pagan literary conventions blended with those of the imported Christian material and resulted in a distinct literary style, adapting and recreating material of Breton, Arthurian, and heroic origin. Adventures of chivalrous knights (Marie de France and Chrétien de Troyes) and heroic kings (Einhard and Turold) were translated alongside famous legends of martyrs and biblical heroes. The break with the pagan religion was the first of a series of cultural disruptions in the North. The systematic encounter with the foreign gave rise to a new perception of self in relation to other . (Abstract shortened by UMI.

Usage of skin care products and risk of rheumatoid arthritis : results from the Swedish EIRA study.

INTRODUCTION: The aim of this study was to investigate the association between exposure to cosmetics, often containing mineral oil, and the risk of developing rheumatoid arthritis (RA). The study was performed against the background that occupational exposure to mineral oil has recently been shown to be associated with an increased risk for RA in man, and that injection of or percutaneous exposure to mineral-oil-containing cosmetics can induce arthritis in certain rat strains. METHODS: A population-based case-control study of incident cases of RA was performed among the population aged 18 to 70 years in a defined area of Sweden during May 1996 to December 2003. A case was defined as an individual from the study base, who received for the first time a diagnosis of RA according to the 1987 American College of Rheumatology criteria. Controls were randomly selected from the study base with consideration taken for age, gender and residential area. Cases (n = 1,419) and controls (n = 1,674) answered an extensive questionnaire regarding environmental and lifestyle factors including habits of cosmetic usage. The relative risk of developing RA was calculated for subjects with different cosmetic usage compared with subjects with low or no usage. Analysis was also performed stratifying the cases for presence/absence of rheumatoid factor and antibodies to citrulline-containing peptides. RESULTS: The relative risks of developing RA associated with use of cosmetics were all close to one, both for women and men, for different exposure categories, and in relation to different subgroups of RA. CONCLUSION: This study does not support the hypothesis that ordinary usage of common cosmetics as body lotions, skin creams, and ointments, often containing mineral oil, increase the risk for RA in the population in general. We cannot exclude, however, that these cosmetics can contribute to arthritis in individuals carrying certain genotypes or simultaneously being exposed to other arthritis-inducing environmental agents.En artikel av författargruppen Epidemiological Investigation of Rheumatoid Arthritis Study Group</p

Common vaccinations among adults do not increase the risk of developing rheumatoid arthritis: results from the Swedish EIRA study

Objective To investigate the association between vaccinations in adults and the risk of developing rheumatoid arthritis (RA). Methods Data from the Swedish population-based Epidemiological Investigation of RA case-control study encompassing 1998 incident cases of RA aged 18-70 years and 2252 randomly selected controls matched for age, sex and residency were analysed. Those vaccinated within 5 years before disease onset were compared with those not vaccinated by calculating OR with 95% CI. Results Vaccinations neither increased the risk of RA overall (OR 1.0, 95% CI 0.9 to 1.1) nor the risk of two major subgroups of RA (antibodies to citrullinated peptide-positive (ACPA-positive) and ACPA-negative disease). Furthermore, vaccinations did not increase the risk of RA in smokers or carriers of HLA-DRB1 shared epitope alleles, two groups with established risk factors for RA. Conclusions In this case-control study of incident cases of newly diagnosed RA, no increased risk of RA following immunisation was observed for vaccinations overall or for any specific vaccination. This indicates that immunological provocation of adults with commonly used vaccines in their present form carries no risk of RA. These findings should be implemented among public healthcare providers in order to encourage vaccinations according to recommended national vaccination schedules