Occupational connective tissue disorders

Abstract

Systemic sclerosis (SSc) can be induced by long-term silica exposure. In terms of clinical and laboratory features, this silica-induced scleroderma is indistinguishable from idiopathic scleroderma. Silica is able to trigger the immune system, vasculature, as well as fibroblasts on the basis of an increased genetic susceptibility. Silica can also contribute to the pathogenesis of other autoimmune diseases such as (systemic) lupus erythematosus, dermatomyositis, rheumatoid arthritis, overlap syndromes, and Sjögren’s syndrome. If silica exposure has been long enough and its concentration high enough under occupational conditions, SSc should be acknowledged as an occupational disease and financially compensated. Silicon (breast augmentation) does not induce the so-called adjuvant disease. Organic solvents such as (chlorinated) aliphatic and aromatic hydrocarbons can trigger scleroderma-like diseases (SLDs) characterized by scleroderma and, in addition, toxic effects to liver, kidney, nervous system, sometimes absence of autoantibodies and to some extent reversibility of the disease.