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New study links RA with prolonged physical workload

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Swedish researchers have found that a prolonged, repetitive physical workload increases the risk of developing rheumatoid arthritis (RA).

Although work-related physical activity over many years is already known to contribute to the development of osteoarthritis (OA) in certain joints, this is thought to be the first study to show a link between physical workload and RA.

The research was presented at last week´s European League Against Rheumatism Annual Congress (EULAR 2016).

To examine whether physical workload is a possible risk factor for RA, the researchers analysed information on different types of self-reported exposure among 3,680 RA patients and 5,935 matched controls included in the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA).

Then, to investigate whether some people are more susceptible than others, the risk was compared in subjects with and without a specific genotype (HLA-DRB1). The researchers also looked at the presence/absence of ACPA (anti-citrullinated protein antibodies) among RA patients.

“We found that some types of physical workload increased the odds of developing RA more than others,” explained Pingling Zeng of the Institute of Environmental Medicine, Karolinska Institute in Stockholm. “There also appeared to be a significant interaction between genetic makeup, in terms of HLA-DRB1 genes, and the risk of ACPA-positive RA from specific types of physical workload.”

According to the study, the estimated odds ratio of developing RA in exposed vs. unexposed subjects was greater than or equal to 1.5 with several repetitive types of manual work that would be common, for example, in the building trade. These include exposure to repeated vibration (1.5), carrying or lifting weights greater than 10kg (1.5), bending/turning (1.6), and working with hands either below knee level (1.7) or above shoulder level (1.8).

“These new insights into the cause of RA may hopefully lead to effective strategies to prevent the development of RA, particularly in those RA patients with a susceptible genotype,” Zeng said.