Journal
AUTOIMMUNITY REVIEWS
Volume 18, Issue 1, Pages 62-72Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.autrev.2018.11.001
Keywords
Systemic sclerosis - environmental factors - occupational factors; crystalline silica; Solvents; Trichloroethylene; Ketones - welding fumes - pesticides
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Funding
- French Ministry of Health [PHRCIR 2003-0549]
- Rouen University Hospital [2002-039HP]
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As a mirror image of the Roman god Janus Bifrons, the environment has a hidden face. To highlight this hidden face of the environment in the field of systemic sclerosis (SSc) will allow to identify responsible agents emerging in the future. To date, there is, in fact, a growing scientific evidence that environmental factors have a crucial impact on both alterations and modulation of epigenetic determinants, resulting in SSc onset and progression. It has been well established that there is a marked correlation between SSc onset and occupational exposure to crystalline silica and organic solvents. More recently, an association between SSc and exposure to heavy metals has further been found, including: antimony, cadmium, lead, mercury. These latter findings interestingly underscore that occupational exposure to heavy metals should be systematically checked in all SSc patients at diagnosis, as the identification of the occupational toxic agent will allow its interruption, which may result in potential improvement of SSc outcome.
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