{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:07:55Z","timestamp":1785330475404,"version":"3.55.0"},"reference-count":70,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100018549","name":"Recruitment Program for Young Professionals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018549","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002706","name":"AFA F\u00f6rs\u00e4kring","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002706","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint pain, swelling, and stiffness. Although smoking is a well\u2010established risk factor for RA, the role of occupational inhalants in RA development is less well recognized. This study aimed to systematically review and synthesize existing evidence on the association between occupational inhalants and the risk of developing RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a systematic review and meta\u2010analysis following the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) guidelines, searching MEDLINE, Embase, and Web of Science from database inception to November 20, 2024. Eligible studies were cross\u2010sectional, were case\u2010control and cohort designs, were population\u2010based, reported original data on occupational inhalant exposures and RA, measured exposures, included a comparison group, and used reliable RA ascertainment methods. Studies relying solely on self\u2010reported RA or focusing on treatment, prognosis, sick leave, or death were excluded. Two reviewers independently conducted literature screening, data extraction, and risk\u2010of\u2010bias assessment using the Newcastle\u2013Ottawa Scale. Random\u2010effects meta\u2010analyses with relative risk were performed for cohort and case\u2010control studies, and heterogeneity was assessed using the I\n                      <jats:sup>2<\/jats:sup>\n                      statistic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 31 studies met inclusion criteria, and 25 were included in meta\u2010analyses across 10 types of occupational inhalants. Significant associations with RA risk were observed for exposure to silica, asbestos, solvents, pesticides, fertilizers, animal dust, and engine exhaust (relative risks ranging from 1.25 to 1.49). Moderate\u2010to\u2010high heterogeneity was observed in seven meta\u2010analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Occupational inhalants are associated with increased RA risk, underscoring the importance of workplace prevention strategies and further research into biologic mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.43446","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T05:39:32Z","timestamp":1764308372000},"page":"830-847","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exposure to Occupational Inhalants and the Risk of Developing Rheumatoid Arthritis: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1928-4096","authenticated-orcid":false,"given":"Qianwen","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, and Center for Molecular Medicine Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-5835","authenticated-orcid":false,"given":"Xin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene West China School of Public Health and West China Fourth Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9836-8396","authenticated-orcid":false,"given":"Emily","family":"Mauro","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4542-9578","authenticated-orcid":false,"given":"Yuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, and Center for Molecular Medicine Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klementy","family":"Shchetynsky","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, and Center for Molecular Medicine Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Klareskog","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Rheumatology, Center for Molecular Medicine Karolinska Institutet, Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Alfredsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, and Center for Molecular Medicine Karolinska University Hospital  Stockholm Sweden"},{"name":"Institute of Environmental Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5878-8986","authenticated-orcid":false,"given":"Xia","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, and Center for Molecular Medicine Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Nutrition and Food Hygiene West China School of Public Health and West China Fourth Hospital, Sichuan University  Chengdu China"},{"name":"Department of Epidemiology and Biostatistics West China School of Public Health and West China Fourth Hospital, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00211-4"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.120899"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21575"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-018-0070-0"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2014.115"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.294.6578.997"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223134"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keac675"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2023-003205"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-024-01216-3"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2018.03.001"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2016.00097"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri.2016.124"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-021-08846-5"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.3163\/1536-5050.104.3.014"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_2_7_18_1","article-title":"The Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of non\u2010randomized studies in meta\u2010analysis","author":"Wells GA","year":"2000","journal-title":"ResearchGate"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.12"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2004.09.002"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.19.1690"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a112220"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3013"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4002"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-212145"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11273"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0000000000002281"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016839"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/oem.57.7.443"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208278"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar1824"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.114694"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.022053"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2021-107899"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23874"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2018-105361"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1289\/EHP129"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.538"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2003.007971"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.9203"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23226"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182312776"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1289\/EHP1013"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009749409099278"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2019-000978"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2019-001049"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2005.08.001"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2019-106018"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyaa287"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.36738"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.05.001"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.3109\/14397595.2013.854076"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0b013e3182529799"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-023233"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2025.103440"},{"issue":"3","key":"e_1_2_7_59_1","article-title":"Sambandet mellan kemiska exponeringar i arbetsmilj\u00f6n och risken att utveckla ledg\u00e5ngsreumatism","volume":"54","author":"Ilar A","year":"2020","journal-title":"Avdelningen f\u00f6r samh\u00e4llsmedicin och folkh\u00e4lsa, G\u00f6teborgs universitet"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1307413"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.0800503"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2016.06.008"},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000705"},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23313"},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39059"},{"key":"e_1_2_7_66_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.43113"},{"key":"e_1_2_7_67_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0226738"},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.1097\/EE9.0000000000000193"},{"key":"e_1_2_7_69_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1351.019"},{"key":"e_1_2_7_70_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar4498"},{"key":"e_1_2_7_71_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-212145"}],"container-title":["Arthritis &amp; Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.43446","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/art.43446","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.43446","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T07:16:45Z","timestamp":1775546205000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/art.43446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,2]]},"references-count":70,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/art.43446"],"URL":"https:\/\/doi.org\/10.1002\/art.43446","archive":["Portico"],"relation":{},"ISSN":["2326-5191","2326-5205"],"issn-type":[{"value":"2326-5191","type":"print"},{"value":"2326-5205","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,2]]},"assertion":[{"value":"2025-04-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}