Occupational connective tissue disorders

Connective tissue disorders involving occupational factors are, first of all, systemic sclerosis (SSc), probably also lupus erythematosus (LE) and very rarely dermatomyositis, mixed connective tissue disease (MCTD), rheumatoid arthritis (RA) and Sjogren s syndrome (Zschunke et al. 1990 Koeger et al. 1991). 

Connective tissue disorders such as SSc, LE, Sjogren s syndrome, dermatomyositis and RA can be induced by occupational exposure to silica, solvents, and other chemical offenders. An enhanced genetic susceptibility seems to favor these disorders. SSc is the most frequent and best-studied disease. While silica precipitates SSc, the other offenders induce scleroderma-like diseases with different clinical and laboratory findings than with SSc. Taking a careful case history of patients with SSc will help to identify the occupational causes. The best way to prevent this type of connective tissue disease is to minimize the exposure to occupational substances. However, efforts in the form of individual expert decisions have to be made in order to acknowledge these disorders as occupational diseases and provide some social and financial support to patients and reduce the harm caused by these disorders. 

Zschunke E, Ziegler V, Haustein UF (1990) Occupationally induced connective tissue disorders. In Adams RM (ed) Occupational skin disease. Saunders, Philadelphia... 

Therapists also deal with the rehabilitation of musculoskeletal disorders that are caused by an autoimmune response. Many of these diseases attack connective tissues, and autoimmune diseases such as rheumatoid arthritis, dermatomyositis, and systemic lupus erythematosus are often the primary reason that patients undergo rehabilitation. Patients with a compromised immune system may develop musculoskeletal problems related to their immunodeficient state. Hence, immunomodulating drugs are frequently used in many patients receiving physical therapy and occupational therapy. 

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