Environmental connection with Sjogren's?

Greetings,
I have been experiencing symptoms of Sjogren's Syndrome from shortly after our office relocated.  Dry skin, rash, horrible mouth burning and soreness, thrush, insatiable thirst, bleeding sinuses and such.  About half of my co-workers have reported similar problems since we moved last year, particularly with mouth problems.  One of these co-workers was just diagnosed with Sjogren's and I am concerned that I have it, too.  Being a male with no hx of RA makes this a longshot, but my symptoms are significant.  I have an appointment with an RA doc to be evaluated.  

I am convinced that these symptoms are being caused by my workplace environment, an old factory which is built at the ocean's edge and currently has manufacturing companies as tenants.   There is water in the basement and there are hazardous chemicals and resins down the hall from my office. Moreover, my symptoms (with some delay) worsen and at least partially resolve based on whether I'm at work or not and whether the heat or air conditioning is running on high or not.  This pattern is also true for my co-workers.  Accordingly, I predicted the recent exacerbation of symptoms I am currently experiencing since the heat has been turned back on.  It's hard to believe that this is all coincidental, but I cannot find a direct link between environmental irritants and Sjogren's Syndrome or its symptoms.  Is there any validation of this relationship?  

Any help you can offer would be genuinely appreciated.  

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Hello,

What was the outcome of your appointment with the rheumatology specialist?

What type of work do you do? What hobbies do you have?

Do you have any medical problems besides the symptoms that you mention in your posting?

And, have you noticed that anything improves or worsens your symptoms?

A could place to start is: http://www.niams.nih.gov/Health_Info/Sjogrens_Syndrome/sjogrens_syndrome_ff.asp

Other resources are below.

To my knowledge, there is not definitive scientific evidence that demonstrates an association of chemicals with Sjögren's syndrome. Because Sjögren's is a syndrome, there may be symptoms such as dry skin that you describe above that are quite common to numerous other illnesses. These non-specific symptoms can be discussed with a health care provider in the context of your other medical problems, medications, supplements, home environment, work environment, hobbies, etc.

In terms of the work environment, your concerns can be addressed by approaching the facilities management personnel, your employee/occupational health point of contact or your HR representative if you have concerns about chemical vapors, humidity, ventilation, etc.


References:
Curr Opin Rheumatol. Published in final edited form as:
Curr Opin Rheumatol. 2009 September; 21(5): 465–470.
doi: 10.1097/BOR.0b013e32832eba21. PMCID: PMC2766246
NIHMSID: NIHMS151765
Pathogenesis of Sjögren's syndrome
Nikolay P. Nikolov and Gabor G. Illei

From the above manuscript: "Sjögren's syndrome is considered an autoimmune disease characterized by chronic inflammation involving the exocrine glands. A widely accepted model of the pathogenesis of Sjögren's syndrome is that in genetically predisposed individuals (reviewed by Harley in this issue), various environmental factors such as viral infections lead to epithelial cell activation and a protracted inflammatory response with features of systemic autoimmunity."

Another review from 2010 states:"The female predominance of Sjögren's syndrome (with more than nine women for one man) might be related to hormonal factors. A role for oestrogen deprivation is strongly suspected, as the disease often starts after the menopause. "...."The hypothesis of a viral trigger has long been suspected in pSS, as in many other autoimmune diseases. Different studies reported that Epstein–Barr virus (EBV) genome and proteins were detected in salivary glands of patients with Sjögren's syndrome more frequently than in controls"

**To my knowledge, there has not been a study that had made a cause and affect connection with EBV and Sjögren's.**

Pathogenesis of Sjögren's syndrome and therapeutic consequences
Mariette, Xaviera; Gottenberg, Jacques-Ericb
Current Opinion in Rheumatology
Issue: Volume 22(5), September 2010, p 471–477


~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.