More MS news articles for July 2001

Death Rate From Autoimmune Disease High Among Teachers

WESTPORT, CT (Reuters Health) Jul 23 - School teachers are at increased risk of death from autoimmune diseases compared with other professionals, according to an analysis of data from the National Occupational Mortality Surveillance system in the US. Investigators suggest that exposure to Epstein-Barr virus early in teachers' careers may account for the discrepancy.

Dr. Stephen J. Walsh and Laurie M. DeChello of the University of Connecticut Health Center in Farmington found that of 860,648 individuals who died between 1985 and 1995 and had been engaged in a professional occupation, 143,553 were school teachers.

Among teachers, 2.3% of deaths were due to one of 13 autoimmune diseases, compared with 1.7% of deaths among those in other professional occupations. The culprits were primarily multiple sclerosis, rheumatoid arthritis, Sjögren's syndrome and systemic lupus erythematosus, the researchers report in the Journal of Rheumatology for July. Multiple sclerosis was the worst offender.

Secondary school teachers ages 35 to 44 were at highest risk, with proportional mortality ratios of 243 in comparison with other professionals (p < 0.0001) and 155 in comparison with elementary school teachers (p = 0.03).

On the other hand, mortality was not increased among teachers ages 25 to 34, and excess total mortality declined steadily after age 45. The 15- to 20-year interval between the start of teaching and the peak of excess mortality "coincides with the typical patterns of pathogenesis and clinical course for autoimmune diseases like multiple sclerosis and systemic lupus erythematosus," the investigators note.

Walsh and DeChello theorize that the amplified mortality rate due to autoimmune disease is due to an occupational risk factor early in teachers' careers, and that the most likely such factor is an infectious agent.

They point out that recent research implicates Epstein-Barr virus in the pathogenesis of multiple sclerosis and the rheumatic diseases. In addition, acute Epstein-Barr infection is one of the few infectious diseases prevalent in secondary school students.

J Rheumatol 2001;28:1537-1545.

Copyright © 2001 Reuters Ltd