US EPA

1520713 

Journal Article 

Ambient air pollution exposures and risk of rheumatoid arthritis in the Nurses' Health Study 

Hart, JE; Källberg, H; Laden, F; Costenbader, KH; Yanosky, JD; Klareskog, L; Alfredsson, L; Karlson, EW 

2013 

Yes 

Arthritis Care and Research
ISSN: 0893-7524 

65 

7 

1190-1196 

English 

23401426 

10.1002/acr.21975 

WOS:000321184000021 

OBJECTIVE: Environmental factors may play a role in the development of rheumatoid arthritis (RA), and we have previously observed increased RA risk among women living closer to major roads (a source of air pollution). We examined whether long-term exposures to specific air pollutants were associated with RA risk among women in the Nurses' Health Study. METHODS: The Nurses' Health Study (NHS) is a large cohort of U.S. female nurses followed prospectively every two years since 1976. We studied 111,425 NHS participants with information on air pollution exposures as well as data concerning other lifestyle and behavioral exposures and disease outcomes. Outdoor levels of different size fractions of particulate matter (PM(10) and PM(2.5) ) and gaseous pollutants (SO(2) and NO(2) ) were predicted for all available residential addresses using monitoring data from the USEPA. We examined the association of time-varying exposures, 6 and 10 years before each questionnaire cycle, and cumulative average exposure with the risks of RA, seronegative (rheumatoid factor [RF] and anti-citrullinated peptide antibodies [ACPA]) RA, and seropositive RA. RESULTS: Over the 3,019,424 years of follow-up, 858 incident RA cases were validated by medical record review by two board-certified rheumatologists. Overall, we found no evidence of increased risks of RA, seronegative or seropositive RA, with exposure to the different pollutants, and little evidence of effect modification by socioeconomic status or smoking status, geographic region, or calendar period. CONCLUSION: In this group of socioeconomically-advantaged middle-aged and elderly women, adult exposures to air pollution were not associated with an increased RA risk. © 2013 by the American College of Rheumatology.