title: Ambient air pollution exposures and risk of rheumatoid arthritis.
abstract: OBJECTIVE
  Environmental factors may play a role in the development of rheumatoid arthritis (RA). We previously observed increased RA risk among women living closer to major roads (a source of air pollution). Herein, we examined whether long-term exposures to specific air pollutants were associated with RA risk among women in the Nurses' Health Study (NHS).
  
  
  METHODS
  The NHS is a large US cohort of female nurses followed up prospectively every 2 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 (PM10 and PM2.5 ) and gaseous pollutants (SO2 and NO2 ) were predicted for all available residential addresses using monitoring data from the US Environmental Protection Agency. We examined the association of time-varying exposures 6 and 10 years before each questionnaire cycle and cumulative average exposure with the risk of RA, seronegative (rheumatoid factor and anti-citrullinated peptide antibody negative) RA, and seropositive RA.
  
  
  RESULTS
  Over the 3,019,424 person-years of followup, 858 incident RA cases were validated by medical record review by 2 board-certified rheumatologists. Overall, we found no evidence of increased risk of RA, seronegative RA, 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.
  
  
  CONCLUSIONS
  In this group of socioeconomically advantaged middle-aged and elderly women, adult exposures to air pollution were not associated with an increased RA risk.
authors: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Jaime.hart@channing.harvard.edu
authors: Jaime E
authors: JE
authors: Hart
authors: Henrik
authors: H
authors: Källberg
authors: Francine
authors: F
authors: Laden
authors: Karen H
authors: KH
authors: Costenbader
authors: Jeff D
authors: JD
authors: Yanosky
authors: Lars
authors: L
authors: Klareskog
authors: Lars
authors: L
authors: Alfredsson
authors: Elizabeth W
authors: EW
authors: Karlson
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D004781:Environmental Exposure / Q000009:adverse effects*; D004784:Environmental Monitoring; D005260:Female; D005740:Gases; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008875:Middle Aged; D010316:Particle Size; D052638:Particulate Matter / Q000009:adverse effects*; D010456:Peptides, Cyclic / Q000276:immunology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000393:Air Pollutants; D001323:Autoantibodies; D005740:Gases; D052638:Particulate Matter; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide
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