Environ Health Perspect. 2009 Jul;117(7):1065-9. Epub 2009 Mar 4.
Exposure to traffic pollution and increased risk of rheumatoid arthritis. Hart JE, Laden F, Puett RC, Costenbader KH, Karlson EW. Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. BACKGROUND: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that affects approximately 1% of the adult population, and to date, genetic factors explain < 50% of the risk. Particulate air pollution, especially of traffic origin, has been linked to systemic inflammation in many studies. OBJECTIVES: We examined the association of distance to road, a marker of traffic pollution exposure, and incidence of RA in a prospective cohort study. METHODS: We studied 90,297 U.S. women in the Nurses' Health Study. We used a geographic information system to determine distance to road at the residence in 2000 as a measure of traffic exposure. Using Cox proportional hazard models, we examined the association of distance to road and incident RA (1976-2004) with adjustment for a large number of potential confounders. RESULTS: In models adjusted for age, calendar year, race, cigarette smoking, parity, lactation, menopausal status and hormone use, oral contraceptive use, body mass index, physical activity, and census-tract-level median income and house value, we observed an elevated risk of RA [hazard ratio (HR) = 1.31; 95% confidence interval (CI), 0.98-1.74] in women living within 50 m of a road, compared with those women living 200 m or farther away. We also observed this association in analyses among nonsmokers (HR = 1.62; 95% CI, 1.04-2.52), nonsmokers with rheumatoid factor (RF)-negative RA (HR = 1.77; 95% CI, 0.93-3.38), and nonsmokers with RF-positive RA (HR = 1.51; 95% CI, 0.82-2.77). We saw no elevations in risk in women living 50-200 m from the road. CONCLUSIONS: The observed association between exposure to traffic pollution and RA suggests that pollution from traffic in adulthood may be a newly identified environmental risk factor for RA.