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Insecticide use and risk of rheumatoid arthritis and systemic lupus erythematosus in the Women's Health Initiative Observational Study
Journal article   Open access   Peer reviewed

Insecticide use and risk of rheumatoid arthritis and systemic lupus erythematosus in the Women's Health Initiative Observational Study

Christine G Parks, Brian T Walitt, Mary Pettinger, Jiu-Chiuan Chen, Anneclaire J de Roos, Julie Hunt, Gloria Sarto and Barbara V Howard
Arthritis care & research (2010), v 63(2), pp 184-194
Feb 2011
PMID: 20740609
url
https://www.onlinelibrary.wiley.com/doi/pdfdirect/10.1002/acr.20335View
Published, Version of Record (VoR) Open

Abstract

Aged Arthritis, Rheumatoid - chemically induced Environmental Exposure Female Humans Insecticides - adverse effects Lupus Erythematosus, Systemic - chemically induced Middle Aged Postmenopause Risk Factors Women's Health
Farming and agricultural pesticide use has been associated with 2 autoimmune rheumatic diseases, rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). However, risk associated with other residential or work place insecticide use is unknown. We analyzed data from the Women's Health Initiative Observational Study (n=76,861 postmenopausal women, ages 50-79 years). Incident cases (n=213: 178 for RA, 27 for SLE, and 8 for both) were identified based on self-report and use of disease-modifying antirheumatic drugs at year 3 of followup. We examined self-reported residential or work place insecticide use (personally mixing/applying by self and application by others) in relation to RA/SLE risk, overall and in relation to farm history. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were adjusted for age, race, region, education, occupation, smoking, reproductive factors, asthma, other autoimmune diseases, and comorbidities. Compared with never used, personal use of insecticides was associated with increased RA/SLE risk, with significant trends for greater frequency (HR 2.04, 95% CI 1.17-3.56 for ≥6 times/year) and duration (HR 1.97, 95% CI 1.20-3.23 for ≥20 years). Risk was also associated with long-term insecticide application by others (HR 1.85, 95% CI 1.07-3.20 for ≥20 years) and frequent application by others among women with a farm history (HR 2.73, 95% CI 1.10-6.78 for ≥6 times/year). These results suggest residential and work place insecticide exposure is associated with the risk of autoimmune rheumatic diseases in postmenopausal women. Although these findings require replication in other populations, they support a role for environmental pesticide exposure in the development of autoimmune rheumatic diseases.

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Collaboration types
Domestic collaboration
Web of Science research areas
Rheumatology
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