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There is increasing interest in attempting to understand what the risk factors are that lead to the development of rheumatoid arthritis (RA). Twin studies have proved a genetic role but also quantified the non-genetic risk. There is thus scope for identifying environmental predictors that might offer a strategy to prevent the disease. Changes in the female hormonal environment such as in pregnancy, breastfeeding and the use of the oral contraceptive (OC) pill appear to have a role. Of the traditional lifestyle exposures, cigarette smoking has been associated with a consistently increased risk that might also apply to the passive inhalation of smoke. Occupation probably has a minor influence, although exposure to silica dust is of aetiological importance. Recent studies have highlighted a role for diet, with suggestions that diets high in caffeine, low in antioxidants and high in red meat may contribute to an increased risk. The most plausible environmental exposure is infection and although several decades of study have produced few definitive candidate organisms, Epstein-Barr virus (EBV) remains an interesting target.

Original publication

DOI

10.1080/03009740600718080

Type

Journal article

Journal

Scandinavian journal of rheumatology

Publication Date

05/2006

Volume

35

Pages

169 - 174

Addresses

arc Epidemiology Unit, Manchester University, School of Epidemiology and Health Sciences, Manchester, UK.

Keywords

Humans, Infection, Arthritis, Rheumatoid, Contraceptives, Oral, Hormonal, Risk Factors, Health Behavior, Life Style, Environmental Exposure