According to the research, women who sprayed insecticides at least six times a year had double the risk of developing autoimmune disease compared to women who didn’t use insecticides.

In addition, the study led by Christine G. Parks, PhD, an epidemiologist with the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina, found almost the same risk of autoimmune disease among women from environments with long-term insecticide spraying by commercial companies.

“We also saw that long-term application of insecticides by others in the home or in the lawn or garden about doubled disease risk,” she said.

The researchers studied the records of 76,861 postmenopausal and mostly white women between the ages of 50-79 who were enrolled in the Women’s Health Initiative Observational Study. Parks and associates focused on questions relating to farm history and insecticide use.

Of the women whose records were examined, 178 were eventually diagnosed with rheumatoid arthritis and 28 with lupus. There were seven other women who were diagnosed with both lupus and rheumatoid arthritis.

Parks said investigators found that a history of just working or living on a farm — although relatively frequent among the women in the survey — did not appear to increase risk of rheumatoid arthritis or lupus.
But compared to people who had never used insecticides, women who had personally mixed or applied insecticides regularly had double the risk of a rheumatic disease.

“About 46% of the rheumatoid arthritis cases occurred among women who mixed or applied insecticides themselves,” Parks said.
Parks cited studies showing that up to 75% of U.S. households use insecticides in the home or garden, with 20% of householders reporting that they had applied insecticide in the month before being surveyed. She also noted that insecticides don’t break down readily in the home environment.

“Our results also provide support for the idea that environmental factors may increase susceptibility or trigger the development of autoimmune diseases in some individuals,” said Parks. “We need to start thinking about what chemicals or other factors related to insecticide use could explain these findings.”

The researchers did indicate that there were some limitations to the study because the questions asked about insecticides did not address specific products.

“It is important to note that these are still relatively uncommon diseases affecting only a small percentage of adults, but I believe it provides proof of principle that these environmental exposures may be risk factors that need to be studied more thoroughly,” she said.

“Although our findings are not proof of a causal relationship with products currently on the market and available for household use,” Parks said, “I think the take-home message is that people should always follow recommended practices to reduce their individual exposures.”

The research was presented at the American College of Rheumatology’s annual meeting.

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Lupus is an autoimmune disease that affects connective tissues. Lupus most often harms the skin, heart, joints, lungs, liver, kidneys, blood vessels and nervous system. The course of the disease is unpredictable, with periods of illness, called flares, alternating with remissions.

The study, led by researcher Samy Suissa, PhD, a professor of epidemiology, evaluated more than 1.7 million women who are in the U.K. General Practice Research Database of more than 6 million people. The women who were evaluated were prescribed combined oral contraceptives which included both estrogen and progestin.

The average length of time the women were followed in the study was 8 years. Researchers found that 768 of the women had received a first-time diagnosis of lupus.

They found that use of oral contraceptives was related to an increased risk of developing the disease. “I think we have clear evidence that these pills, especially at higher doses, can increase the risk of lupus,” Dr. Suissa says.

“Women who take oral contraceptives have a 50% higher risk of having lupus than women who don’t take them,” – Samy Suissa, PhD.

But researchers do not believe that the contraceptive on its own increases the risk, he says. “We think it probably interacts with some genetic predisposition.”

However, Dr. Suissa says the risk is still small.

Dr. Suissa’s team determined that the risk is higher in women who take higher dosage pills with 50 micrograms of estrogen or more compared to those who took 30 micrograms or less.

Women who took the highest dose pills had a 190% increased risk of developing lupus, while those who took the lowest had a 40% increased risk.

They also found that the risk increased by 150% in new users during the initial three months.

The results of the study were published in the April 15 issue of Arthritis & Rheumatism.

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#3: Projections of Increases in Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation

It is estimated that 46 million adults in the U.S are afflicted with rheumatoid arthritis or other rheumatic conditions (e.g. gout, lupus, fybromyalgia). It is further estimated that nearly 67 million adults will have doctor-diagnosed arthritis by the year 2030. This includes 25 million that are expected to have limitations in their activity as a result of the arthritis.

In 2007 the U.S. Centers for Disease Control and Prevention developed state-by-state projected increases based on state arthritis prevalence estimates. This analysis indicates an average projected increase in doctor-diagnosed arthritis of 34% from 2005 to 2030. In addition, 10 states are projected to have increases between 50% and 99% while 3 states are projected to have increases of over 100%.

Florida, with an estimated increase of 3.7 million people, is projected to have the largest increase in the absolute number of people with doctor-diagnosed arthritis. Likewise, Florida is predicted to have an increase of 1.3 million people with arthritis-attributable activity limitation. Primarily because of an expected population decline, the District of Columbia is projected to have the only decrease in the country in the numbers of adults with doctor-diagnosed arthritis and arthritis-attributable activity limitations.

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#4: Identification of RA Susceptibility Genes STAT4 and TRAF1-C5

Genetic researchers have been able to perform evaluations of variations in DNA. One of the areas of research that has advanced is the study of single nucleotide polymorphisms, or SNP (pronounced “snip”). These advances have allowed evaluations to be performed in a fraction of the time it used to take.

As a result of this researchers have exploded their ability to link genetic variants with disease susceptibility. Relationships between a variant and a disease used to take years to identify, but now can be accomplished in just days.

In 2007, Dr. Peter K Gregersen of the Feinstein Institute for Medical Research in Manhasset, N.Y., along with a substantial international tem, announced that they discovered 2 genes that are linked to an increased risk for development of rheumatoid arthritis (RA). This brings to 5 the total number of genes with links to RA.

These 2 genes, important in both RA and lupus, are known as STAT4 and TRAF1-C5. Having 2 copies of STAT4 was associated with a doubling of the risk for lupus and a 60% increase in risk for rheumatoid arthritis. TRAF1-C5 are actually 2 genes that are very close to each other on chromosome 9 but it is not yet know which of these genes is linked to the increased risk. However, it is know that having a variant at this location on chromosome 9 was linked to a 35% increase in risk for RA.

Read more in our post on Another Genetic Link to Rheumatoid Arthritis

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