Environmental Epidemiology and Risk Factors for Autoimmune Disease

M. A. Dooley, MD, MPH, S. L. Hogan, PhD, MPH


Curr Opin Rheumatol. 2003;15(2) 

In This Article

Case-Controlled Population Based Studies

In the past year, results from two large, well designed, population-based case-control studies have contributed substantial insights into risk factors for developing RA[16*] and SLE.[18*,19*,20*,21*] The case-control study design offers a unique opportunity to simultaneously evaluate a number of potential causal factors.[22] These studies include genetic typing and a detailed description of environmental exposures. The details of these case control studies are summarized in Table 1. The RA study describes a positive association with smoking as well as with a short fertile period in women and inverse relationships with length of breast-feeding, history of atopic allergies, psychosocial stress, and level of education,[16*] consistent with previous studies.[23] This study also suggests increased risk for RA with the use of private well water, a history of self-reported thyroid conditions, and use of insulin. These factors have received little prior attention but may provide new insights and should be explored more fully.

The Carolina Lupus Study (CLU), a population-based case-control study based in the southeastern United States explored a number of risk factors for the development of SLE.[18*,19*,20*,21*] Risk factors evaluated in this study included smoking, use of hair treatments, infectious exposures, hormonal and reproductive factors, and occupational exposure to crystalline silica. Each of these exposures is reviewed in more detail below.


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