What is Rheumatoid Arthritis?
Rheumatoid arthritis (RA), which affects about 1.3 million people in the U.S., is an inflammatory disease of the joints. It arises when the immune system goes awry and attacks the membrane that lines the joints. Symptoms include stiffness, swelling, pain or discomfort, and loss of joint function, among others. RA affects people in different ways. For example, it is chronic in many people, but for some sufferers, symptoms come and go. In addition, some people have severely debilitating symptoms (these people may not be able to walk without assistance or grip an object well), while others are only mildly affected.
What are the Risk Factors for RA?
The exact cause (or causes) of RA remains unknown. However, it is believed that, in particular, genetics (family history), hormones, and certain environmental factors all play a role in contributing to RA. Here is a rundown of the specific risk factors thought to be associated with the manifestation of RA in an individual and with the exacerbation of symptoms in an individual who already has RA:
- Family History. Unlike most genetics diseases, it is not believed that RA is a heritable disease. Instead, scientists believe that people can inherit one or more genetic factors that make them more susceptible to developing RA than those who do not inherit those factors. For this reason, people having family members who suffer from RA are more likely of being afflicted with this disease than are those whose family is free of RA.
- Age. Although RA can strike at any age, it is most likely to arise in middle age and older individuals (age 40 to about age 60).
- Sex. Women are two to three times more likely to suffer from RA than are men.
- Smoking. Smokers are more likely to develop RA than are those who do not smoke. Further, smoking can aggravate symptoms in a person who already has RA.
- Second Hand Smoke. There is evidence that frequent exposure to second hand smoke can cause RA or exacerbate its symptoms.
- Diet. It is thought that diets rich in caffeine, low in antioxidants and/or high in red meat can contribute to the development or exacerbation of RA.
- Hormones. Alteration to the hormonal make-up of females, such as which occurs during pregnancy, breastfeeding and oral contraceptive use, is thought to contribute to RA.
- Ethnicity. Caucasians and Native Americans are more at risk of being inflicted with RA than are any other ethnic group.
- Weight. Overweight individuals are at increased risk for RA.
- Occupational Hazards. In particular, it is believed repeated exposure to silica dust, which is a component of sandstone and rock, can lead to RA in an individual. Those who are often exposed to silica dust include excavators, those who perform tunneling work, road construction workers, and those who work in the slate and glass manufacturing industries.
The above list may not represent all of the causes of rheumatoid arthritis as others are likely to exist. Further, while certain RA risk factors are unavoidable, it is clear that individuals can take some steps to help avoid developing arthritis, or aggravating its symptoms. These would include avoiding smoking or second hand smoke, maintaining a healthy weight, choosing to forgo "the pill" for other contraceptives, and avoiding environments having high amounts of silica dust (or at least wearing proper face protection if those environments are unavoidable).
If you suspect that you may have RA, please consult your family doctor. He or she can help diagnose and advise you regarding your symptoms and can help create a health plan for treating them. This article is only meant to provide basic information regarding RA, it is not meant to take the place of your doctor’s advice.
What are the Risk Factors for RA?
J.E. Oliver and A.J. Silman, Risk factors for the development of rheumatoid arthritis, Scandanavian Journal of Rheumatology 35:169-174 (2006).
Mayo Clinic, Rheumatoid Arthritis (https://www.mayoclinic.com/health/rheumatoid-arthritis/DS00020)
National Institutes of Health, Handout on Health: Rheumatoid Arthritis (https://www.niams.nih.gov/Health_Info/Rheumatic_Disease/default.asp)
R. Carter-DeWitt, M.D., Risk Factors for Rheumatoid Arthritis, Aurora Health Care (https://www.aurorahealthcare.org/yourhealth/healthgate/getcontent.asp?URLhealthgate=%2220085.html%22)