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BACKGROUND: Farming has been associated with rheumatoid arthritis (RA), but the role of pesticides is not known.

OBJECTIVES: We examined associations between RA and pesticides or other agricultural exposures among female spouses of licensed pesticide applicators in the Agricultural Health Study.

METHODS: Women were enrolled between 1993 and 1997 and followed through 2010. Cases (n=275 total, 132 incident), confirmed by a physician or by self-reported use of disease modifying antirheumatic drugs, were compared with noncases (n=24,018). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models adjusted for age, state, and smoking pack-years.

RESULTS: Overall, women with RA were somewhat more likely to have reported lifetime use of any specific pesticide versus no pesticides (OR=1.4; 95% CI: 1.0, 1.6). Of the 15 pesticides examined, maneb/mancozeb (OR=3.3; 95% CI: 1.5, 7.1) and glyphosate (OR=1.4; 95% CI: 1.0, 2.1) were associated with incident RA compared with no pesticide use. An elevated, but non-statistically significant association with incident RA was seen for DDT (OR=1.9; 95% CI: 0.97, 3.6). Incident RA was also associated with the application of chemical fertilizers (OR=1.7; 95% CI: 1.1, 2.7) and cleaning with solvents (OR=1.6; 95% CI: 1.1, 2.4), but inversely associated with lifetime livestock exposure as a child and adult (OR=0.48; 95% CI: 0.24, 0.97) compared with no livestock exposure.

CONCLUSIONS: Our results suggest that specific agricultural pesticides, solvents, and chemical fertilizers may increase the risk of RA in women, while exposures involving animal contact may be protective.