Rheumatoid arthritis (RA) has an intricate etiology that includes environmental factors as well as genetics. Organophosphate esters (OPEs) are frequently used as chemical additives in many personal care products and household items. However, there has been limited research on their potential effects on rheumatoid arthritis (RA). The specific associations between OPEs and RA remain largely unexplored. This study investigates any potential associations between adult rheumatoid arthritis risk and exposure to OPEs. We investigated data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 among participants over 20 years old. In two models, multivariable logistic regression was utilized to investigate the relationship between exposure to OPEs and RA. Furthermore, subgroup analyses stratified by age, gender, and dose exposure response were evaluated. Generalized additive models and smooth curve fits were used to characterize the nonlinear relationship between RA and OPEs. In conclusion, 5490 individuals (RA: 319, Non-RA: 5171) were analyzed. Higher quantiles (Q4) of DPHP and DBUP showed a higher prevalence of RA than the lowest quantiles. Our findings show that adult RA prevalence is higher in those who have been exposed to OPEs (DPHP, DBUP). Interestingly, these correlations seem to be stronger among women, the elderly, those with higher BMIs, and those who have diabetes. The dose-response curve for DPHP and DBUP demonstrated an upward-sloping trend. In contrast, BCEP and BCPP showed a U-shaped relationship and an inverted U-shaped relationship with the probability of RA.BDCPP demonstrated a complex relationship with a peak at lower concentrations followed by a decrease. Finally, our study also concludes that exposure to OPEs plays a crucial role in the pathogenesis of RA.

Highlights

Urinary metabolites of OPEs (DPHP, DBUP) are associated with the increased prevalence of RA.

BDCPP appears to have a protective effect, reducing the risk of RA.

Associations are more prominent in females, participants over 60 years, and those with higher BMI.

Exposure to OPEs plays a critical role in the pathogenesis of rheumatoid arthritis (RA).

The authors have declared no competing interest.

This study did not receive any funding

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The study used observational survey data ONLY (3 survey cycles of NHANES) openly available human data that were originally located at:https://wwwn.cdc.gov/nchs/nhanes/Default.aspx

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