{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T19:13:48Z","timestamp":1791054828158,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["U54 GM115458"],"award-info":[{"award-number":["U54 GM115458"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["R01ES019325"],"award-info":[{"award-number":["R01ES019325"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the association of inhalant exposures with rheumatoid arthritis (RA)\u2013related autoantibodies and severity in US veterans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants in the Veterans Affairs Rheumatoid Arthritis (VARA) registry were mailed surveys assessing occupational, agricultural, and military inhalant exposures. Demographic characteristics, disease activity, functional status, and extraarticular features were obtained from the VARA registry, while HLA\u2013DRB1 shared epitope (SE) status, anti\u2013cyclic citrullinated peptide (anti\u2010CCP) antibodies, and rheumatoid factor (RF) were measured using banked DNA\/serum from enrollment. Associations between inhalant exposures and RA\u2010related factors (autoantibodies, severity, and extraarticular features) were assessed using multivariable linear and logistic regression models adjusted for age, sex, race, and tobacco use and stratified by SE status. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Questionnaires were returned by 797 of 1,566 participants (50.9%). Survey respondents were older, more often White or male, and less frequently smokers, and had lower disease activity compared to nonrespondents. Anti\u2010CCP positivity was more common among veterans exposed to burn pits (OR 1.66 [95% CI 1.02, 2.69]) and military waste disposal (OR 1.74 [95% CI 1.04, 2.93]) independent of other factors. Among participants who were positive for SE alleles, burn pit exposure (OR 5.69 [95% CI 2.73, 11.87]) and military waste disposal exposure (OR 5.05 [95% CI 2.42, 10.54]) were numerically more strongly associated with anti\u2010CCP positivity. Several inhalant exposures were associated with the presence of chronic lung disease, but not with the presence of RF or the level of disease activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Military burn pit exposure and military waste disposal exposure were independently associated with the presence of anti\u2010CCP antibodies in RA patients. These findings are consistent with emerging evidence that various inhalant exposures influence autoantibody expression and RA risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.41559","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T11:24:01Z","timestamp":1602761041000},"page":"392-400","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Association of Agricultural, Occupational, and Military Inhalants With Autoantibodies and Disease Features in US Veterans With Rheumatoid Arthritis"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2134-8690","authenticated-orcid":false,"given":"Ariadne V.","family":"Ebel","sequence":"first","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Lutt","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center, Omaha, and University of Nebraska at Lincoln  Lincoln"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill A.","family":"Poole","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey M.","family":"Thiele","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0799-7563","authenticated-orcid":false,"given":"Joshua F.","family":"Baker","sequence":"additional","affiliation":[{"name":"Philadelphia VA Medical Center and University of Pennsylvania  Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6640-9173","authenticated-orcid":false,"given":"Grant W.","family":"Cannon","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System and University of Utah  Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Gaffo","sequence":"additional","affiliation":[{"name":"Birmingham VA Medical Center and University of Alabama at Birmingham  Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail S.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Washington, DC VA Medical Center Georgetown University, and Howard University  Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Reimold","sequence":"additional","affiliation":[{"name":"Dallas VA Medical Center and University of Texas Southwestern  Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascale","family":"Schwab","sequence":"additional","affiliation":[{"name":"VA Portland Healthcare System and Oregon Health and Science University  Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namrata","family":"Singh","sequence":"additional","affiliation":[{"name":"University of Washington  Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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