Survey to evaluate exposure to environmental factors in patients with rheumatoid arthritis

This study develops and validates an instrument to investigate and identify environmental factors associated with rheumatoid arthritis (RA), in order to improve the understanding of potential triggers.

Using an exhaustive review of the literature and the involvement of a panel of rheumatology experts, a survey was designed based mainly on environmental exposures that covered various dimensions. The distribution of the evaluated categories was assessed to determine their sufficiency, coherence, relevance, and clarity by Kruskal-Wallis test, Kendall's W for concordance, and finally, it was subjected to content validation by experts and underwent pilot testing.

The survey consisted of 89 items total divided in 7 dimensions (sociodemographic aspects, consumables -cigarette-, other consumables, occupational or pollutants, previous diagnoses, other factors, and questions for potential cases). The assessment conducted by the experts showed a high concordance among them with values between 0.76 and 0.96. The pilot test demonstrated that the survey can be satisfactorily applied to Spanish-speaking people with different levels of education.

The created and validated instrument offers a solid tool adapted to the Latin American culture to investigate environmental factors associated with RA. Its development contributes to filling a gap in the scientific literature and highlights the importance of considering these factors in the understanding and intervention of the disease, both in patients with RA and individuals at potential risk of developing this disease.