Autoimmune Diseases and Your Environment

A healthy immune system defends the body against 

disease and infection. But if the immune system 

malfunctions, it mistakenly attacks healthy cells, tissues, 

and organs. Called autoimmune disease, these attacks can 

affect any part of the body, weakening bodily function 

and even turning life-threatening.

Scientists know about more than 100 autoimmune 

diseases. Some are well known, such as Type 1 diabetes, 

multiple sclerosis, lupus, and rheumatoid arthritis, while 

others are rare and difficult to diagnose. With unusual 

autoimmune diseases, patients may suffer years before 

getting a proper diagnosis. Most of these diseases have no 

cure. Some require lifelong treatment to ease symptoms.

Autoimmune diseases are on the rise 

Collectively, these diseases affect 5-9% of the 

population and create considerable personal and public 

health burdens. Race, ethnicity, and sex are genetic 

characteristics linked to the chance of developing an 

autoimmune disease. These diseases afflict women more 

than men, and are among the leading causes of death for 

young and middle-aged women.1

Autoimmune diseases appear to be increasing throughout 

the world, yet the reasons are unexplained.2

 The 

prevalence of antinuclear antibodies, the most common 

indicator of autoimmunity in human cells, increased 

substantially over a recent 25-year span in the U.S.3

Research increasingly suggests that autoimmune diseases 

likely result from the interactions of environmental 

and genetic risk factors. Autoimmune diseases seem 

more common when people are in contact with certain 

environmental exposures, as described below.

What is NIEHS Doing?

For decades, NIEHS has researched how the environment 

may affect development of autoimmune diseases. 

In 2010, the institute gathered an interdisciplinary panel of 

40 experts to evaluate the state of the science in this area. 

Among many conclusions, the panel stated: 

• Solvent exposure, from working with products such as 

paint thinners and cleaners, is linked to systemic sclerosis. 

• Crystalline silica exposure, from working with quartz or 

granite, for example, can contribute to the development 

of several autoimmune diseases.

• Smoking can contribute to the development of 

seropositive rheumatoid arthritis. 

Unraveling the genetic and environmental underpinnings 

of autoimmune disease remains a focus at NIEHS and the 

National Toxicology Program (NTP). Research progress 

leads to discoveries such as:

• Added risk from ultraviolet (UV) radiation –

Short-term ultraviolet radiation exposure, as from 

outdoor sunlight, may affect the onset of juvenile 

dermatomyositis, an illness with muscle weakness and 

skin rashes. The chance of illness increased as the UV 

index increased to its highest levels in the month before 

symptoms began.4

• Links to childhood poverty – Childhood in a household 

with lower socioeconomic status and education levels is 

linked to rheumatoid arthritis in adulthood.5

• Agricultural chemical association – Exposure to 

some pesticides may play a role in the development of 

rheumatoid arthritis in male farmers.6

The same study shows that in farm wives, an increased 

chance of developing rheumatoid arthritis was associated 

with other types of farm-related exposures, such as 

painting and using solvents. More research is needed on 

these and other potential risk and protective factors.7

• Genetic factors in autoimmune muscle disease –

Using DNA samples from myositis patients of European 

ancestry, NIEHS researchers identified primary genetic risk 

factors associated with this autoimmune muscle disease.8

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Phone: 919-541-3345 • www.niehs.nih.gov

April 2020

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• Insight into genetic link to rheumatoid arthritis –

NIEHS-funded researchers are closer to explaining why 

a genetic risk that increases the chance of developing 

rheumatoid arthritis is amplified by environmental 

pollutants like cigarette smoke.9

• Role of nutrition – Vitamin D may help prevent 

immune dysfunction in older populations.10 For lupus 

patients, NIEHS-funded researchers found that dietary 

micronutrients—choline, folate, and vitamin B12—

may improve symptoms, but more research is needed.11

NIEHS is conducting these clinical studies:

• Immunity Cells in Blood studies how immune cells in 

the bloodstream may, under certain circumstances, 

contribute to inflammation. 

• Adult and Juvenile Myositis investigates the causes, 

immune system changes, and medical problems 

associated with myositis, an inflammatory muscle 

disease that can damage muscles and other organs, 

resulting in significant disability.

• Myositis in Military Personnel compares people who 

developed myositis during active duty to military 

personnel without autoimmune diseases, to assess 

risk factors for myositis.

• Calcinosis Study examines the development 

of painful calcium deposits in people with 

dermatomyositis, a form of myositis associated with 

a skin rash, muscle weakness, and inflamed muscles.

• MYORISK Study seeks to understand the 

environmental factors that may result in 

dermatomyositis or polymyositis, a form of 

myositis that causes muscle weakness on both 

sides of the body.

• Rheumatic Disorders in Siblings identifies genetic 

and environmental factors by studying families 

with siblings or twins in which one of them has 

developed an autoimmune disease while the others 

have not. 

To volunteer for a study on the causes of, and 

possible treatments for, autoimmune diseases, 

visit www.clinicaltrials.gov.

For more information on the 

National Institute of Environmental Health Sciences, 

go to www.niehs.nih.gov.

National Institute of Environmental Health Sciences

1 Ramos PS, et al. 2015. Genetics of autoimmune diseases: insights from population genetics. J Hum Genet. 60(11): 657–664. 

2 Schiffenbauer A and FW Miller. Noninfectious environmental agents and autoimmunity [Book Chapter] The Autoimmune Diseases (2020) pp. 345-362. 

3 Dinse GE, et al. Increasing Prevalence of Antinuclear Antibodies in the United States. April 8, 2020. Arthr & Rheumatol. doi: 10.1002/art.41214

4 Shah M, et al. Childhood Myositis Heterogeneity Collaborative Study Group. 2013. Ultraviolet radiation exposure is associated with clinical and autoantibody 

phenotypes in juvenile myositis. Arthritis Rheum. 65(7): 1934–1941. 

5 Parks CG, et al. 2013. Childhood socioeconomic factors and perinatal characteristics influence development of rheumatoid arthritis in adulthood. 

Ann Rheum Dis. 72(3): 350–356. 

6 Meyer A, et al. 2017. Pesticide exposure and risk of rheumatoid arthritis among licensed male pesticide applicators in the Agricultural Health Study. 

Environ Health Perspect 125(7): 077010. 

7 Parks CG et al., 2016. Rheumatoid Arthritis in Agricultural Health Study Spouses: Associations with Pesticides and Other Farm Exposures. Environ Health Perspect. 

124 (11): 1728-1734. 

8 Miller FW, et al. 2015. Genome-wide association study identifies HLA 8.1 ancestral haplotype alleles as major genetic risk factors for myositis phenotypes. 

Genes Immun. 16(7):470–480. 

9 Fu J, et al. 2018. Shared epitope-aryl hydrocarbon receptor crosstalk underlies the mechanism of gene-environment interaction in autoimmune arthritis. 

PNAS 115(18):4755-4760. 

10 Meier HC, et al. 2016. Association between vitamin D deficiency and antinuclear antibodies in middle-aged and older U.S. adults. Cancer Epidemiol Biomarkers Prev 

25(12):1559-1563. 

11 Strickland FM, et al. 2013. Arthritis Rheum. 65(7):1872–1881. Diet influences expression of autoimmune associated genes and disease severity by epigenetic 

mechanisms in a transgenic lupus model.