Layout 1


ISDS Annual Conference Proceedings 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and
reproduction in any medium, provided the original work is properly cited.

ISDS 2012 Conference Abstracts

Risk and Protective Factors for Arthritis Status and
Severity
Masaru Teramoto*1, Fred Breukelman2, Ferdinando A. Gatto2 and Sheniz Moonie3

1Health Sciences, Drexel University, Philadelphia, PA, USA; 2Delaware Health and Social Services, Dover, DE, USA; 3University of
Nevada, Las Vegas, Las Vegas, NV, USA

Objective
To examine how cigarette smoking, alcohol consumption, obesity,

and physical activity are associated with the risk and severity of
arthritis among adults living in Delaware.

Introduction
Research has indicated several risk and protective factors for

arthritis, including cigarette smoking, alcohol consumption, obesity,
and physical activity (1–4). However, it is not well understood how
all these factors interact to increase/decrease the risk of arthritis.

Methods
Data from the 2009 Delaware Behavioral Risk Factor Surveillance

System (BRFSS) were analyzed in the current study. Potential risk
and protective factors for arthritis status and severity examined in this
study included: smoking status, alcohol consumption, weight status,
and physical activity level. Weighted percentages were calculated for
the risk and protective factors by arthritis status and activity limita-
tion due to arthritis/joint symptoms, and were analyzed using a Rao-
Scott !2 test. A logistic regression analysis was performed to
determine an odds ratio (OR) while adjusting for gender, age,
race/ethnicity, and education.

Results
Adults living in Delaware self-reporting arthritis were more likely

to be former and current smokers than those without self-reported
arthritis (p < 0.001, OR = 1.64–1.70). Moderate and heavy alcohol
drinking was associated with lower prevalence and severity of arthri-
tis (p < 0.001, OR = 0.45–0.74). There was a significant relationship
between obesity and arthritis status or activity limitation due to arthri-
tis/joint symptoms (p < 0.01, OR = 1.62–2.14). Furthermore, people
with arthritis having activity limitation due to arthritis/joint symp-
toms were more likely to not meet the current physical activity rec-
ommendations (5) (p = 0.013, OR = 1.49).

Conclusions
Cigarette smoking, alcohol consumption, obesity, and physical ac-

tivity are all associated with the prevalence and severity of arthritis.
It is possible that smoking and obesity have a negative impact on the
risk and severity of arthritis, whereas alcohol consumption and phys-
ical activity may reduce its risk and severity. Further research, in-
cluding prospective cohort studies, is necessary to determine the true
absolute risk of developing arthritis, so that we can design the effec-
tive prevention strategies.

Table 1. Risk and protective factors by arthritis status and severity

Notes: Values given as % (SE).
aNot overweight/obese: < 25.0 kg/m2, Overweight: 25.0–29.9 kg/m2, Obese:
" 30 kg/m2.
bModerate physical activity for " 30 minutes/day on " 5 days/week, or vig-
orous physical activity for " 20 minutes/day on " 3 days/week (5).
*Rao-Scott !2 test.

Keywords
alcohol; smoking; arthritis; Behavioral Risk Factor Surveillance

References

1. Albano SA, Santana-Sahagun E, Weisman MH. Cigarette smoking and
rheumatoid arthritis. Semin Arthritis Rheum 2001; 31:146–159.

2. Maxwell JR, Gowers IR, Moore DJ, et al. Alcohol consumption is in-
versely associated with risk and severity of rheumatoid arthritis.
Rheumatology 2010; 49:2140–2146.

3. Anandacoomarasamy A, Caterson I, Sambrook P, et al. The impact of
obesity on the musculoskeletal system. Int J Obes 2008; 32:211–222.

4. Manninen P, Riihimaki H, Heliovaara M, et al. Physical exercise and
risk of severe knee osteoarthritis requiring arthroplasty. Rheumatology
2001; 40:432–437.

5. Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health:
updated recommendation for adults from the American College of
Sports Medicine and the American Heart Association. Circulation
2007; 116:1081–1093.

*Masaru Teramoto
E-mail: Masaru.Teramoto@drexel.edu

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e179, 2013