Rheumatoid arthritis (RA) is closely associated with environmental factors. Volatile organic compounds (VOCs) are a common environment pollutant which can induce autoimmune diseases. However, studies on the relationship between VOCs and RA are still unclear. This study aimed to evaluate the potential associations between exposure to urinary VOCs and RA risk among adults. Data was analyzed from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. We used logistics regression, restricted cubic splines (RCS) model, (Weighted Quantile Sum) WQS, qgcomp and (Bayesian Kernel Machine Regression) BKMR models to assess single and mixed relationships between VOCs and RA. A total of 3390 participants and 15 urinary VOCs included in this study. The results showed that AMCC, CEMC, DHBC, MB3C, PHGA, and PMMC were significantly higher than in RA compare to the participants without RA. Logistic regression model reveals that AAMC, AMCC, CEMC, CYMC, DHBC, HPMC, and MB3C were positive correlation with RA which age between 20 and 50. Then the WQS, qgcomp, and BKMR model suggest a positive association between mixed urinary VOCs and RA, with WQS and qgcomp model highlighting CYMC and CEMC as the major contributors in age 20-59 group. In BKMR analysis, the overall effects of co-exposure displayed CYMC, CEMC, and AMCC has significant positive with RA in age 20-59. Furthermore, RCS regression proved the positive linear relationship between CYMC, AMCC, and CEMC with RA. According to our study results, we demonstrated that exposure to certain urinary VOCs (CYMC, CEMC, and AMCC) is associated with an increased prevalence of RA among adults that age 20-59.
