Long-term exposure to fine particulate matter and ozone and the onset of systemic autoimmune rheumatic diseases: an open cohort study in Quebec, Canada

Objectives To estimate associations between fine particulate matter (PM.sub.2.5) and ozone and the onset of systemic autoimmune rheumatic diseases (SARDs). Methods An open cohort of over 6 million adults was constructed from provincial physician billing and hospitalization records between 2000 and 2...

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Published in:Arthritis research & therapy 2022-06, Vol.24 (1), p.1-151, Article 151
Main Authors: Zhao, Naizhuo, Smargiassi, Audrey, Jean, Sonia, Gamache, Philippe, Laouan-Sidi, Elhadji-Anassour, Chen, Hong, Goldberg, Mark S, Bernatsky, Sasha
Format: Article
Language:English
Subjects:
Age
Air pollution
Arthritis
Autoimmune diseases
Chronic illnesses
Cohort analysis
Connective tissue
Environmental aspects
Fine particulate matter
Health aspects
Hospitalization
Outdoor air quality
Ozone
Particles
Pollutants
Population
Rheumatic diseases
Risk factors
Rural areas
Socioeconomic factors
Statistics
Systemic autoimmune rheumatic diseases
Variables
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Summary:Objectives To estimate associations between fine particulate matter (PM.sub.2.5) and ozone and the onset of systemic autoimmune rheumatic diseases (SARDs). Methods An open cohort of over 6 million adults was constructed from provincial physician billing and hospitalization records between 2000 and 2013. We defined incident SARD cases (SLE, Sjogren's syndrome, scleroderma, polymyositis, dermatomyositis, polyarteritis nodosa and related conditions, polymyalgia rheumatic, other necrotizing vasculopathies, and undifferentiated connective tissue disease) based on at least two relevant billing diagnostic codes (within 2 years, with at least 1 billing from a rheumatologist), or at least one relevant hospitalization diagnostic code. Estimated PM.sub.2.5 and ozone concentrations (derived from remote sensing and/or chemical transport models) were assigned to subjects based on residential postal codes, updated throughout follow-up. Cox proportional hazards models with annual exposure levels were used to calculate hazard ratios (HRs) for SARDs incidence, adjusting for sex, age, urban-versus-rural residence, and socioeconomic status. Results The adjusted HR for SARDS related to one interquartile range increase in PM.sub.2.5 (3.97 [micro]g/m.sup.3) was 1.12 (95% confidence interval 1.08-1.15), but there was no clear association with ozone. Indirectly controlling for smoking did not alter the findings. Conclusions We found associations between SARDs incidence and PM.sub.2.5, but no relationships with ozone. Additional studies are needed to better understand interplays between the many constituents of air pollution and rheumatic diseases. Keywords: Systemic autoimmune rheumatic diseases, Air pollution, Fine particulate matter, Ozone
ISSN:1478-6362
1478-6354
1478-6362
DOI:10.1186/s13075-022-02843-5