Potential Short-Term Air Pollution Effects on Rheumatoid Arthritis Activity in Metropolitan Areas in the North of Italy: A Cross-Sectional Study

Francesca Ingegnoli, Tania Ubiali, Tommaso Schioppo, Valentina Longo, Antonella Murgo, Orazio De Lucia, Ennio Giulio Favalli, Simona Iodice, Valentina Bollati and Roberto Caporali
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Francesca Ingegnoli: Division of Clinical Rheumatology, ASST Pini-CTO, 20122 Milano, Italy
Tania Ubiali: Division of Clinical Rheumatology, ASST Pini-CTO, 20122 Milano, Italy
Tommaso Schioppo: Division of Clinical Rheumatology, ASST Pini-CTO, 20122 Milano, Italy
Valentina Longo: Division of Clinical Rheumatology, ASST Pini-CTO, 20122 Milano, Italy
Antonella Murgo: Division of Clinical Rheumatology, ASST Pini-CTO, 20122 Milano, Italy
Orazio De Lucia: Division of Clinical Rheumatology, ASST Pini-CTO, 20122 Milano, Italy
Ennio Giulio Favalli: Division of Clinical Rheumatology, ASST Pini-CTO, 20122 Milano, Italy
Simona Iodice: EPIGET–Epidemiology, Epigenetics and Toxicology Lab, Department of Clinical Sciences & Community Health, Università degli Studi di Milano, 20122 Milano, Italy
Valentina Bollati: Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Research Center for Environmental Health, Università degli Studi di Milano, 20122 Milano, Italy
Roberto Caporali: Division of Clinical Rheumatology, ASST Pini-CTO, 20122 Milano, Italy

IJERPH, 2021, vol. 18, issue 16, 1-14

Abstract: Rheumatoid arthritis (RA) flare is related to increased joint damage, disability, and healthcare use. The impact of short-term air pollution exposure on RA disease activity is still a matter of debate. In this cross-sectional study, we investigated whether short-term exposure to particulate matter (PM) 10 , PM 2.5 , nitrogen dioxide (NO 2 ), and ozone (O 3 ) affected RA disease activity (DAS28 and SDAI) in 422 consecutive RA residents in Lombardy, North of Italy. Air pollutant concentrations, estimated by Regional Environmental Protection Agency (Lombardy—Italy) at the municipality level, were used to assign short-term exposure from the day of enrolment, back to seven days. Some significant negative associations emerged between RA disease activity, PM 10 , and NO 2 , whereas some positive associations were observed for O 3 . Patients were also stratified according to their ongoing Disease-Modifying anti-Rheumatic Drugs (DMARDs) treatment: no DMARDs ( n = 25), conventional synthetic DMARDs ( n = 108), and biological or targeted synthetic DMARDs ( n = 289). Therapy interaction seemed partially able to influence the relationship between short-term air pollution exposure and RA disease activity (PM 2.5 levels and DAS28 at the day of the visit-O 3 levels and disease activity scores for the seven days before the evaluation). According to our results, the impact of short-term air pollution exposure (seven days) minimally impacts disease activity. Moreover, our study suggests therapy could alter the response to environmental factors. Further evidence is needed to elucidate determinants of RA flare and its management.

Keywords: rheumatoid arthritis; air pollution; particulate matter; disease activity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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