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Observational Study
. 2022 Feb;8(1):e002055.
doi: 10.1136/rmdopen-2021-002055.

Association between long-term exposure to air pollution and immune-mediated diseases: a population-based cohort study

Giovanni Adami  1 , Marco Pontalti  2 , Giorgio Cattani  3 , Maurizio Rossini  2 , Ombretta Viapiana  2 , Giovanni Orsolini  2 , Camilla Benini  2 , Eugenia Bertoldo  2 , Elena Fracassi  2 , Davide Gatti  2 , Angelo Fassio  2
Affiliations
Observational Study

Association between long-term exposure to air pollution and immune-mediated diseases: a population-based cohort study

Giovanni Adami et al. RMD Open. 2022 Feb.

Abstract

Objective: Environmental air pollution has been associated with disruption of the immune system at a molecular level. The primary aim of the present study was to describe the association between long-term exposure to air pollution and risk of developing immune-mediated conditions.

Methods: We conducted a retrospective observational study on a nationwide dataset of women and men. Diagnoses of various immune-mediated diseases (IMIDs) were retrieved. Data on the monitoring of particulate matter (PM)10 and PM2.5 concentrations were retrieved from the Italian Institute of Environmental Protection and Research. Generalised linear models were employed to determine the relationship between autoimmune diseases prevalence and PM.

Results: 81 363 subjects were included in the study. We found a positive association between PM10 and the risk of autoimmune diseases (ρ+0.007, p 0.014). Every 10 µg/m3 increase in PM10 concentration was associated with an incremental 7% risk of having autoimmune disease. Exposure to PM10 above 30 µg/m3 and PM2.5 above 20 µg/m3 was associated with a 12% and 13% higher risk of autoimmune disease, respectively (adjusted OR (aOR) 1.12, 95% CI 1.05 to 1.20, and aOR 1.13, 95% CI 1.06 to 1.20). Exposure to PM10 was associated with an increased risk of rheumatoid arthritis; exposure to PM2.5 was associated with an increased risk of rheumatoid arthritis, connective tissue diseases (CTDs) and inflammatory bowel diseases (IBD).

Conclusion: Long-term exposure to air pollution was associated with higher risk of developing autoimmune diseases, in particular rheumatoid arthritis, CTDs and IBD. Chronic exposure to levels above the threshold for human protection was associated with a 10% higher risk of developing IMIDs.

Keywords: arthritis; autoimmune diseases; autoimmunity; health care; outcome assessment.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Prevalence of autoimmune diseases across Italy in the DeFRA database. (B) Long-term exposure to PM of less than 10 µm in Italy (2013–2019 average concentration in μg/m3). PM, particulate matter.
Figure 2
Figure 2
Risk of immune-mediated conditions at chronic exposure to PM10 ≥30 µg/m3. PM, particulate matter.
Figure 3
Figure 3
Risk of immune-mediated conditions at chronic exposure to PM2.5≥20 µg/m3. PM, particulate matter.
See this image and copyright information in PMC

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