Abstract
Background:Fine particulate matter (PM2.5) has been linked to induction of oxidative stress as well as pulmonary and systemic inflammation. We hypothesized that ambient PM2.5 variation would be associated with the occurrence of childhood-onset systemic lupus erythematosus (cSLE). Methods:We collected data from the Taiwan National health insurance research database and linked these data to the Taiwan Air Quality-Monitoring Database. Children <18 years old, identified from January 1, 2000 were followed up until the first diagnosis of cSLE was made or until December 31, 2012. The daily average PM2.5 was categorized into four quartile-based groups (Q1-Q4). We measured the incidence rate, hazard ratios (HRs), and 95% confidence intervals for cSLE stratified by the quartiles of PM2.5 concentration using Cox proportional hazards models adjusted for age, sex, monthly income, and urbanization. Results:A total of 394 children (0.16%) were newly diagnosed with cSLE during the observation period. The incidence rate for cSLE increased with PM2.5 levels, from 4.7 (Q1) to 21.9 (Q4) per 100,000 person-years. Compared with those exposed to the concentrations in the Q1 level, the adjusted HR from Q2 to Q4 for cSLE increased with PM2.5 exposure concentrations from 2.74 to 4.23. Conclusions:The present study provides evidence that long-term variations in PM2.5 levels are risk factors for the development of cSLE.
Associations Between Fine Particulate Matter (PM2.5) and Childhood-Onset Systemic Lupus Erythematosus
