AB0229 SHORT-TERM EXPOSURE TO OUTDOOR AIR POLLUTANTS AND RHEUMATOID ARTHRITIS ACTIVITY IN METROPOLITAN AREAS IN THE NORTH OF ITALY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1415.1-1415
Author(s):  
F. Ingegnoli ◽  
T. Ubiali ◽  
T. Schioppo ◽  
V. Longo ◽  
S. Iodice ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Air Pollution ◽  
Disease Activity ◽  
Air Pollutants ◽  
Positive Trend ◽  
Inverse Association ◽  
Short Term ◽  
Short Term Exposure ◽  
The Impact

Background:Air pollution is believed to cause oxidative stress and systemic inflammation, that could trigger autoimmunity in rheumatoid arthritis (RA). Several epidemiological studies investigated the possible role of air pollution in the outbreak of RA with controversial results. As far as we know, studies on the effects on disease activity of short-term exposure have not been published.Objectives:To evaluate the impact of short-term exposure to air pollutants (daily mean PM10, PM2.5, NO2and O3) on disease activity in patients with RA.Methods:Consecutive patients with RA (ACR/EULAR Criteria 2010) resident in Lombardy (Italy) were enrolled. In each patient Disease Activity Score on 28 joints (DAS28), Simple Disease Activity Index (SDAI) were assessed. Daily PM10, PM2.5, NO2and O3concentrations, estimated by Regional Environmental Protection Agency at municipality resolution, were used to assign short-term exposure from day of visit back to 14 days. Multivariable linear regression models were performed to identify the day of the pollutants independently associated with disease activity indices, adjusting for the variables significant at the univariate analysis. β coefficients were reported for 1 μg/m3increments of pollutants’ concentrations.Results:422 RA patients were enrolled in the study between January and June 2018: 81.5% females, mean age 58.2±13.3 years, mean disease duration 16.1±11.5 years, 27.3% current smokers, 59.5% RF positivity, 54.5% ACPA positivity. Sparse punctual statistically significant negative associations emerged at the multivariate analysis between PM10, PM2.5, NO2and the outcomes, although with very low estimates, whereas positive associations resulted for O3.Afterwards patients were stratified in 3 subgroups according to their ongoing treatment (no therapy, n=25, conventional synthetic Disease Modifying anti-Rheumatic Drugs -DMARDs-, n=108 and biological or targeted synthetic DMARDs, n=289). A statistical significance was found by analysing the influence of therapy on the interaction between PM2.5and DAS28 (Figure below): a positive trend between PM2.5and DAS28 appeared in the first two groups (no therapy, 0.013±0.007, p=0.06 and csDMARDs, 0.006±0.004, p=0.17), whereas a statistically significant inverse association was seen in the b/tsDMARDs group (-0.005±0.002, p=0.01). Therapy interaction was particularly evident in several days before the visit also for O3.Conclusion:The changes of the outcome measures related to the increase of the pollutants’ levels did not reach the minimal clinically important difference, therefore air pollution seems barely relevant on disease activity once the loss of tolerance is established in RA. O3and PM/NO2always exhibit an opposite performance having inversely proportional atmospheric concentrations, whereas the biological role of this substance is still matter of debate and will need further understanding. Therapy seems to be able to interact with the relation between air pollutants and the parameters considered.Disclosure of Interests:Francesca Ingegnoli: None declared, Tania Ubiali: None declared, Tommaso Schioppo: None declared, Valentina Longo: None declared, Simona Iodice: None declared, Ennio Giulio Favalli Consultant of: Consultant and/or speaker for BMS, Eli-Lilly, MSD, UCB, Pfizer, Sanofi-Genzyme, Novartis, and Abbvie, Speakers bureau: Consultant and/or speaker for BMS, Eli-Lilly, MSD, UCB, Pfizer, Sanofi-Genzyme, Novartis, and Abbvie, Orazio De Lucia: None declared, Antonella Murgo: None declared, Valentina Bollati: None declared, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB

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

2021 ◽  
Vol 18 (16) ◽  
pp. 8490
Author(s):  
Francesca Ingegnoli ◽  
Tania Ubiali ◽  
Tommaso Schioppo ◽  
Valentina Longo ◽  
Antonella Murgo ◽  
...  
Keyword(s):  
Air Pollution ◽  
Disease Activity ◽  
Cross Sectional Study ◽  
Short Term ◽  
Cross Sectional ◽  
Short Term Exposure ◽  
Air Pollution Exposure ◽  
Synthetic Dmards ◽  
Pollution Exposure ◽  
The Impact

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, PM2.5, nitrogen dioxide (NO2), and ozone (O3) 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, PM10, and NO2, whereas some positive associations were observed for O3. 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 (PM2.5 levels and DAS28 at the day of the visit-O3 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.

scholarly journals Short-Term Effect of Air Pollution on Tuberculosis Based on Kriged Data: A Time-Series Analysis

2020 ◽  
Vol 17 (5) ◽  
pp. 1522 ◽  
Author(s):  
Shuqiong Huang ◽  
Hao Xiang ◽  
Wenwen Yang ◽  
Zhongmin Zhu ◽  
Liqiao Tian ◽  
...  
Keyword(s):  
Air Pollution ◽  
Air Pollutants ◽  
Additive Model ◽  
Ground Level ◽  
Air Pollutant ◽  
Aerodynamic Diameter ◽  
Short Term ◽  
Short Term Exposure ◽  
Incident Cases ◽  
The Impact

Tuberculosis (TB) has a very high mortality rate worldwide. However, only a few studies have examined the associations between short-term exposure to air pollution and TB incidence. Our objectives were to estimate associations between short-term exposure to air pollutants and TB incidence in Wuhan city, China, during the 2015–2016 period. We applied a generalized additive model to access the short-term association of air pollution with TB. Daily exposure to each air pollutant in Wuhan was determined using ordinary kriging. The air pollutants included in the analysis were particulate matter (PM) with an aerodynamic diameter less than or equal to 2.5 micrometers (PM2.5), PM with an aerodynamic diameter less than or equal to 10 micrometers (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ground-level ozone (O3). Daily incident cases of TB were obtained from the Hubei Provincial Center for Disease Control and Prevention (Hubei CDC). Both single- and multiple-pollutant models were used to examine the associations between air pollution and TB. Seasonal variation was assessed by splitting the all-year data into warm (May–October) and cold (November–April) seasons. In the single-pollutant model, for a 10 μg/m3 increase in PM2.5, PM10, and O3 at lag 7, the associated TB risk increased by 17.03% (95% CI: 6.39, 28.74), 11.08% (95% CI: 6.39, 28.74), and 16.15% (95% CI: 1.88, 32.42), respectively. In the multi-pollutant model, the effect of PM2.5 on TB remained statistically significant, while the effects of other pollutants were attenuated. The seasonal analysis showed that there was not much difference regarding the impact of air pollution on TB between the warm season and the cold season. Our study reveals that the mechanism linking air pollution and TB is still complex. Further research is warranted to explore the interaction of air pollution and TB.

scholarly journals The Impact of Short-Term Exposure to Air Pollution on the Exhaled Breath of Healthy Adults

Sensors ◽  
2021 ◽  
Vol 21 (7) ◽  
pp. 2518
Author(s):  
Ariana Lammers ◽  
Anne H. Neerincx ◽  
Susanne J. H. Vijverberg ◽  
Cristina Longo ◽  
Nicole A. H. Janssen ◽  
...  
Keyword(s):  
Air Pollution ◽  
Ambient Air ◽  
Healthy Adults ◽  
Partial Least Square ◽  
Exhaled Breath ◽  
Short Term ◽  
Post Exposure ◽  
Short Term Exposure ◽  
Validation Set ◽  
The Impact

Environmental factors, such as air pollution, can affect the composition of exhaled breath, and should be well understood before biomarkers in exhaled breath can be used in clinical practice. Our objective was to investigate whether short-term exposures to air pollution can be detected in the exhaled breath profile of healthy adults. In this study, 20 healthy young adults were exposed 2–4 times to the ambient air near a major airport and two highways. Before and after each 5 h exposure, exhaled breath was analyzed using an electronic nose (eNose) consisting of seven different cross-reactive metal-oxide sensors. The discrimination between pre and post-exposure was investigated with multilevel partial least square discriminant analysis (PLSDA), followed by linear discriminant and receiver operating characteristic (ROC) analysis, for all data (71 visits), and for a training (51 visits) and validation set (20 visits). Using all eNose measurements and the training set, discrimination between pre and post-exposure resulted in an area under the ROC curve of 0.83 (95% CI = 0.76–0.89) and 0.84 (95% CI = 0.75–0.92), whereas it decreased to 0.66 (95% CI = 0.48–0.84) in the validation set. Short-term exposure to high levels of air pollution potentially influences the exhaled breath profiles of healthy adults, however, the effects may be minimal for regular daily exposures.

scholarly journals Artrite Reumatoide e a Poluição do Ar

UNICIÊNCIAS ◽  
2021 ◽  
Vol 24 (2) ◽  
pp. 195-200
Author(s):  
Dayane Dos Santos Souza Magalhães ◽  
Leticia Rosa Espírito Santo de Freitas ◽  
Maria Amélia Dos Santos Peres Santos Souza ◽  
Vander Fernandes ◽  
Walkiria Shimoya-Bittencourt ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Air Pollution ◽  
Disease Activity ◽  
Air Pollutants ◽  
Activity Index ◽  
Age Groups ◽  
Unknown Etiology ◽  
World Population ◽  
Artrite Reumatoide ◽  
The Relationship

A artrite reumatoide é uma doença inflamatória, crônica, autoimune, sistêmica e progressiva com etiologia ainda desconhecida, que causa danos progressivos ao sistema musculoesquelético. Esta doença atinge aproximadamente 0,5% a 1% da população mundial, predomina no sexo feminino e acomete todas as faixas etárias com maior prevalência entre 40-60 anos. A atividade da doença é avaliada pelo Índice de Atividade da Doença (DAS28) analisando 28 articulações. Estudos demonstram que a poluição atmosférica está associada aos agravos à saúde humana e à perda de qualidade de vida. Este estudo teve como objetivo relatar o papel da poluição atmosférica na artrite reumatoide, através de uma revisão narrativa de literatura, a partir das bases de dados PubMed e Scielo. Incluíram-se artigos nos idiomas inglês e português publicados em periódicos, nacionais e internacionais, acerca da temática da pesquisa. A relação entre o desenvolvimento da AR e diferentes poluentes atmosféricos foi analisada em diversos estudos, que demostraram associação entre diferentes poluentes atmosféricos e o desenvolvimento da doença, no entanto, nenhum estudo publicado até a data atual, avaliou a relação com a exacerbação da atividade da doença.   Palavras-chave: Artrite Reumatoide. Poluição do Ar. Doenças Autoimunes.   Abstract Rheumatoid arthritis is an inflammatory, chronic, autoimmune, systemic and progressive disease with a still unknown etiology that causes progressive damage to the musculoskeletal system. This disease affects approximately 0.5% to 1% of the world population, predominates in females and affects all age groups with a higher prevalence between 40-60 years. The disease activity is assessed by the Disease Activity Index (DAS28) analyzing 28 joints. Studies show that air pollution is associated with damage to human health and loss of quality of life. This study aimed to report the role of air pollution in rheumatoid arthritis, through a literature narrative review, using the PubMed and Scielo databases. Articles in English and Portuguese published in national and international journals about the research theme were included. The relationship between the RA development and different air pollutants has been analyzed in several studies, which showed an association between different air pollutants and the development of the disease, however, no study published to date has evaluated the relationship with the disease activity exacerbation.   Keywords: Rheumatoid Arthritis. Air Pollution. Autoimmune Diseases.    

scholarly journals Short-term effects of air pollution on blood pressure

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
You-Jung Choi ◽  
Sun-Hwa Kim ◽  
Si-Hyuck Kang ◽  
Sun-Young Kim ◽  
Ok-Jin Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Air Pollution ◽  
Air Pollutants ◽  
Ambient Air ◽  
Ambient Air Pollution ◽  
Pathophysiological Mechanism ◽  
Short Term ◽  
Mortality And Morbidity ◽  
Short Term Exposure ◽  
Increased Risk

AbstractElevated blood pressure (BP) has been proposed as a possible pathophysiological mechanism linking exposure to ambient air pollution and the increased risk of cardiovascular mortality and morbidity. In this study, we investigated the hourly relationship between ambient air pollutants and BP. BP measurements were extracted from the electronic health record database of the Seoul National University Bundang Hospital from February 2015 to June 2017. A total of 98,577 individual BP measurements were matched to the hourly levels of air pollutants. A generalized additive model was constructed for hour lags of 0–8 of air pollutants adjusting for age, sex, meteorological variables, and time trend. Systolic BP was shown to be significantly lower at 2–4 hours and 3–5 hours after increased levels of SO2 and CO, respectively (0.24 mmHg and 0.26 mmHg for an interquartile range, respectively). In contrast, O3 and NO2 were associated with significantly increased systolic BP at 3–5 lag hours and at 0–2 lag hours, respectively. BP elevation in association with O3 and NO2 was shown to be significantly greater in hypertensive patients than normotensive subjects. Our findings suggest that short-term exposure to air pollution may be associated with elevated BP.

Rheumatoid arthritis—management

2013 ◽  
Author(s):  
Chris Deighton
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Occupational Therapists ◽  
Established Disease ◽  
Minimal Disease ◽  
Specialist Nurses ◽  
The Impact ◽  
Informed Patient

Influential guidelines on rheumatoid arthritis (RA) management agree on most key recommendations. Early diagnosis of persistent synovitis, and identification of poor prognostic markers, is essential. Rapid intervention is vital with drugs to suppress inflammation, slow down damaging disease components, and prevent disability. The label of RA covers a broad spectrum of disease severity, and there is controversy on: • whether the same interventions are needed for all patients • whether monotherapy or combination treatment is appropriate • the role of steroids in RA • the appropriate introduction of biological therapies. Treating to specified targets is optimal evidence-based practice, where patients are reviewed regularly for disease activity assessments, and inadequate control rectified. Aiming for remission is the ultimate goal, though for some patients minimal disease activity may be appropriate. Patient education addressing self-management is important, and the multidisciplinary team (MDT: specialist nurses, physiotherapists, occupational therapists, podiatrists, psychologists) needs to be involved from the start to minimize the impact on quality of life of the patient. For established disease, rapid access is important for flares, and to consider whether disease management could be improved. An intermittent overview of established disease is important with access to the MDT, and assessments for comorbidities such as ischaemic heart disease, osteoporosis, and depression, as well as complications of the disease itself such as cervical spine disease, vasculitis, and lung and eye complications. An informed patient needs to be central to all decision making.

P–736 Elevated levels of ambient air pollutants increase the primary sex ratio in human embryos

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Maluf ◽  
M Malu. Perin ◽  
P O Malu. Perin ◽  
P Perin
Keyword(s):  
Air Pollution ◽  
Sex Ratio ◽  
Air Pollutants ◽  
Ambient Air ◽  
Outdoor Air ◽  
Exposure Risk ◽  
Short Term ◽  
Primary Sex Ratio ◽  
Short Term Exposure

Abstract Study question Are there any associations between ambient outdoor air pollution and the primary sex ratio (PSR)? Summary answer Short-term exposure to increased PM10, PM2.5 and NO2 levels were significantly associated with higher PSR. What is known already PSR estimates represent a backward extrapolation from data based on spontaneous or induced abortions, fetal deaths or live births and are usually male-biased. A recent study, analyzing 3- to 6-day-old embryos derived from assisted reproductive technology (ART) procedures, showed that the sex ratio at conception is unbiased (0.5). Epidemiologic studies of air pollution on secondary (birth) sex ratio showed that higher levels of particulate pollution were associated with increased rates of female birth. However, a direct association between urban levels of air pollutants and PSR has not been reported. Study design, size, duration A retrospective cohort study was carried out to assess the impact of long- or short-term exposure to six ambient outdoor air pollutants (particulate matter, PM10µm and PM2.5µm; SO2; CO; NO2; O3) on PSR (XY/XX) of couples undergoing their first IVF cycle for preimplantation genetic screening (N = 337). Data was from fixed air quality monitoring stations across the city between January 2014 and December 2018. Embryos with sex chromosome abnormalities were excluded from the analysis. Participants/materials, setting, methods Average concentrations of the pollutants for the 90 (long-term exposure) and 15 days (short-term exposure) predating oocyte retrieval represented the exposures of interest. Pollutant levels were categorized into quartiles (Q1 to Q4) and exposure risk was divided into two periods in which average concentrations and confidence intervals for the pollutants were in the upper quartile (Q4 period) or not (Q1-Q3 period). The strength association between exposure risk and PSR was performed through analysis of covariance. Main results and the role of chance The estimated means of PM10, PM2.5, SO2, NO2, O3 and CO for Q1-Q3/Q4 periods were 27.7/39.3, 16.7/23.7, 2.5/3.9, 37.0/46.4, 32.2/45.3 µg/m3 and 0.64/0.87 ppm and 26.3/43.0, 16.0/26.3, 2.4/4.2, 36.5/47.8, 31.7/50.4 µg/m3 and 0.62/0.90 ppm for long- and short-term exposures, respectively. PM10, PM2.5 and NO2 levels in the Q4 period had significantly higher PSR (138.1, 134.0 and 137.6) when compared to Q1-Q3 period (94.4, 98.1 and 96.4) for the short-term exposure (p = 0.0193; p = 0.0439; p = 0.0180, respectively). PM10, PM2.5, SO2, NO2 and CO levels in the Q4 and Q1-Q3 periods for the long-term exposure showed no significant effect on PSR. Contrastingly, O3 levels in the Q4 period had significantly lower PSR (82.6) when compared to Q1-Q3 (115.9) for the long-term exposure (p = 0.0202). A monotonic increase in PSR was observed with increased PM10 concentration in the Q4 period for the short-term exposure (F-ratio: 4.4476; p = 0.0352). Limitations, reasons for caution Some limitations of the study should be underlined, such as its retrospective nature, exposure assessment based on pollutant levels derived from a network average across city sites, and limited extrapolation of the results to the general population. Wider implications of the findings: Our data suggest that short-term exposure to environmental factors could affect the primary sex ratio in polluted seasons or cities. A monotonic effect on PSR in the case of exposure to increasing PM10 levels was identified. Trial registration number Not applicable

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