Association of particulate matter with autoimmune rheumatic diseases among adults in South Korea

• Published in: Rheumatology (Oxford, England) Vol. 60; no. 11; pp. 5117 - 5126
• Main Authors: Park, Jun Seok, Choi, Seulggie, Kim, Kyuwoong, Chang, Jooyoung, Kim, Sung Min, Kim, Seong Rae, Lee, Gyeongsil, Son, Joung Sik, Kim, Kyae Hyung, Lee, Eun Young, Park, Sang Min
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 03.11.2021
• Subjects: Adult; Aged; Autoimmune Diseases - epidemiology; Autoimmune Diseases - etiology; Clinical Science; Female; Humans; Incidence; Male; Middle Aged; Particulate Matter - adverse effects; Republic of Korea - epidemiology; Retrospective Studies; Rheumatic Diseases - epidemiology; Rheumatic Diseases - etiology; Young Adult; Republic of Korea; epidemiology; particulate matter; systemic lupus erythematosus; rheumatoid arthritis; ankylosing spondylitis
• ISSN: 1462-0324; 1462-0332; 1462-0332
• DOI: 10.1093/rheumatology/keab127

The primary objective of this study was to investigate adverse effects of ambient particulate matter of various sizes on the incidence of the prevalent autoimmune rheumatic diseases (AIRDs): RA, AS and SLE. We investigated 230 034 participants in three metropolitan cities of South Korea from the National Health Insurance Service-National Sample Cohort (NHIS-NSC). Starting from January 2010, subjects were followed up until the first event of prevalent AIRDs, death, or December 2013. The 2008-2009 respective averages of particulate matter2.5 (<2.5 μm) and particulate mattercoarse (2.5 μm to 10 μm) were linked with participants' administrative district codes. Adjusted hazard ratios (aHRs) and 95% CIs were estimated using Cox regression analysis in one- and two-pollutant models. Adjusted for age, sex, region, and household income, in the two-pollutant model, RA incidence was positively associated with the 10 μg/m³ increment of particulate matter2.5 (aHR = 1.74, 95% CI: 1.06, 2.86), but not with particulate mattercoarse (aHR = 1.27, 95% CI: 0.87, 1.85). In the one-pollutant model, the elevated incidence rate of RA was slightly attenuated (particulate matter2.5 aHR = 1.61, 95% CI: 0.99, 2.61; particulate mattercoarse aHR = 1.13, 95% CI: 0.80, 1.61), with marginal statistical significance for particulate matter2.5. The RA incidence was also higher in the 4th quartile group of particulate matter2.5 compared with the first quartile group (aHR = 1.83, 95% CI: 1.07, 3.11). Adverse effects from particulate matter were not found for AS or SLE in either the one- or two-pollutant models. The important components of particulate matter10 associated with RA incidence were the fine fractions (particulate matter2.5); no positive association was found between particulate matter and AS or SLE.