Exposure to Industrial Air Pollutants Linked to Rheumatoid Arthritis Biomarker

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Exposure to industrial emissions of fine particles matter and sulfur dioxide are associated with the presence of anti-citrullinated protein antibodies (ACPA), a characteristic biomarker for rheumatoid arthritis, according to a study presented at the annual meeting of the American College of Rheumatology in Atlanta on November 12.

There have been few studies of associations between industrial air emissions and rheumatic disease, or diseases-related serological biomarkers. Moreover, previous studies typically analyzed individual rather than mixed emissions. In this study, researchers investigated associations between individual and combined exposures to industrial sulfur dioxide, nitrogen dioxide, and fine particles matter on anti-citrullinated protein antibodies.

In an interview with Rheumatology Network, Sasha Bernatsky, M.D., senior scientist at the Research Institute of the McGill University Health Centre in Montreal, Canada, said “this research could really benefit patients – in the short term, by empowering them with the knowledge that there are possible environmental triggers of disease that they can possibly avoid. In the long-term, if all of us, especially regulators, continue to focus on air quality, it will mean better health for all.”

Researchers determined serum ACPA for 7,600 randomly selected CARTaGENE general population subjects in Quebec, Canada. Industrial sulfur dioxide, nitrogen dioxide and fine particles matter concentrations were assigned based on residential postal codes at the time of sera collection. ACPA positivity was defined by 20 units/ml, 40 units/ml, and 60 units/ml thresholds, which were present in 786, 292 and 134 participants, respectively, after adjusting for age, sex, French Canadian origin, smoking, and family income. Researchers also investigated associations between regional overall fine particles matter exposure and ACPA positivity, and the associations between the combined three industrial exposures and the ACPA positivity.

Significant associations between individual and combined industrial exposures and ACPA positivity (defined by the 20 units/ml and 40 units/ml thresholds) were evident for industrial emissions of fine particles matter and sulfur dioxide, without clear associations for nitrogen dioxide. The results showed that industrial fine particles matter may have a stronger effect than the other exposures.

“With the increasing evidence of the adverse health effects of air pollution, physicians should be prepared for questions from patients regarding what they may be able to do to limit harm.

“As general advice, since concentrations of air pollutants decline steeply according to distance from roadways, individuals can reduce exposure to air pollutants by avoiding regular physical activity within 500 meters of high-traffic roadways (especially during rush hours) or industrial emitters of air pollution.

“We know some but not all of the triggers of autoimmune rheumatic disease. Future research should continue to explore potential environmental risk factors, including how these environmental exposures relate to genetic and epigenetic profiles of patients who develop these conditions,” Dr. Bernatsky said.

REFERENCE

“LO2 - Multiple Industrial Air Pollutants and Anti-Citrullinated Protein Antibody Positivity.” Sasha Bernatsky, M.D., 9 a.m., Tuesday, Nov. 12. 2019 ACR/ARP Annual Meeting, Atlanta