Influence of ambient air pollution on rheumatoid arthritis disease activity score Index

Ahmad Alsaber, Jiazhu Pan, Adeeba Al-Herz, Dhary S. Alkandary, Adeeba Al-Hurban, Parul Setiya, KRRD Group

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Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune of an unknown etiology. Air pollution has been proposed as one of the possible risk factors associated with disease activity, although has not been extensively studied. In this study we measure the relationship between exposure to air pollutants and RA activity. Data on RA patients were extracted from the Kuwait Registry for Rheumatic Diseases (KRRD). Disease activity was measured using disease activity score with 28 examined joints (DAS-28) and the Clinical Disease Activity Index (CDAI) during their hospital visits from 2013 to 2017. Air pollution was assessed using air pollution components (PM10, NO2, SO2, O3, and CO). Air pollution data were obtained from Kuwait Environmental Public Authority (K-EPA) from six different air quality-monitoring stations during the same period. Multiple imputations by the chained equations (MICE) algorithm, were applied to estimate missing air pollution data. Patients data were linked with air pollution data according to date and patient governorate address. Descriptive statistics, correlation analysis, and linear regression techniques were employed using STATA software. A total of 1,651 RA patients with 9,875 follow-up visits were studied. We detected an increased risk of RA using DAS-28 in participants exposed to SO2 and NO2 with b = 0.003 (95% CI: 0.0004–0.005, p < 0.01) and b = 0.003 (95% CI: 0.002–0.005, p < 0.01), respectively, but not to PM10, O3, and CO concentrations. Conclusively, we observed a strong association between air pollution with RA disease activity. This study suggests air pollution as a risk factor for RA and recommends further measures to be taken by the authorities to control this health problem.
Original languageEnglish
Article number416
Number of pages17
JournalInternational Journal of Environmental Research and Public Health
Volume17
Issue number2
DOIs
Publication statusPublished - 8 Jan 2020

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Rheumatoid Arthritis
Air Pollution
amsonic acid
Kuwait
Carbon Monoxide
Risk Factors
Air Pollutants
Multiple Imputation
Air Quality
Influence
Correlation Analysis
Pollutants
Rheumatic Diseases
Linear regression
Registries
Linear Models
Health
Software
Joints
Air

Keywords

  • air pollution
  • rheumatoid arthritis
  • DAS-28
  • CDAI
  • RA registry
  • KRRD
  • Kuwait
  • Middle East
  • AQI

Cite this

Alsaber, Ahmad ; Pan, Jiazhu ; Al-Herz, Adeeba ; Alkandary, Dhary S. ; Al-Hurban, Adeeba ; Setiya, Parul ; Group, KRRD . / Influence of ambient air pollution on rheumatoid arthritis disease activity score Index. In: International Journal of Environmental Research and Public Health. 2020 ; Vol. 17, No. 2.
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abstract = "Rheumatoid arthritis (RA) is a chronic autoimmune of an unknown etiology. Air pollution has been proposed as one of the possible risk factors associated with disease activity, although has not been extensively studied. In this study we measure the relationship between exposure to air pollutants and RA activity. Data on RA patients were extracted from the Kuwait Registry for Rheumatic Diseases (KRRD). Disease activity was measured using disease activity score with 28 examined joints (DAS-28) and the Clinical Disease Activity Index (CDAI) during their hospital visits from 2013 to 2017. Air pollution was assessed using air pollution components (PM10, NO2, SO2, O3, and CO). Air pollution data were obtained from Kuwait Environmental Public Authority (K-EPA) from six different air quality-monitoring stations during the same period. Multiple imputations by the chained equations (MICE) algorithm, were applied to estimate missing air pollution data. Patients data were linked with air pollution data according to date and patient governorate address. Descriptive statistics, correlation analysis, and linear regression techniques were employed using STATA software. A total of 1,651 RA patients with 9,875 follow-up visits were studied. We detected an increased risk of RA using DAS-28 in participants exposed to SO2 and NO2 with b = 0.003 (95{\%} CI: 0.0004–0.005, p < 0.01) and b = 0.003 (95{\%} CI: 0.002–0.005, p < 0.01), respectively, but not to PM10, O3, and CO concentrations. Conclusively, we observed a strong association between air pollution with RA disease activity. This study suggests air pollution as a risk factor for RA and recommends further measures to be taken by the authorities to control this health problem.",
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Influence of ambient air pollution on rheumatoid arthritis disease activity score Index. / Alsaber, Ahmad; Pan, Jiazhu; Al-Herz, Adeeba ; Alkandary, Dhary S. ; Al-Hurban, Adeeba ; Setiya, Parul ; Group, KRRD .

In: International Journal of Environmental Research and Public Health, Vol. 17, No. 2, 416, 08.01.2020.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Influence of ambient air pollution on rheumatoid arthritis disease activity score Index

AU - Alsaber, Ahmad

AU - Pan, Jiazhu

AU - Al-Herz, Adeeba

AU - Alkandary, Dhary S.

AU - Al-Hurban, Adeeba

AU - Setiya, Parul

AU - Group, KRRD

PY - 2020/1/8

Y1 - 2020/1/8

N2 - Rheumatoid arthritis (RA) is a chronic autoimmune of an unknown etiology. Air pollution has been proposed as one of the possible risk factors associated with disease activity, although has not been extensively studied. In this study we measure the relationship between exposure to air pollutants and RA activity. Data on RA patients were extracted from the Kuwait Registry for Rheumatic Diseases (KRRD). Disease activity was measured using disease activity score with 28 examined joints (DAS-28) and the Clinical Disease Activity Index (CDAI) during their hospital visits from 2013 to 2017. Air pollution was assessed using air pollution components (PM10, NO2, SO2, O3, and CO). Air pollution data were obtained from Kuwait Environmental Public Authority (K-EPA) from six different air quality-monitoring stations during the same period. Multiple imputations by the chained equations (MICE) algorithm, were applied to estimate missing air pollution data. Patients data were linked with air pollution data according to date and patient governorate address. Descriptive statistics, correlation analysis, and linear regression techniques were employed using STATA software. A total of 1,651 RA patients with 9,875 follow-up visits were studied. We detected an increased risk of RA using DAS-28 in participants exposed to SO2 and NO2 with b = 0.003 (95% CI: 0.0004–0.005, p < 0.01) and b = 0.003 (95% CI: 0.002–0.005, p < 0.01), respectively, but not to PM10, O3, and CO concentrations. Conclusively, we observed a strong association between air pollution with RA disease activity. This study suggests air pollution as a risk factor for RA and recommends further measures to be taken by the authorities to control this health problem.

AB - Rheumatoid arthritis (RA) is a chronic autoimmune of an unknown etiology. Air pollution has been proposed as one of the possible risk factors associated with disease activity, although has not been extensively studied. In this study we measure the relationship between exposure to air pollutants and RA activity. Data on RA patients were extracted from the Kuwait Registry for Rheumatic Diseases (KRRD). Disease activity was measured using disease activity score with 28 examined joints (DAS-28) and the Clinical Disease Activity Index (CDAI) during their hospital visits from 2013 to 2017. Air pollution was assessed using air pollution components (PM10, NO2, SO2, O3, and CO). Air pollution data were obtained from Kuwait Environmental Public Authority (K-EPA) from six different air quality-monitoring stations during the same period. Multiple imputations by the chained equations (MICE) algorithm, were applied to estimate missing air pollution data. Patients data were linked with air pollution data according to date and patient governorate address. Descriptive statistics, correlation analysis, and linear regression techniques were employed using STATA software. A total of 1,651 RA patients with 9,875 follow-up visits were studied. We detected an increased risk of RA using DAS-28 in participants exposed to SO2 and NO2 with b = 0.003 (95% CI: 0.0004–0.005, p < 0.01) and b = 0.003 (95% CI: 0.002–0.005, p < 0.01), respectively, but not to PM10, O3, and CO concentrations. Conclusively, we observed a strong association between air pollution with RA disease activity. This study suggests air pollution as a risk factor for RA and recommends further measures to be taken by the authorities to control this health problem.

KW - air pollution

KW - rheumatoid arthritis

KW - DAS-28

KW - CDAI

KW - RA registry

KW - KRRD

KW - Kuwait

KW - Middle East

KW - AQI

U2 - 10.3390/ijerph17020416

DO - 10.3390/ijerph17020416

M3 - Article

VL - 17

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

SN - 1660-4601

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ER -