The association between air pollution and hospitalization for patients with systemic lupus erythematosus in Chile: A daily time series analysis
- DOI
- Language of the publication
- English
- Date
- 2020-11-13
- Type
- Article
- Author(s)
- Cakmak, Sabit
- Blanco-Vidal, Claudia
- Lukina, Anna O.
- Dales, Robert
- Publisher
- Elsevier
Abstract
Genetic and environmental factors are thought to influence the activity of systemic lupus erythematosus (SLE), but relatively little is known about the effects of ambient air pollution. Using pollution data from air monitoring stations in the urban centers in Santiago Chile, along with daily patient hospitalization data from 2001 to 2012, an association between ambient air pollution and daily hospital admissions for SLE was tested using generalized linear models. Averaged over all regions pollutant mean 24 h concentrations were: 0.96 ppm carbon monoxide (CO), 64 ppb ozone (O3), 43 ppb nitrogen dioxide (NO2), 9 ppb sulphur dioxide (SO2), 29 μg/m3 particulate matter ≤ 2.5 μm in mean aerodynamic diameter (PM2.5), and 67 μg/m3 particulate matter ≤ 10 μm in diameter (PM10). The relative risk estimates in single pollutant models for an interquartile range (IQR) increase in pollutant were: RR = 1.34 (95% CI: 1.06–1.83) for SO2, RR = 1.60 (95% CI: 1.15–2.24) for CO, and RR = 1.41 (95% CI: 1.14–1.86) for PM2.5. In two-pollutant models, the significance of SO2 and PM2.5 persisted despite adjustments for each of the other measured pollutants. These findings suggest that acute increases in air pollution increase the risk of hospitalization with a primary diagnosis of SLE.
Plain language summary
"Health Canada is responsible for the assessment and management of health risks to Canadians associated with exposure to air pollutants in the environment. In this study, Health Canada assessed the risk associated with air pollutants and Idiopathic interstitial lung diseases (IILDs). IILD, characterized by inflammation and thickening/scarring of the fluid filled interconnected spaces in the lung, can cause difficulty breathing, low oxygen in the blood or even death within a few years, but its association with air pollution is not well known. Using ambient air pollution (Ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide and particulate matter) and climate data from seven air monitoring stations distributed in the seven urban centres in Santiago, Chile, along with daily patient hospitalization data from 2001 to 2012, an association between ambient air pollution and daily hospital admissions for IILD was tested. Our findings suggest that short term increases in air pollution may be one risk factor in the worsening of IILD symptoms requiring hospitalization. Given that air pollution exposure is modifiable, findings from this study and those of others suggest that reducing exposure may possibly reduce hospitalizations for IILD. Exposure can be reduced through new cleaner methods of energy generation, and public education to reduce personal exposure."
Subject
- Health,
- Health and safety