Fine Particulate Matter Components and Risk of Rheumatoid Arthritis: A Large General Canadian Open Cohort Study.

IF 3.7 2区 医学 Q1 RHEUMATOLOGY Arthritis Care & Research Pub Date : 2024-07-16 DOI:10.1002/acr.25403
Naizhuo Zhao, Audrey Smargiassi, Hong Chen, Jessica Widdifield, Sasha Bernatsky
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Abstract

Objective: Exposure to fine particulate matter (PM2.5) has been linked to many diseases. However, it remains unclear which PM2.5 chemical components for these diseases, including rheumatoid arthritis (RA), are more harmful. This study aimed to assess potential associations between PM2.5 components and RA and quantify the individual effects of each chemical component on RA risk.

Methods: An open cohort of 11,696,930 Canadian adults was assembled using Ontario administrative health data from January 2007 onward. Individuals were followed until RA onset, death, emigration from Ontario, or the end of the study (December 2019). Incident RA cases were defined by physician billing and hospitalization discharge diagnostic codes. The average levels of PM2.5 components (ammonium, black carbon, mineral dust, nitrate, organic matter, sea salt, and sulfate) for 5 years before cohort entry were assigned to participants based on residential postal codes. A quantile g-computation and Cox proportional hazard models for time to RA onset were developed for the mixture of PM2.5 components and environmental overall PM2.5, respectively.

Results: We identified 67,676 new RA cases across 130,934,256 person-years. The adjusted hazard ratios for the time to RA onset were 1.027 and 1.023 (95% confidence intervals 1.021-1.033 and 1.017-1.029) per every decile increase in exposures to all seven components and per 1 μg/m3 increase in the overall PM2.5, respectively. Ammonium contributed the most to RA onset in the seven components.

Conclusion: Exposure to PM2.5 components was modestly associated with RA risk. Public health efforts focusing on specific components (eg, ammonium) may be a more efficient way to reduce RA burden.

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细颗粒物成分与类风湿性关节炎的风险:一项大型加拿大普通人群开放式队列研究。
目的:接触细颗粒物(PM2.5)与许多疾病有关。然而,目前仍不清楚哪些 PM2.5 化学成分对这些疾病(包括类风湿性关节炎)的危害更大。本研究旨在评估PM2.5成分与类风湿关节炎之间的潜在关联,并量化每种化学成分对类风湿关节炎风险的个体影响:利用安大略省从 2007 年 1 月起的行政健康数据,对 11,696,930 名加拿大成年人进行了开放式队列研究。研究人员对这些人进行了跟踪调查,直至他们出现 RA、死亡、移民出安大略省或研究结束(2019 年 12 月)。根据医生账单和住院出院诊断代码对RA病例进行定义。根据居住地的邮政编码,为受试者分配加入队列前五年的 PM2.5 成分(铵、黑碳、矿物粉尘、硝酸盐、有机物、海盐和硫酸盐)平均水平。针对PM2.5成分混合物和环境总体PM2.5,分别建立了RA发病时间的量子g计算模型和Cox比例危险模型:我们在130,934,256人年中发现了67,676例新的RA病例。PM2.5中所有七种成分的暴露量每增加十分位数,RA发病时间的调整危险比分别为1.027和1.023(95%置信区间:1.021-1.033和1.017-1.029);PM2.5总体浓度每增加1微克/立方米,RA发病时间的调整危险比分别为1.027和1.023(95%置信区间:1.021-1.033和1.017-1.029)。在七种成分中,铵对RA发病的影响最大:结论:PM2.5成分暴露与RA风险略有关联。关注特定成分(如铵)的公共卫生工作可能是减少RA负担的更有效方法。
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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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