Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Air Pollution: Is There an Association with Rheumatic Disease?

Gavin R. Sun, MD, Sasha Bernatsky, MD, Gilaad G. Kaplan, MD, & Cheryl Barnabe, MD  |  Issue: December 2015  |  December 17, 2015

Ollyy/shutterstock.com

Image Credit: Ollyy/shutterstock.com

Interactions between an individual’s genetic background and their exposure to environmental factors are thought to result in a cascade of immune reactions, ultimately leading to the development of autoimmune diseases such as rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE) and juvenile dermatomyositis.1,2 For example, an environmental factor that conclusively affects susceptibility to the development of RA is smoking, but with risk magnified by the presence and number of copies of shared epitope.3,4

Air pollution is a recognized risk factor for respiratory and cardiovascular disease, but has also been associated with immune-mediated diseases, such as inflammatory bowel disease and multiple sclerosis.5,6 Air pollution may mediate its effect on autoimmune disease by directly stimulating an inflammatory response or indirectly through alterations in the microbiome.7-9 Thus, air pollution has been hypothesized to influence the development of rheumatic diseases. In this review, we summarize sources of air pollution, how levels can be measured and what evidence exists for associations between rheumatic disease development and exposure to air pollution.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Sources of Air Pollution

Air pollution comprises a complex mixture of particles and gases from a variety of industrial and private sources. Fossil fuel use is the main source of emission of airborne pollutants in developed countries. In general, exposure to air pollution can result in activation of the immune response; an early study demonstrated measurable differences in immunoglobulins, complement components, haptoglobin and a-1-glycoprotein between a female population exposed to higher compared to lower atmospheric pollution.10

Particulate matter (PM) <2.5µm in size (PM2.5) has been the focus of most of the published literature on air pollution and health. PM air pollution is a mixture of solid, liquid, or solid and liquid particles suspended in air that can travel long distances from remote sources or be concentrated by weather-related factors (e.g., winter inversions). It is largely composed of ammonium sulfate and ammonium nitrate derived from diesel fuel combustion and products of motor vehicle gas combustion and coal-powered power plants.11,12 PM2.5 particles can penetrate the gas-exchange region of the lung, creating oxidative stress and triggering activation of macrophages and epithelial cells in the alveolar tissues, ultimately resulting in an inflammatory response and secretion of pro-inflammatory cytokines.11,13

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Other measured pollutants include particulate matter <10µm in size (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2). PM10 particles are larger and are, therefore, less likely to be carried from distant sources or penetrate the trachea-bronchial tree. SO2 is formed during petroleum refining or cement manufacturing and also from coal-fired power plants, locomotives, ships and some non-road diesel-burning equipment.14

Page: 1 2 3 4 5 6 7 | Single Page
Share: 

Filed under:ConditionsRheumatoid ArthritisSystemic Lupus Erythematosus Tagged with:air pollutionenvironmentLupusRheumatic DiseaseRheumatoid arthritis

Related Articles
    Oksana Kuzmina/shutterstock.comx

    Environmental Factors in Pediatric Systemic Autoimmune Diseases

    March 20, 2017

    Systemic autoimmune diseases are thought to result from immune dysregulation in genetically susceptible individuals who were exposed to environmental risk factors. Many studies have identified genetic risk factors for these diseases, but concordance rates among monozygotic twins are 25–40%, suggesting that nonheritable environmental factors play a more prominent role.1,2 Through carefully conducted epidemiologic and other…

    Industrial Fine Particulate Air Pollution Linked to Increased ACPA Positivity

    April 13, 2020

    Researchers investigating the effects of air pollutants on a biomarker for rheumatic autoimmune diseases have found a significant correlation between anti-citrullinated protein antibody positivity in the general population and exposure to industrial fine particulate matter…

    Atmospheric & Environmental Changes Tied to Organ-Specific Lupus Flares

    November 19, 2019

    NEW YORK (Reuters Health)—Changes in atmospheric and environmental factors may contribute to organ-specific disease exacerbation in patients with systemic lupus erythematosus (SLE), according to a new study. The study found “strong associations between atmospheric variables and fine particulate matter concentration over the 10 days prior to a patient visit and organ-specific lupus flares at the…

    2015 ACR/ARHP Annual Meeting: RA Pathogenesis and Prevention

    February 17, 2016

    SAN FRANCISCO—Evolving research into the pathogenesis of rheumatoid arthritis (RA) is increasingly showing that rather than a single causative dysfunctional pathway leading to disease, multiple pathways are involved, the study of which can shed additional light on what is occurring in a person’s body prior to developing symptoms of disease. Saying it another way, no…

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences