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Environmental Threats in Rheumatic Disease

  |  Issue: December 2024  |  

Because air pollution is a complex phenomenon, data linking air pollution and rheumatic diseases remain scarce and difficult to interpret. Using ground-level monitoring stations and satellite data, an increasing amount of data to better define and characterize air pollution has been collected. Fine particulate matter and nitrogen dioxide in air pollution have been associated with lupus flares, RA disease activity and RA risk.

Climate Change

Lastly, Paul Dellaripa, MD, Brigham and Women’s Hospital, Boston, discussed the implications of global climate change on patient health.2 Because physicians are trusted sources on climate change, rheumatologists can play important roles in mitigation, adaptation and advocacy. In particular, clinicians can discuss with patients health co-benefits, such as increasing the intake of plant-based food.

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In addition, as environmental exposures become more frequent, Dr. Dellaripa contends that clinicians will need to learn how to proactively warn those whose health may be at risk. Potential means to address this challenge include heat alert systems, air quality alert systems, natural disaster contingency plans and mental health services. He concludes by observing that 8% of global greenhouse gas emissions are from the U.S. healthcare system so there is a lot of scope for rheumatologists to help improve our ability to confront these threats.

Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS, is the director of the rheumatology fellowship training program at the University of Iowa, Iowa City, and the physician editor of The Rheumatologist. Follow him on X (formerly Twitter) @BharatKumarMD.

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References

  1. Katsumoto TR, Stolyar L, Dandeniya CL, et al. Impact of climate change on rheumatic diseases: A scoping review. J Clim Chang Health. 2024 Sep–Oct;19:100338.
  2. Dellaripa PF, Sung LH, Bain PA, et al.; American College of Rheumatology Committee on Research. American College of Rheumatology white paper: The effects of climate change on rheumatic conditions—An evolving landscape and a path forward. Arthritis Rheumatol. 2024 Oct;76(10):1459-1466. doi: 10.1002/art.42919. Epub 2024 Jun 4. PMID: 38751102; PMCID: PMC11498941.

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