Association Between Ambient Air Pollutant Exposures and Childhood-Onset Systemic Lupus Erythematosus: A 12-Year Population-Based Cohort Study in Taiwan

Yenju Shih¹ and Chang-Ching Wei ², ¹Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, Taichung city, Taiwan (Republic of China), ²Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Children Hospital, China Medical University Hospital, Taichung, Taiwan, Taichung city, Taiwan (Republic of China)

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Air pollution, Childhood-onset systemic lupus erythematosus, Incidence, Particulate matter and Total hydrocarbons

Session Information

Date: Sunday, November 10, 2019

Title: SLE – Clinical Poster I: Epidemiology & Pathogenesis

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Air pollutants exposure has been linked to inducing oxidative stress, pulmonary and systemic inflammation. We hypothesized that long-term exposure to air pollution would be associated with childhood-onset systemic lupus erythematosus (cSLE).

Methods: We collected data from the Taiwan National health insurance research database and linked these data to the Taiwan Air Quality-Monitoring Database. Children < 18 years old, identified from January 1st, 2000, were followed-up until the first diagnosis of cSLE was made or December 31st, 2012. The daily average air pollutant concentrations, including particulate matter (PM2.5) and total hydrocarbons (THC), were categorized into four quartile-based groups (Q1-Q4). We measured the incidence rate, hazard ratios (HRs) and 95% confidence intervals for cSLE stratified by the quartiles of air pollutant concentration using Cox proportional hazards models, adjusted for age, sex, monthly income, and urbanization.

Results: A total of 394 children (0.16%) were diagnosed with SLE. The incidence rate for SLE increased with PM_2.5 and THC exposure concentration, from 4.7 (Q1) to 21.9 (Q4) and 9.5 (Q1) to 26.1 (Q4) per 100,000 person-years, respectively. Compared with those exposed to the concentrations in Q1 level, the adjusted HR for SLE increased with the PM_2.5 and THC exposure concentrations from 2.74 to 4.23 and 0.93 to 3.03, respectively.

Conclusion: The present study provides evidence that long-term ambient air pollutant exposures are risk factors of the development of cSLE.

Table 1. Baseline demographics and exposure of air pollutants in Taiwan children, 2000-2012

Table 2. Baseline urbanization level among quartiles of daily average concentration of air pollutants in Taiwan children, 2000-2012

Table 3. The risk of systemic lupus erythematosus in children exposed to various air pollutants stratified by quartile of daily average concentration in Cox proportional hazard regression

Disclosure: Y. Shih, None; C. Wei, None.

To cite this abstract in AMA style:

Shih Y, Wei C. Association Between Ambient Air Pollutant Exposures and Childhood-Onset Systemic Lupus Erythematosus: A 12-Year Population-Based Cohort Study in Taiwan [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/association-between-ambient-air-pollutant-exposures-and-childhood-onset-systemic-lupus-erythematosus-a-12-year-population-based-cohort-study-in-taiwan/. Accessed .

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