Background/Purpose: The impact of climate change on autoimmune and rheumatic diseases remains poorly understood. However, emerging evidence suggests extreme weather events, often related to climate change, may be associated with disease flares, hospitalizations, and disruptions in access to medical care. This pilot study, the first retrospective online survey of its kind, investigates associations between extreme weather events, patient demographics, and self-reported disease flares.

Methods: An online survey was distributed to U.S. individuals with autoimmune and rheumatic diseases, collecting data on demographics, diagnoses, self-reported flares, and exposure to extreme weather events (e.g., floods, wildfires). It also assessed healthcare utilization, treatment disruptions, mental health impacts, and barriers to medical access post-extreme weather. Respondents were grouped based on whether their disease flare occurred within 90 days of their most severe extreme weather event or not. Chi-square analyses examined associations between flares, demographics, weather events, and healthcare access.

Results: Among 155 participants, 88 participants (57%) reported having a disease flare within the period investigated. Participants with polymyalgia rheumatica (50% vs. 10.5%, p = 0.004) and rheumatoid arthritis (24% vs. 9.8%, p = 0.045), were more likely to experience flares within 90 days of their most severe extreme weather event exposure when compared with individuals who did not have the specified disease. Conversely, those with Raynaud’s phenomenon (2.7% vs. 14.9%, p = 0.046) and Sjogren’s disease (2.8% vs 14.8%, p = 0.052) were less likely to experience a flare within 90 days of their most severe extreme weather event. Additionally, participants who were unable to store medication safely (75% vs. 10.4%, p < 0.001) or who had trouble remembering key details of the event (60% vs. 20.8%, p = 0.044) following their most severe extreme weather event were more likely to experience flares within 90 days of this event compared to individuals who did not have those characteristics. Finally, participants who identified as Black (33.3% vs. 10.3%, p = 0.018) were more likely to experience flares within 90 days of their most severe extreme weather event compared to individuals who did not identify as Black.

Conclusion: Difficulty storing medication, specific diseases (polymyalgia rheumatica, rheumatoid arthritis), and identifying as Black were associated with increased flare risk within 90 days following extreme weather events. These findings point to possible mechanisms—like improper medication storage—and reinforce evidence that climate change disproportionately affects vulnerable populations, including racial and ethnic minorities. This exploratory project lays the foundation for future research and education aimed at improving patient resilience to climate change. Next steps include developing a shorter survey focused on the timing and location of severe weather events and flares, and expanding survey dissemination in the U.S. and internationally to better understand the link between severe weather and autoimmune disease flares.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/online-patient-survey-on-the-impact-of-extreme-weather-events-on-autoimmune-and-rheumatic-diseases/