ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 319

Systemic Juvenile Idiopathic Arthritis and Exposure to Fine Particulate Air Pollution

Andrew S. Zeft1, Sampath Prahalad2, Rayfel Schneider3, Alexei Grom4, Fatma Dedeoglu5, Pamela F. Weiss6, Carter Mix7 and C. Arden Pope8, 1Pediatrics, Rheumatology, The Cleveland Clinic, Cleveland, OH, 2Emory University, Atlanta, GA, 3Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada, 4Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 5on behalf of CARRAnet Investigators, Palo Alto, CA, 6Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, PA, 7Brigham Young University, Provo, UT, 8Economics, Brigham Young University, Provo, UT

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: , , ,

Session Information

Title: Pediatric Rheumatology - Pathogenesis and Genetics

Session Type: Abstract Submissions (ACR)

Background/Purpose: Environmental factors are understood to play a pathogenic role in the etiology of Systemic Onset Juvenile Idiopathic Arthritis (SJIA). Fine particulate matter (aerodynamic diameter £2.5-mm cut point, PM2.5) is a measurable component of ambient urban pollution, and positive associations of short-term PM2.5 exposure with the reported clinical presentation of SJIA in young children have been described in a regional cohort. Our objective was to further establish associations between short-term ambient pollution exposures and the reported clinical event dates of SJIA onset in cases residing from multiple metropolitan regions. 

Methods: A case-crossover study design was used to analyze associations of short-term PM2.5 exposures with the event date of SJIA symptom onset from cases residing in the metropolitan regions of Boston, Philadelphia, Atlanta, Cincinnati, and Toronto. Time trends, seasonality, month, and weekday were controlled for by matching. Selected exposure windows (up to 14 days) of PM2.5 were examined.

Results: Positive, statistically significant associations between PM2.5 concentrations and elevated risk of SJIA onset were not observed.  The most positive associations of short-term PM2.5 exposure with the reported clinical onset of SJIA were in children <5.5 years of age (RR 1.75, 95% CI 0.85-3.62). An ad hoc extended pooled analysis including previously reported cases residing from Utah’s metro areas identified an increased risk of SJIA for children <5.5 years of age (RR = 1.76, 95% CI 1.07-2.89 per 10 µg/m3 increase in 3-day lagged moving average of PM2.5).

Conclusion: Even in this multi-city, multi-period study only small, statistically insignificant PM2.5-SJIA associations are observed. However, similar to previously observed results, the PM2.5-SJIA association is most suggestive in preschool aged children. More subjects with spatial and temporal specificity may be required by the analysis to demonstrate effects, and further research may be useful in larger numbers of SJIA cases and in geographic areas which experience a greater ambient particulate burden.

Disclosure:

A. S. Zeft,
None;

S. Prahalad,
None;

R. Schneider,
None;

A. Grom,
None;

F. Dedeoglu,
None;

P. F. Weiss,
None;

C. Mix,
None;

C. A. Pope,
None.

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