PM10 increases mortality risk in rheumatoid arthritis-associated interstitial lung disease

Objectives The effect of air pollution on the prognosis of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) remains poorly understood. We aimed to evaluate the effect of long-term exposure to particulate matter with an aerodynamic diameter of ≤10 µm (PM10) and nitrogen dioxide (NO2...

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Main Authors: Jin Woo Song, Sun-Young Kim, Hee-Young Yoon, Soo Han Kim
Format: Article
Language:English
Published: BMJ Publishing Group 2024-02-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/10/1/e003680.full
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author Jin Woo Song
Sun-Young Kim
Hee-Young Yoon
Soo Han Kim
author_facet Jin Woo Song
Sun-Young Kim
Hee-Young Yoon
Soo Han Kim
author_sort Jin Woo Song
collection DOAJ
description Objectives The effect of air pollution on the prognosis of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) remains poorly understood. We aimed to evaluate the effect of long-term exposure to particulate matter with an aerodynamic diameter of ≤10 µm (PM10) and nitrogen dioxide (NO2) on mortality in patients with RA-ILD.Methods We included 309 patients (mean age, 61.7 years; male, 44.3%) with RA-ILD. Individual-level long-term exposures to PM10 and NO2 at their residential addresses were estimated using a national-scale exposure prediction model. The effect of the two air pollutants on mortality was estimated using a Cox-proportional hazards model adjusted for individual-level and area-level characteristics.Results The median follow-up period was 4.8 years, and 40.8% of patients died or underwent lung transplantation. The annual average concentrations of PM10 and NO2 were 56.3 μg/m3 and 22.4 ppb, respectively. When air pollutant levels were stratified by quartiles, no association was observed between air pollutant concentration and mortality in patients with RA-ILD. However, when stratified by two groups (high exposure (top 25th percentile) vs low exposure (bottom 75th percentile)), we observed a significant association between high PM10 exposure and mortality (HR 1.68; 95% CI 1.11 to 2.52; p=0.013) but no association between NO2 exposure and mortality. In the subgroup analyses, the effect of high PM10 exposure on mortality was significant in patients aged <65 years (HR 1.98; 95% CI 1.02 to 3.85; p=0.045).Conclusions Our results indicated that high PM10 exposure may be associated with mortality in patients with RA-ILD.
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spelling doaj-art-382f7fb7f1e945c2be63dbdabd6593db2025-08-20T03:48:31ZengBMJ Publishing GroupRMD Open2056-59332024-02-0110110.1136/rmdopen-2023-003680PM10 increases mortality risk in rheumatoid arthritis-associated interstitial lung diseaseJin Woo Song0Sun-Young Kim1Hee-Young Yoon2Soo Han Kim3Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Korea (the Republic of)Department of Cancer AI & Digital Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South KoreaDivision of Allergy and Respiratory Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea (the Republic of)Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South KoreaObjectives The effect of air pollution on the prognosis of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) remains poorly understood. We aimed to evaluate the effect of long-term exposure to particulate matter with an aerodynamic diameter of ≤10 µm (PM10) and nitrogen dioxide (NO2) on mortality in patients with RA-ILD.Methods We included 309 patients (mean age, 61.7 years; male, 44.3%) with RA-ILD. Individual-level long-term exposures to PM10 and NO2 at their residential addresses were estimated using a national-scale exposure prediction model. The effect of the two air pollutants on mortality was estimated using a Cox-proportional hazards model adjusted for individual-level and area-level characteristics.Results The median follow-up period was 4.8 years, and 40.8% of patients died or underwent lung transplantation. The annual average concentrations of PM10 and NO2 were 56.3 μg/m3 and 22.4 ppb, respectively. When air pollutant levels were stratified by quartiles, no association was observed between air pollutant concentration and mortality in patients with RA-ILD. However, when stratified by two groups (high exposure (top 25th percentile) vs low exposure (bottom 75th percentile)), we observed a significant association between high PM10 exposure and mortality (HR 1.68; 95% CI 1.11 to 2.52; p=0.013) but no association between NO2 exposure and mortality. In the subgroup analyses, the effect of high PM10 exposure on mortality was significant in patients aged <65 years (HR 1.98; 95% CI 1.02 to 3.85; p=0.045).Conclusions Our results indicated that high PM10 exposure may be associated with mortality in patients with RA-ILD.https://rmdopen.bmj.com/content/10/1/e003680.full
spellingShingle Jin Woo Song
Sun-Young Kim
Hee-Young Yoon
Soo Han Kim
PM10 increases mortality risk in rheumatoid arthritis-associated interstitial lung disease
RMD Open
title PM10 increases mortality risk in rheumatoid arthritis-associated interstitial lung disease
title_full PM10 increases mortality risk in rheumatoid arthritis-associated interstitial lung disease
title_fullStr PM10 increases mortality risk in rheumatoid arthritis-associated interstitial lung disease
title_full_unstemmed PM10 increases mortality risk in rheumatoid arthritis-associated interstitial lung disease
title_short PM10 increases mortality risk in rheumatoid arthritis-associated interstitial lung disease
title_sort pm10 increases mortality risk in rheumatoid arthritis associated interstitial lung disease
url https://rmdopen.bmj.com/content/10/1/e003680.full
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