Camila Maria Paiva França1,2, Adriana Maluf Elias Sallum1,2, Alfésio Luis Ferreira Braga1,2, Fernando Louzada Strufaldi1,2, Clovis Artur Almeida Silva1,2, Sylvia Costa Lima Farhat3,4. 1. From the Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, and the Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo; Pediatric Rheumatology Unit, and Emergency Department, Children's Institute, Faculdade de Medicina, Universidade de São Paulo, São Paulo; Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Católica de Santos, Santos, Brazil. 2. C.M. França, MD, PhD, Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina, Universidade de São Paulo; A.M. Sallum, MD, PhD, Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina, Universidade de São Paulo; A.L. Braga, MD, PhD, Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, and Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Católica de Santos; F.L. Strufaldi, MB, Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo; C.A. Silva, MD, PhD, Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina, Universidade de São Paulo, and Division of Rheumatology, Faculdade de Medicina, Universidade de São Paulo; S.C. Farhat, MD, PhD, Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, and Emergency Department, Children's Institute, Faculdade de Medicina, Universidade de São Paulo. 3. From the Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, and the Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo; Pediatric Rheumatology Unit, and Emergency Department, Children's Institute, Faculdade de Medicina, Universidade de São Paulo, São Paulo; Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Católica de Santos, Santos, Brazil. sylvia.farhat@gmail.com. 4. C.M. França, MD, PhD, Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina, Universidade de São Paulo; A.M. Sallum, MD, PhD, Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina, Universidade de São Paulo; A.L. Braga, MD, PhD, Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, and Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Católica de Santos; F.L. Strufaldi, MB, Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo; C.A. Silva, MD, PhD, Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina, Universidade de São Paulo, and Division of Rheumatology, Faculdade de Medicina, Universidade de São Paulo; S.C. Farhat, MD, PhD, Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, and Emergency Department, Children's Institute, Faculdade de Medicina, Universidade de São Paulo. sylvia.farhat@gmail.com.
Abstract
OBJECTIVE: To evaluate exposure to environmental factors inhaled during pregnancy and after birth until juvenile idiopathic arthritis (JIA) diagnosis among residents of a large city. METHODS: This is an exploratory case-control study that consists of 66 patients with JIA and 124 healthy controls matched by age and sex, living in the São Paulo, Brazil, metropolitan area until JIA diagnosis, and whose mothers had resided in this region during pregnancy. A structured and reliable questionnaire (κ index for test-retest was 0.80) assessed demographic data, gestational and perinatal-related factors, and exposure to inhalable environmental elements during pregnancy and after birth (occupational exposure to inhalable particles and/or volatile vapor, exposure to cigarette smoke, and the presence of industrial activities or gas stations near the home, work, daycare, or school). Tropospheric pollutants included particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO). RESULTS: During pregnancy, intrauterine cigarette smoke exposure (OR 3.43, 95% CI 1.45-8.12, p = 0.005) and maternal occupational exposure (OR 13.69, 95% CI 4.4-42.3, p < 0.001) were significant independent risk factors for JIA diagnosis. In contrast, maternal employment (OR 0.06, 95% CI 0.02-0.2, p < 0.001) and ideal maternal weight gain (OR 0.36, 95% CI 0.2-0.8, p = 0.017) presented negative associations. Secondhand smoke exposure from birth to JIA diagnosis (OR 3.6, 95% CI 1.8-7.3, p < 0.001) and exposure to O3 during the second year of life (OR 2.76, 95% CI 1.20-6.37, p = 0.017) were independent and significant risk factors for the pathogenesis of JIA. CONCLUSION: In our study, cigarette smoke exposure (intrauterine and after birth), exposure to O3 in the second year of life, and maternal occupational exposure were identified as potential risk factors for JIA, warranting further study.
OBJECTIVE: To evaluate exposure to environmental factors inhaled during pregnancy and after birth until juvenile idiopathic arthritis (JIA) diagnosis among residents of a large city. METHODS: This is an exploratory case-control study that consists of 66 patients with JIA and 124 healthy controls matched by age and sex, living in the São Paulo, Brazil, metropolitan area until JIA diagnosis, and whose mothers had resided in this region during pregnancy. A structured and reliable questionnaire (κ index for test-retest was 0.80) assessed demographic data, gestational and perinatal-related factors, and exposure to inhalable environmental elements during pregnancy and after birth (occupational exposure to inhalable particles and/or volatile vapor, exposure to cigarette smoke, and the presence of industrial activities or gas stations near the home, work, daycare, or school). Tropospheric pollutants included particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO). RESULTS: During pregnancy, intrauterine cigarette smoke exposure (OR 3.43, 95% CI 1.45-8.12, p = 0.005) and maternal occupational exposure (OR 13.69, 95% CI 4.4-42.3, p < 0.001) were significant independent risk factors for JIA diagnosis. In contrast, maternal employment (OR 0.06, 95% CI 0.02-0.2, p < 0.001) and ideal maternal weight gain (OR 0.36, 95% CI 0.2-0.8, p = 0.017) presented negative associations. Secondhand smoke exposure from birth to JIA diagnosis (OR 3.6, 95% CI 1.8-7.3, p < 0.001) and exposure to O3 during the second year of life (OR 2.76, 95% CI 1.20-6.37, p = 0.017) were independent and significant risk factors for the pathogenesis of JIA. CONCLUSION: In our study, cigarette smoke exposure (intrauterine and after birth), exposure to O3 in the second year of life, and maternal occupational exposure were identified as potential risk factors for JIA, warranting further study.
Authors: Francisco Airton Castro Rocha; Joaquim Ivo Vasques Dantas Landim; Marcela Gondim Aguiar; João Pedro Emrich Accioly; Carolina Noronha Lechiu; Luiza Helena Acácio Costa; Carlos Nobre Rabelo Júnior; Leila Nascimento da Rocha; Hermano Alexandre Lima Rocha Journal: Rheumatol Int Date: 2018-08-13 Impact factor: 2.631
Authors: Sarah L N Clarke; Katie S Mageean; Ilaria Maccora; Sean Harrison; Gabriele Simonini; Gemma C Sharp; Caroline L Relton; Athimalaipet V Ramanan Journal: Rheumatology (Oxford) Date: 2022-02-02 Impact factor: 7.580