Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan; Japan Environment and Children's Study Programme Office, Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan.
Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan.
Sci Total Environ. 2019 Jun 10;668:342-349. doi: 10.1016/j.scitotenv.2019.03.018. Epub 2019 Mar 3.
Systemic lupus erythematosus (SLE) is a multi-systemic chronic autoimmune disease, the etiology of SLE is still unclear. Only a few studies evaluated the associations between air pollution and SLE. We conducted a population-based cohort study in Taiwan to examine the associations of air pollution with SLE. A total of 682,208 individuals aged 18-70 years were retrieved from National Health Insurance Research Database. We applied 1-km resolution land use regression and satellite-based models to estimate air pollutant concentrations during 2001-2010. The mixed effect Cox models with time-dependent variables were performed to estimate the associations between air pollution and SLE, as hazard ratios (HRs) with 95% confidence interval (CI). We identified 1292 newly diagnosed SLE patients with average age of 43.26 ± 13.64 years, most of them were female. There were positive associations of SLE with exposure to a 9.76 ppb increase in nitrogen dioxide (NO), a 0.20 ppm increase in carbon monoxide (CO), and a 10.2 μg/m increase in fine particles (PM) (HR = 1.21, 95% CI: 1.08-1.36, HR = 1.44, 95% CI: 1.31-1.59, and HR = 1.12, 95% CI: 1.02-1.23, respectively). Additionally, we observed negative associations with ozone (O) and sulfur dioxide (SO). According to the exposure-response relationships, exposure to NO between 28 and 38 ppb, exposure to CO above 0.6 ppm, and exposure to PM between 18 and 46 μg/m were positively associated with SLE. The results suggested that long-term exposure to traffic-related gaseous air pollutants (NO and CO) less than current National Ambient Air Quality Standards and PM are significantly associated with the risk of SLE.
系统性红斑狼疮（SLE）是一种多系统慢性自身免疫性疾病，其病因尚不清楚。只有少数研究评估了空气污染与 SLE 之间的关联。我们在台湾进行了一项基于人群的队列研究，以检查空气污染与 SLE 之间的关联。从国家健康保险研究数据库中检索到了 682208 名年龄在 18-70 岁之间的个体。我们应用 1 公里分辨率的土地利用回归和基于卫星的模型来估计 2001-2010 年期间的空气污染物浓度。使用具有时变变量的混合效应 Cox 模型来估计空气污染与 SLE 之间的关联，作为危险比（HR）及其 95%置信区间（CI）。我们确定了 1292 名新诊断的 SLE 患者，平均年龄为 43.26±13.64 岁，其中大多数为女性。暴露于二氧化氮（NO）增加 9.76 ppb、一氧化碳（CO）增加 0.20 ppm 和细颗粒物（PM）增加 10.2μg/m 时，SLE 的发病风险呈正相关（HR=1.21，95%CI：1.08-1.36，HR=1.44，95%CI：1.31-1.59，HR=1.12，95%CI：1.02-1.23）。此外，我们观察到臭氧（O）和二氧化硫（SO）呈负相关。根据暴露-反应关系，暴露于 28 至 38 ppb 之间的 NO、高于 0.6 ppm 的 CO 和 18 至 46μg/m 之间的 PM 与 SLE 呈正相关。结果表明，长期暴露于交通相关的气态空气污染物（NO 和 CO）低于当前的国家环境空气质量标准以及 PM 与 SLE 的风险显著相关。
