Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Mei-Shan Road, Hefei, Anhui, 230032, China.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Mei-Shan Road, Hefei, Anhui, 230032, China.
Environ Res. 2022 Nov;214(Pt 3):114017. doi: 10.1016/j.envres.2022.114017. Epub 2022 Aug 15.
BACKGROUND: Emerging evidence showed that air pollutants are associated with development and recurrence of autoimmune disorders, but there is scarce evidence regarding the relationship between air pollutants and Sjogren's syndrome (SS). We sought to investigate whether air pollutants affect the risk of outpatient visits for SS and to quantify the burden of SS visits attributable to air pollution exposure in Hefei, China. METHODS: Daily data on outpatient visits for SS, air pollutants and meteorological data in Hefei, China, from January 1, 2015 to December 31, 2020 were obtained. A distributed lag non-linear model in conjunction with a generalized linear model were employed to assess the relationship between air pollution and SS outpatient visits. Stratified analyses were further performed by gender, age and season. Attributable fraction (AF) and attributable number (AN) were used to reflect disease burden. RESULTS: There were 4501 records of outpatient visits for SS. Exposure to PM was associated with increased risk of SS outpatient visits (relative risk (RR) = 1.218, 95% confidence interval (CI): 1.017-1.458, lag 0-14 day). An increase of 24 μg/m (interquartile range) in NO concentration was associated with 26.3% increase in the risk of SS outpatient visits (RR = 1.263, 95%CI: 1.105-1.445, lag 0-10 day). In contrast, exposure to O was associated with decreased risk of SS outpatient visits (RR = 0.692, 95%CI: 0.510-0.939, per 63 μg/m in O exposure, lag 0-27 day). Stratified analyses showed that females (vs. males) was more vulnerable to SS outpatient visits associated with NO and O exposure. SS patients aged ≥65 years (vs. aged <65 years) were susceptible to PM exposure. Exposure to PM or NO in the cold season was associated with higher risk of SS outpatient visits than that in the warm season. In addition, the AN (232, 95%CI: 119, 324) and AF (5.16%, 95%CI: 2.55%, 7.21%) of NO exposure were higher than those of PM exposure. CONCLUSION: PM and NO exposure are associated with increased risk of SS outpatient visits, while O exposure appears to be associated with decreased risk of SS outpatient visits. The effect of air pollutants exposure on risk of SS outpatients can be modified by age, gender and season. The burden of SS outpatient visits attributable to NO exposure is higher than those attributable to PM exposure.
背景：新出现的证据表明，空气污染物与自身免疫性疾病的发生和复发有关，但关于空气污染物与干燥综合征（SS）之间的关系，证据仍然匮乏。我们旨在研究空气污染物是否会影响 SS 门诊就诊的风险，并量化在中国合肥因空气污染物暴露导致的 SS 就诊负担。
方法：获取了 2015 年 1 月 1 日至 2020 年 12 月 31 日期间，中国合肥的 SS 门诊就诊量、空气污染物和气象数据的每日数据。采用分布式滞后非线性模型结合广义线性模型来评估空气污染物与 SS 门诊就诊量之间的关系。进一步按性别、年龄和季节进行分层分析。归因分数（AF）和归因数量（AN）用于反映疾病负担。
结果：共记录了 4501 例 SS 门诊就诊病例。PM 暴露与 SS 门诊就诊风险增加相关（相对风险（RR）=1.218，95%置信区间（CI）：1.017-1.458，滞后 0-14 天）。NO 浓度每增加 24μg/m（四分位距），SS 门诊就诊风险增加 26.3%（RR=1.263，95%CI：1.105-1.445，滞后 0-10 天）。相反，O 暴露与 SS 门诊就诊风险降低相关（RR=0.692，95%CI：0.510-0.939，O 暴露每增加 63μg/m，滞后 0-27 天）。分层分析表明，与 O 暴露相比，女性（vs. 男性）更易受到与 NO 和 O 暴露相关的 SS 门诊就诊的影响。年龄≥65 岁（vs. <65 岁）的 SS 患者易受 PM 暴露影响。与温暖季节相比，寒冷季节的 PM 或 NO 暴露与 SS 门诊就诊的风险更高。此外，NO 暴露的 AN（232，95%CI：119，324）和 AF（5.16%，95%CI：2.55%，7.21%）高于 PM 暴露的 AN（178，95%CI：91，262）和 AF（2.75%，95%CI：1.28%，4.35%）。
结论：PM 和 NO 暴露与 SS 门诊就诊风险增加相关，而 O 暴露似乎与 SS 门诊就诊风险降低相关。空气污染物暴露对 SS 门诊就诊风险的影响可因年龄、性别和季节而异。NO 暴露导致的 SS 门诊就诊负担的归因分数高于 PM 暴露的归因分数。
Healthcare (Basel). 2024-10-24
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