Zhao Naizhuo, Smargiassi Audrey, Chen Hong, Widdifield Jessica, Bernatsky Sasha
McGill University Health Centre, Montreal, Quebec, Canada.
University of Montreal, Montreal, Quebec, Canada.
Arthritis Care Res (Hoboken). 2025 Jan;77(1):15-22. doi: 10.1002/acr.25403. Epub 2024 Aug 9.
Exposure to fine particulate matter (PM) has been linked to many diseases. However, it remains unclear which PM chemical components for these diseases, including rheumatoid arthritis (RA), are more harmful. This study aimed to assess potential associations between PM components and RA and quantify the individual effects of each chemical component on RA risk.
An open cohort of 11,696,930 Canadian adults was assembled using Ontario administrative health data from January 2007 onward. Individuals were followed until RA onset, death, emigration from Ontario, or the end of the study (December 2019). Incident RA cases were defined by physician billing and hospitalization discharge diagnostic codes. The average levels of PM components (ammonium, black carbon, mineral dust, nitrate, organic matter, sea salt, and sulfate) for 5 years before cohort entry were assigned to participants based on residential postal codes. A quantile g-computation and Cox proportional hazard models for time to RA onset were developed for the mixture of PM components and environmental overall PM, respectively.
We identified 67,676 new RA cases across 130,934,256 person-years. The adjusted hazard ratios for the time to RA onset were 1.027 and 1.023 (95% confidence intervals 1.021-1.033 and 1.017-1.029) per every decile increase in exposures to all seven components and per 1 μg/m increase in the overall PM, respectively. Ammonium contributed the most to RA onset in the seven components.
Exposure to PM components was modestly associated with RA risk. Public health efforts focusing on specific components (eg, ammonium) may be a more efficient way to reduce RA burden.
接触细颗粒物（PM）与多种疾病有关。然而，对于包括类风湿性关节炎（RA）在内的这些疾病，尚不清楚哪些PM化学成分危害更大。本研究旨在评估PM成分与RA之间的潜在关联，并量化每种化学成分对RA风险的个体影响。
利用2007年1月起安大略省的行政卫生数据组建了一个由11,696,930名加拿大成年人组成的开放队列。对个体进行随访，直至发生RA、死亡、从安大略省移民或研究结束（2019年12月）。通过医生计费和住院出院诊断代码确定新发RA病例。根据居住邮政编码，将队列进入前5年的PM成分（铵、黑碳、矿物粉尘、硝酸盐、有机物、海盐和硫酸盐）平均水平分配给参与者。分别针对PM成分混合物和环境总体PM，建立了RA发病时间的分位数g计算模型和Cox比例风险模型。
在130,934,256人年中，我们确定了67,676例新发RA病例。所有七种成分暴露每增加十分位数，以及总体PM每增加1μg/m³，RA发病时间的调整风险比分别为1.027和1.023（95%置信区间为1.021 - 1.033和1.017 - 1.029）。在这七种成分中，铵对RA发病的贡献最大。
接触PM成分与RA风险存在适度关联。针对特定成分（如铵）的公共卫生措施可能是减轻RA负担的更有效方法。
