Atmospheric pollution: influence on hospital admissions in paediatric rheumatic diseases

• Published in: Lupus Vol. 21; no. 5; pp. 526 - 533
• Main Authors: Vidotto, JP, Pereira, LAA, Braga, ALF, Silva, CA, Sallum, AM, Campos, LM, Martins, LC, Farhat, SCL
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-04-2012; Sage Publications Ltd
• Subjects: Adolescent; Air Pollutants - adverse effects; Air pollution; Air Pollution - adverse effects; Ankylosing spondylitis; Arthritis; Autoimmune diseases; Brazil - epidemiology; Carbon monoxide; Child; Child, Preschool; Data processing; Dermatomyositis; Epidemiology; Female; Hospitalization - statistics & numerical data; Hospitals; Humans; Humidity; Inflammation; Information systems; Investigations; Linear Models; Lupus; Male; Morbidity; Nitrogen dioxide; Outdoor air quality; Oxidative Stress; Ozone; Particulate matter; Particulate Matter - adverse effects; Patient admissions; Pediatrics; Poisson Distribution; Pollutants; Pollution; Purpura; Regression analysis; Respiratory diseases; Rheumatic diseases; Rheumatic Diseases - epidemiology; Rheumatic Diseases - etiology; Rheumatic Diseases - physiopathology; Rheumatology; Scleroderma; Seasonal variations; Sulfur; Sulfur dioxide; Systemic lupus erythematosus; Systemic sclerosis; Temperature effects; Time Factors; Brazil; lag structure; Tropospheric pollution; time series; hospital admissions; health effects; paediatric rheumatic diseases
• ISSN: 0961-2033; 1477-0962
• DOI: 10.1177/0961203312437806

Objective: To investigate the lag structure effects from exposure to atmospheric pollution in acute outbursts in hospital admissions of paediatric rheumatic diseases (PRDs). Methods: Morbidity data were obtained from the Brazilian Hospital Information System in seven consecutive years, including admissions due to seven PRDs (juvenile idiopathic arthritis, systemic lupus erythematosus, dermatomyositis, Henoch–Schönlein purpura, polyarteritis nodosa, systemic sclerosis and ankylosing spondylitis). Cases with secondary diagnosis of respiratory diseases were excluded. Daily concentrations of inhaled particulate matter (PM10), sulphur dioxide (SO2) nitrogen dioxide (NO2), ozone (O3) and carbon monoxide (CO) were evaluated. Generalized linear Poisson regression models controlling for short-term trend, seasonality, holidays, temperature and humidity were used. Lag structures and magnitude of air pollutants’ effects were adopted to estimate restricted polynomial distributed lag models. Results: The total number of admissions due to acute outbursts PRD was 1,821. The SO2 interquartile range (7.79 µg/m3) was associated with an increase of 1.98% (confidence interval 0.25–3.69) in the number of hospital admissions due to outcome studied after 14 days of exposure. This effect was maintained until day 17. Of note, the other pollutants, with the exception of O3, showed an increase in the number of hospital admissions from the second week. Conclusion: This study is the first to demonstrate a delayed association between SO2 and PRD outburst, suggesting that oxidative stress reaction could trigger the inflammation of these diseases.