Associations of fire smoke and other pollutants with incident rheumatoid arthritis and rheumatoid arthritis-associated interstitial lung disease

Document Type

Journal Article

Publication Date

1-12-2025

Journal

Arthritis & rheumatology (Hoboken, N.J.)

DOI

10.1002/art.43113

Abstract

OBJECTIVE: Determine whether pollutants such as fire smoke-related particulate matter smaller than 2.5 microns (PM) are associated with incident rheumatoid arthritis (RA) and RA-associated interstitial lung disease (RA-ILD). METHODS: This case-control study used Veterans Affairs data 10/1/2009-12/31/2018. We identified incident RA and RA-ILD cases using validated algorithms, matching each case to up to 10 controls on age, gender, and VA enrollment year. We obtained pollutants including fire smoke PM, carbon monoxide, nitrogen oxides (NOx), ozone overall PM PM, and sulfur dioxide (SO) at least one year before index date. We fit conditional logistic regression models to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI) for incident RA and RA-ILD, adjusted for confounders. RESULTS: We identified 9,701 incident RA cases (mean age 65, 86% male), including 531 RA-ILD cases (mean age 69, 91% male), and 68,852 matched controls. Fire smoke PM was not associated with RA (aOR 1.07, 95% CI 0.92-1.23), but was associated with RA-ILD (aOR 1.98, 95% CI 1.08-3.62, per 1 μg/m). Increased levels of NOx were associated with RA (aOR 1.16, 95% CI 1.06-1.27, highest vs. lowest quartile). The highest quartiles of ozone (aOR 1.19, 95% CI 1.06-1.34) and PM (aOR 1.25, 95% CI 1.10-1.43) were associated with seronegative RA. Carbon monoxide, overall PM, and SO were not, or negatively, associated with RA and RA-ILD. CONCLUSION: Increased fire smoke PM was associated with RA-ILD, while NOx, ozone, and PM were associated with RA risk. Thus, air pollution may increase the risk of RA and RA-ILD.

Department

School of Medicine and Health Sciences Student Works

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