Industrial Fine Particulate Air Pollution Linked to Increased ACPA Positivity

Dr. Bernatsky says it would be valuable for further research to study whether RA patients exposed to air pollution have worse disease outcomes. “We do know that some elements of disease activity in systemic lupus, a disease with some features that may resemble RA, can be correlated with PM²_2.5 [fine particulate matter] levels,”she says.³

She advises healthcare providers to be prepared for questions from patients about what they can do to limit their exposure to harmful air pollution. In addition to consulting online air quality indicators, Dr. Bernatsky suggests patients look at other research tied to reducing the adverse effects of air pollution exposure. New evidence exists that some adverse effects of air pollution may be avoided by having a healthy diet. Example: The Mediterranean diet focuses on plant-based foods, olive oil and moderate intake of alcohol, providing antioxidants and anti-inflammatory compounds.⁴

“Health researchers should also continue to investigate and monitor the health effects of air pollution to help policy makers improve the health of populations,” she stresses. Dr. Bernatsky’s team is also planning more research around the questions of whether the effects of environmental exposures are modified by the genetic and epigenetic profiles of patients.

In the meantime, Dr. Bernatsky encourages rheumatologists and their patients to “take actions toward reducing their ecological footprint at home, at work and everywhere” by carpooling, biking, using public transportation and walking whenever possible. For academics looking for ways to learn about and advocate for policy changes, she suggests reviewing a recent article on the topic in Academic Medicine.⁵

Carina Stanton is a freelance science journalist based in Denver.

References

1. Zhao N, Smargiassi A, Hatzopoulou M, et al. Multiple industrial air pollutants and anti-citrullinated protein antibody positivity [abstract #L02]. Arthritis Rheumatol. 2019 Oct; 71(suppl 10).
2. Bernatsky S, Smargiassi A, Joseph L, et al. Industrial air emissions, and proximity to major industrial emitters, are associated with anti-citrullinated protein antibodies. Environ Res. 2017 Aug;157:60–63. Epub 2017 May 17.
3. Bernatsky S, Fournier M, Pineau CA, et al. Associations between ambient fine particulate levels and disease activity in patients with systemic lupus erythematosus (SLE). Environ Health Perspect. 2011 Jan;119(1):45–49. Epub 2010 Sep 22.
4. Lim CC, Hayes RB, Ahn J, et al. Mediterranean diet and the association between air pollution and cardiovascular disease mortality risk. Circulation. 2019 Apr 9;139(15):1766–1775.
5. Fernandez Lynch H, Bateman-House A, Rivera SM. Academic advocacy: Opportunities to influence health and science policy under U.S. lobbying law. Acad Med. 2020 Jan;95(1):44–51.