Abstract
In recent years, a growing number of studies have found that air pollution plays critical roles in the onset and development of autoimmune diseases, but few studies have shown an association between air pollutants and dermatomyositis (DM). We sought to investigate the relationship between short-term exposure to air pollution and outpatient visits for DM and to quantify the burden of DM due to exposure to air pollutants in Hefei, China. Daily records of hospital outpatient visits for DM, air pollutants and meteorological factors data in Hefei from January 1, 2018 to December 31, 2021 were obtained. We used a distributed lag non-linear model (DLNM) in conjunction with a generalized linear model (GLM) to explore the association between air pollution and outpatient visits for DM, and conducted stratified analyses by gender, age and season. Moreover, we used attributable fraction (AF) and attributable number (AN) to reflect the burden of disease. A total of 4028 DM clinic visits were recorded during this period. High concentration nitrogen dioxide (NO2) exposure was associated with increased risk of DM outpatient visits (relative risk (RR) 1.063, 95% confidence interval (CI) 1.015–1.114, lag 0–5). Intriguingly, exposure to high concentration ozone (O3) was associated with reduced risk of outpatient visits for DM (RR 0.974, 95% CI 0. 0.954–0.993, lag 0–6). The results of stratified analyses showed that the cold season (vs. warm season) were more susceptible to outpatient visits for DM associated with NO2 and O3 exposure. In addition, we observed that an increased risk of DM outpatient visits was attributable to high concentration NO2 exposure, while high concentration O3 exposure was associated with a decreased risk of DM outpatient visits. This study provided a scientific basis for the etiology research and health protection of DM.
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The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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This study was funded by grants from the National Natural Science Foundation of China (82273710, 81872687), Anhui Provincial Natural Science Foundation (2108085Y26, 2108085QH361), Research Fund of Anhui Institute of Translational Medicine (2021zhyx-B04) and Postgraduate Innovation Research and Practice Program of Anhui Medical University (YJS20230007).
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All authors contributed to the study conception and design. H-F P and J-H T conceived the present idea and were responsible for the design of the study. Z-D W performed the statistical analysis and manuscript writing. C C and Y-S H participated in acquisition of data and data analysis. Y C and Y-T F participated in modification of English. Literature search by J-X H, K-J Y and J W. All authors read and approved the final manuscript.
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Wu, ZD., Chen, C., He, YS. et al. Association between air pollution exposure and outpatient visits for dermatomyositis in a humid subtropical region of China: a time-series study. Environ Geochem Health 45, 6095–6107 (2023). https://doi.org/10.1007/s10653-023-01616-6
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DOI: https://doi.org/10.1007/s10653-023-01616-6