impact factor

Paediatric Rheumatology


Systemic onset juvenile idiopathic arthritis and exposure to fine particulate air pollution

1, 2, 3, 4, 5, 6, 7, 8


  1. Pediatric Rheumatology, The Cleveland Clinic, Cleveland, OH, USA.
  2. Emory University School of Medicine, Atlanta, USA.
  3. University of Toronto, Hospital for Sick Children, Toronto, Canada.
  4. Harvard University, Boston Children’s Hospital, MA, USA.
  5. University of Pennsylvania, Children’s Hospital Philadelphia, PA, USA.
  6. University of Cincinnati Medical Center; Cincinnati Children’s Hospital, OH, USA.
  7. Brigham Young University, Provo, UT, USA.
  8. Brigham Young University, Provo, UT, USA.

2016 Vol.34, N°5
PI 0946, PF 0952
Paediatric Rheumatology

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PMID: 27607024 [PubMed]

Received: 01/02/2016
Accepted : 19/05/2016
In Press: 01/09/2016
Published: 18/09/2016


Fine particulate matter (PM2.5) is a measurable component of ambient pollution, and positive associations of short-term PM2.5 exposure with the clinical presentation of systemic onset juvenile idiopathic arthritis (SJIA) in young children have been described in a regional cohort. Our objective was to further establish associations between short-term pollution exposures and the reported clinical event of SJIA onset in cases residing from multiple metropolitan regions.
A case-crossover study design was used to analyse associations of short-term PM2.5 exposures with the event of SJIA symptom onset from cases residing in five metropolitan regions. Time trends, seasonality, month, and weekday were controlled for by matching. Selected exposure windows (to 14 days) of PM2.5 were examined.
Positive, statistically significant associations between PM2.5 concentrations and elevated risk of SJIA were not observed. The most positive associations of short-term PM2.5 exposure with SJIA were in children <5.5 years (RR 1.75, 95% CI 0.85-3.62). An ad hoc extended pooled analysis including previously reported cases from Utah’s metropolitan areas identified an increased risk of SJIA for children <5.5 years (RR = 1.76, 95% CI 1.07–2.89 per 10 μg/m3 increase in 3-day lagged moving average PM2.5).
In this multi-city, multi-period study small, statistically insignificant PM2.5-SJIA associations are observed. However, as found in prior study, the PM2.5-SJIA association is most suggestive in preschool aged children. Larger numbers of SJIA cases spatially located in geographic areas which experience a greater day to day ambient particulate burden may be required by the analysis to demonstrate effects.

Rheumatology Article