PM2.5 and ozone were associated with SLE onset; mineral dust was an important contributor.
Abstract
Concerns are growing regarding the relationship of air pollution (especially fine particulate matter, PM2.5) in diseases like systemic lupus erythematosus (SLE). It is unclear which chemical components of ambient PM2.5 may be most harmful, and whether other air pollutants play additional roles. We aimed to evaluate the association between the mixture of PM2.5 components and SLE onset, quantifying their relative contributions to SLE risk, and potential effect modification by ambient ozone levels.
Using MarketScan® administrative health data, we assembled an urban open cohort of all enrollees ≥18-year-old (without prior SLE) with residential core-based statistical area (CBSA) information. Each year after 2013, eligible individuals entered the cohort and were followed until SLE onset, death, insurance disenrollment, or study end (Dec. 2023). SLE incident cases were identified by ≥1 hospitalization or ≥2 physician billing diagnostic codes. From the cohort, all SLE cases and a 20% random baseline sub-cohort were combined into a case-cohort sample. Concentrations of PM2.5 components (ammonium, black carbon, mineral dust, sulfate, nitrate, organic matter, sea salt) and ambient ozone for 2 years before cohort entry were estimated by satellite- and ground-based models and assigned based on CBSAs at cohort entry. Extended quantile g-computation models assessed potential associations of SLE onset with the mixture of PM2.5components, ozone and their interaction, adjusting for sex, age, baseline chronic obstructive pulmonary disease (as a proxy for smoking), geographic region, and year of cohort entry. Index weights estimated by quantile g-computation models quantified the relative contributions of individual PM2.5 components to SLE risk.
Our case-cohort sample numbered 8,345,067 individuals including 21,485 new SLE cases. At the median ozone referent level (ie, 36.1 parts per billion), the adjusted hazard ratio for SLE onset was 1.142 (95% confidence interval, CI 1.107-1.179) per every quartile increase in all PM2.5 components (Table 1). Ozone was also associated with increased risk of SLE (HR 1.009, 95% CI 1.001-1.017). There was effect modification such that the HR for PM2.5 was highest when ozone level was lowest (Table 1). Similar results were seen in sub-groups stratified by sex or age. Mineral dust consistently had the largest index weight across different sub-groups and ozone levels.
Table 1.
Systemic Lupus Erythematosus Risk: Hazard Ration (HR) estimates for effects of PM
2.5
component mixture, ozone, and the interaction between the exposures, at different referent levels of ozone.
PM2.5 and ozone were associated with SLE onset; mineral dust was an important contributor. Mineral dust triggers pulmonary inflammation and is a plausible trigger of autoimmunity and SLE onset. Addressing sources of ambient mineral dust (road traffic, construction, farming) may help reduce SLE incidence.
Ambient air pollution, particularly fine particulate matter (PM
2.5
), has been linked to cerebrovascular disease. However, findings on the short-term effects of PM
2.5
exposure on hemorrhagic stroke (HS) have been inconsistent across studies. Therefore, this study investigated the association between short-term PM
2.5
exposure and HS hospitalization in Yancheng, China.
An individual-level time-stratified case-crossover study was conducted using hospitalization records of patients with HS from four major hospitals in Yancheng between 2022 and 2024. Conditional logistic regression models were applied to estimate the associations between short-term PM
2.5
exposure and HS hospitalization across different lag structures. Stratified analyses were further performed according to sex, age, hypertension, diabetes, smoking, alcohol consumption, and season.
A total of 2,312 patients hospitalized for HS were included in the analysis. The strongest association was observed at lag01, where each 10 μg/m
3
increase in PM
2.5
concentration was associated with a 3.24% increase in HS hospitalization (95% CI: 0.55%−6.00%). Significant increases were also observed at lag0 and lag1, with corresponding effect estimates of 2.50% (95% CI: 0.11%−4.95%) and 2.76% (95% CI: 0.32%−5.27%), respectively. The associations remained significant after adjustment for ozone (O
3
) but were no longer statistically significant after adjustment for sulfur dioxide (SO
2
), nitrogen dioxide (NO
2
), and carbon monoxide (CO). Relatively stronger effect estimates were observed among females, older adults, individuals with hypertension or diabetes, smokers, alcohol consumers, and during the cold season.
Short-term PM
2.5
exposure was associated with an increased risk of HS hospitalization in Yancheng, China, with the strongest effects observed within the first two days after exposure. The associations were more pronounced among susceptible populations and during the cold season.
K. Qian, Xiao-Rong Xu, Chunxiang Xu et al.· Frontiers in Public Health· 0 citations
This study examines the long-term associations between ambient air pollutants and the burden of major respiratory and infectious diseases in this geographically sensitive region. A retrospective analysis was conducted using ICD-10-coded hospital records of patients diagnosed with asthma, chronic obstructive pulmonary disease (COPD), bronchitis, and tuberculosis from January 2020 to June 2026. These data were integrated with in situ air quality measurements, including PM10, PM2.5, and SO2, as well as satellite-derived Aerosol Optical Depth (AOD) from MODIS. Disease incidence was stratified by year, sex, and age groups (0–85+ years) to assess demographic susceptibility patterns. Respiratory diseases constituted a substantial public health burden over the study period. Asthma showed a marked female predominance (≈29,700 females vs. ≈16,000 males) and a bimodal age distribution with peaks in early childhood (0–5 years) and mid-adulthood (35–50 years). COPD was predominantly observed in males (≈8300 males vs. ≈5500 females), with a higher median age range (≈67–70 years). Bronchitis exhibited a similar bimodal pattern, disproportionately affecting both pediatric and elderly populations, while overall case numbers declined over time. Tuberculosis incidence was approximately threefold higher in males than females, with notable age-related divergence, affecting younger females (≈30–32 years) and middle-aged males (≈42–45 years). The findings suggest a spatial–temporal correspondence between elevated pollutant concentrations and respiratory disease prevalence in the Iğdır Basin. The observed sex- and age-specific disparities underscore the potential value of region-specific environmental health strategies, strengthened air quality management, and continuous epidemiological surveillance in enclosed basin environments.
Melahat Batu Ağırkaya, Fatma Şencan, Mehmet Ali Çelik· Pollutants· 0 citations
Abstract Background Acute respiratory infections (ARIs) remain a major global health concern. Although long-term air pollution exposure has been linked to ARIs, prospective evidence from community-based populations remains limited. Objective This study aimed to quantify the burden of ARIs in the community and examine the associations between long-term exposure to particulate matter 2.5 (PM2.5) and ozone (O3) and the risks of ARIs, with additional analyses using influenza-like illness (ILI) as a more specific outcome. Methods We conducted a prospective cohort study including 3617 residents in Shanghai, China, who were followed weekly for 1 year. Individual-level exposure to PM2.5 and O3 concentrations was estimated using high-resolution datasets. Cox proportional hazards models with shared frailty were applied to assess associations with ARIs. Exposure windows of 3, 6, 9, and 12 months were evaluated, and the optimal window was selected based on the Akaike information criterion. Effect estimates were reported per IQR increase. Dose-response relationships, subgroup analyses, and multiple sensitivity analyses were performed. Results During 3217 person-years of follow-up, 885 ARI events were documented (0.27 per person-year). In the fully adjusted model using the 12-month exposure window, each IQR increase in PM2.5 was associated with higher risks of ARIs (hazard ratio [HR] 1.594, 95% CI 1.340‐1.897), with stronger associations observed for ILI (HR 1.948, 95% CI 1.484‐2.557). For O3, the corresponding HRs were 1.510 (95% CI 1.135‐2.007) for ARIs, with stronger associations for ILI (HR 2.229, 95% CI 1.385‐3.588). PM2.5 showed a nonlinear association with ARIs, whereas linear relationships were observed for PM2.5 with ILI and O3 with both outcomes. Evidence of effect modification was observed by age, residence, and season for PM2.5 and by season for O3. Results were robust across multiple sensitivity analyses. Conclusions Long-term exposure to PM2.5 and O3 is associated with increased risk of ARIs, with similar associations observed for ILI. These findings highlight the importance of long-term air pollution control and targeted interventions for susceptible populations, particularly during cold seasons.
Xiaole Duan, Xiao Yu, Hongyu Liang et al.· JMIR Public Health and Surve...· 0 citations
No hypothesis clearly characterizes the role of PM in the pathogenesis of the discussed liver diseases, in particular, at the molecular genetic level, and creating a formalized description of the processes mediating the effect of PM on the human body helps to better understand their role.
A. F. Kolpakova, R. N. Sharipov, F. Kolpakov· Experimental and Clinical Ga...· 0 citations
Ambient fine particulate matter (PM2.5) is a proven human lung carcinogen associated with lung cancer incidence. However, the relative toxicity of the various chemical components of PM2.5 and their joint association with all-cause mortality following lung cancer diagnosis remain unclear. We conducted a cohort study of 528,127 adults aged ≥65 years with lung cancer diagnosed between 2000-2019, derived from the SEER-Medicare database. Patients were followed annually from diagnosis until death, loss to follow-up, or end of the study in 2019. Two-year moving average exposures to 15 PM2.5 chemical components were estimated using high-resolution spatiotemporal models and linked to each patient based on residential ZIP code in each year. We used generalized weighted quantile sum regression with random holdouts to estimate both the joint association of PM2.5 component mixtures with all-cause mortality and the relative contribution of each component, adjusted for demographics, histological type, stage, first-course treatments, comorbidities, and neighborhood-level covariates. We found that joint exposure to PM2.5 component mixtures was associated with increased mortality, with relative risk of 1.011 (95% confidence interval [CI]: 1.010, 1.013) per decile increase in all components. Although differences in contributions were modest, silicon, nitrate, vanadium, zinc, and iron appeared to be more influential contributors, suggesting that controlling related sources, such as road dust, traffic emissions, fossil fuel combustion, and heavy fuel oil combustion, may obtain greater potential benefits. Exploratory subgroup analyses suggested that the joint association may be stronger among patients with non-small cell lung cancer, those with later-stage disease, and female patients.
Yaguang Wei, Jiaowei Gong, Edgar Castro et al.· Environmental Research· 0 citations
Air pollution at least 4 years before hospitalization may increase the odds of hospitalization with Parkinson’s Disease, and reducing air pollution exposure may have long-term effects on PD prevention.
Scott W. Delaney, Lauren Mock, Veronica A. Wang et al.· Environmental Epidemiology· 0 citations
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