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International Journal of Rheumatology
Volume 2016, Article ID 5356307, 11 pages
Review Article

Association between Air Pollution and the Development of Rheumatic Disease: A Systematic Review

1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
2McGill University, Montréal, QC, Canada
3Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

Received 7 July 2016; Revised 15 September 2016; Accepted 4 October 2016

Academic Editor: Lisa Rider

Copyright © 2016 Gavin Sun et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. Environmental risk factors, such as air pollution, have been studied in relation to the risk of development of rheumatic diseases. We performed a systematic literature review to summarize the existing knowledge. Methods. MEDLINE (1946 to September 2016) and EMBASE (1980 to 2016, week 37) databases were searched using MeSH terms and keywords to identify cohort, case-control, and case cross-over studies reporting risk estimates for the development of select rheumatic diseases in relation to exposure of measured air pollutants (). We extracted information on the population sample and study period, method of case and exposure determination, and the estimate of association. Results. There was no consistent evidence of an increased risk for the development of rheumatoid arthritis (RA) with exposure to NO2, SO2, PM2.5, or PM10. Case-control studies in systemic autoimmune rheumatic diseases (SARDs) indicated higher odds of diagnosis with increasing PM2.5 exposure, as well as an increased relative risk for juvenile idiopathic arthritis (JIA) in American children <5.5 years of age. There was no association with SARDs and NO2 exposure. Conclusion. There is evidence for a possible association between air pollutant exposures and the development of SARDs and JIA, but relationships with other rheumatic diseases are less clear.