TY - JOUR T1 - Association between long-term exposure to air pollution and immune-mediated diseases: a population-based cohort study JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2021-002055 VL - 8 IS - 1 SP - e002055 AU - Giovanni Adami AU - Marco Pontalti AU - Giorgio Cattani AU - Maurizio Rossini AU - Ombretta Viapiana AU - Giovanni Orsolini AU - Camilla Benini AU - Eugenia Bertoldo AU - Elena Fracassi AU - Davide Gatti AU - Angelo Fassio Y1 - 2022/02/01 UR - http://rmdopen.bmj.com/content/8/1/e002055.abstract N2 - Objective Environmental air pollution has been associated with disruption of the immune system at a molecular level. The primary aim of the present study was to describe the association between long-term exposure to air pollution and risk of developing immune-mediated conditions.Methods We conducted a retrospective observational study on a nationwide dataset of women and men. Diagnoses of various immune-mediated diseases (IMIDs) were retrieved. Data on the monitoring of particulate matter (PM)10 and PM2.5 concentrations were retrieved from the Italian Institute of Environmental Protection and Research. Generalised linear models were employed to determine the relationship between autoimmune diseases prevalence and PM.Results 81 363 subjects were included in the study. We found a positive association between PM10 and the risk of autoimmune diseases (ρ+0.007, p 0.014). Every 10 µg/m3 increase in PM10 concentration was associated with an incremental 7% risk of having autoimmune disease. Exposure to PM10 above 30 µg/m3 and PM2.5 above 20 µg/m3 was associated with a 12% and 13% higher risk of autoimmune disease, respectively (adjusted OR (aOR) 1.12, 95% CI 1.05 to 1.20, and aOR 1.13, 95% CI 1.06 to 1.20). Exposure to PM10 was associated with an increased risk of rheumatoid arthritis; exposure to PM2.5 was associated with an increased risk of rheumatoid arthritis, connective tissue diseases (CTDs) and inflammatory bowel diseases (IBD).Conclusion Long-term exposure to air pollution was associated with higher risk of developing autoimmune diseases, in particular rheumatoid arthritis, CTDs and IBD. Chronic exposure to levels above the threshold for human protection was associated with a 10% higher risk of developing IMIDs.Data are available upon reasonable request. ER -