Weather conditions may worsen symptoms in rheumatoid arthritis patients: The possible effect of temperature

doi:10.1016/j.reuma.2012.09.006

Reumatología Clínica

Volume 9, Issue 4, July–August 2013, Pages 226-228

https://doi.org/10.1016/j.reuma.2012.09.006 Get rights and content

Abstract

Objective

Patients with rheumatoid arthritis (RA) complain that weather conditions aggravate their symptoms. We investigated the short-term effects of weather conditions on worsening of RA and determined possible seasonal fluctuations.

Methods

We conducted a case-crossover study in Madrid, Spain. Daily cases of RA flares were collected from the emergency room of a tertiary level hospital between 2004 and 2007.

Results

245 RA patients who visited the emergency room 306 times due to RA related complaints as the main diagnostic reason were included in the study. Patients from 50 to 65 years old were 16% more likely to present a flare with lower mean temperatures.

Conclusions

Our results support the belief that weather influences rheumatic pain in middle aged patients.

Resumen

Objetivo

Los pacientes con artritis reumatoide (AR) se quejan de que las condiciones meteorológicas empeoran sus síntomas. Este estudio trata de ver los efectos a corto plazo de las condiciones climáticas en empeoramiento sintomático en pacientes con AR y determinar posibles fluctuaciones estacionales.

Métodos

Se realizó un estudio de casos cruzados en Madrid, España. Los casos diarios de empeoramiento de la AR se obtuvieron de la sala de urgencias de un hospital terciario entre 2004 y 2007.

Resultados

245 pacientes con AR con 306 visitas a urgencias con AR como diagnostico principal se incluyeron en el estudio. Los pacientes de 50 a 65 años tuvieron un 16% más de probabilidades de presentar empeoramiento sintomático de la AR con una menor temperatura media.

Conclusiones

Nuestros resultados apoyan la creencia de que el clima influye en el dolor reumático de los pacientes con mediana edad.

Introduction

Patients with rheumatic conditions often complain that certain meteorological conditions aggravate their disease symptoms.1, 2, 3 However, studies on influence of weather conditions1, 3, 4, 5, 6, 7, 8 have reported conflicting results, most related to rheumatoid arthritis patients (RA). Some studies indicated that weather conditions do not influence the symptoms of arthritis,2, 3 whereas others found an influence related to low temperature, high atmospheric pressure, and high humidity.1, 4, 9 Moreover, some authors found a seasonal effect6, 7 but others did not.5, 8 Thus, scientific evidence on the effects of atmospheric factors on rheumatic diseases is sparse and non-conclusive. Discrepancies could be related to the diverse climatic conditions from each geographic area studied and also due to the different methodologies used.

To our knowledge no study has previously been conducted in our setting for these rheumatic disorders. Our objective is to investigate the short-term effects of weather conditions on the acute worsening in rheumatic patients due to RA related conditions and also to determine possible seasonal fluctuations.

Section snippets

Methods

This study was conducted in the city of Madrid, Spain, with a Mediterranean continental climate very influenced by urban conditions. Winters are cold, with mean temperatures below 10 °C with frequent frosts at night and occasional snowfalls. Summers are warm with mean temperatures over 20 °C.

Daily cases of RA worsening, were defined as those patients who come to the emergency room, were attended by a rheumatologist of Hospital Clínico San Carlos, and were diagnosed with RA as the main cause

Results

A total of 245 patients with 306 RA visits to the emergency room due to RA as the main diagnostic reason during the study period were included. Most were women (71%), with a mean age of 63.6 ± 16.4 years. Two thirds were attended at least twice in the emergency room due to RA worsening, with some level of disability (90% with a Rosser index less than 0.990). During the study period weather conditions were on average: 14.6 °C of temperature (ranging from −5 to 39), 54% of relative humidity (15–96),

Discussion

There is a popular belief that rheumatic conditions are particularly sensitive to fluctuations of weather. We have found associations with meteorological conditions (specifically with temperature), and RA related problems in the subgroup of middle age patients.

The failure to find associations with other age groups could be explained because age itself is a risk factor for disability, thus elderly could have in general more difficulty to go to the emergency room by themselves. Moreover,

Ethical considerations

Protection of human and animal subjects. The authors declare that the procedures followed were in accordance with the regulations of the responsible Clinical Research Ethics Committee and in accordance with those of the World Medical Association and the Helsinki Declaration.
Confidentiality of data. The authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information

Conflict of interest

Authors declare that they have no conflict of interest.

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Original breveWeather conditions may worsen symptoms in rheumatoid arthritis patients: The possible effect of temperatureInfluencia de las condiciones climáticas en el empeoramiento de los síntomas de artritis reumatoide: El posible efecto de la temperatura

Abstract

Objective

Methods

Results

Conclusions

Resumen

Objetivo

Métodos

Resultados

Conclusiones

Introduction

Section snippets

Methods

Results

Discussion

Ethical considerations

Conflict of interest

Pain

Weather effects in rheumatoid arthritis: from controversy to consensus. A review

J Rheumatol

Does the weather really matter? A cohort study of influences of weather and solar conditions on daily variations of joint pain in patients with rheumatoid arthritis

Arthritis Rheum

Weather conditions can influence rheumatic diseases

Proc West Pharmacol Soc

Seasonal symptom severity in patients with rheumatic diseases: a study of 1,424 patients

J Rheumatol

Seasonal distribution of relapse onset in rheumatoid arthritis and spondyloarthropathy: the possible effect of the solar factor

Clin Exp Rheumatol

What's in season for rheumatoid arthritis patients? Seasonal fluctuations in disease activity

Rheumatology (Oxford)

Original breve
Weather conditions may worsen symptoms in rheumatoid arthritis patients: The possible effect of temperatureInfluencia de las condiciones climáticas en el empeoramiento de los síntomas de artritis reumatoide: El posible efecto de la temperatura