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June 09, 2022
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Data find ‘direct correlation’ between air pollution and osteoporosis, autoimmune disease

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There is a “direct correlation” between microscopic particles found in air pollution and increased incidence of osteoporosis and autoimmune disease in a cohort of individuals in Italy, according to a presenter at the EULAR 2022 Congress.

“It is estimated that some 3.5 million people die per year simply because of air pollution,” Hendrik Schulze-Koops, MD, of the division of rheumatology and clinical immunology in the department of medicine IV at Ludwig-Maximilans University Munich, in Germany, said in a press conference at EULAR.

Pollution from cars. Source: Adobe stock.
“It is estimated that some 3.5 million people die per year simply because of air pollution,” Hendrik Schulze-Koops, MD, told attendees. Source: Adobe Stock

“We have to accept that there is something in the air that is not supposed to be there,” Schulze-Koops said. “It is not only different kinds of gases, but different kinds of particles.”

Schulze-Koops was discussing a study conducted by Giovanni Adami, MD, a rheumatologist in the rheumatology unit of the University of Verona, and colleagues, which suggested that exposure to different types of particulate matter (PM) in air pollution has been associated with poor bone health at a molecular level. Specifically, this pollution can stimulate bone resorption and stop bone formation.

In the current study, Adami and colleagues aimed to describe potential associations between long-term exposure to particulate matter in air pollution and osteoporosis.

The researchers used the DeFRAcalc79 dataset for osteoporosis-related information and findings from the Italian institute of environment protection and research for air pollution. The researchers examined exposure in urban and rural areas between January 2013 and December 2019, accounting for potential confounders including age, BMI, fragility and frailty parameters, history of fractures and menopause. Glucocorticoid use and comorbidities were included in a second model, while a third model looked at northern, central and southern Italy as areas of residency.

The overall analysis included 59,950 women from 110 provinces.

Exposure to one type of particle, PM2.5, carried negative associations with femoral neck ( –0.005; 95 CI, –0.007 to –0.003) and lumbar spine ( –0.003; 95% CI –0.006 to –0.001) T-score levels, according to the findings. Moreover, individuals who were chronically exposed to PM2.5 at a level above 25 micrograms/m3 demonstrated a 16% increase in the likelihood of recording an osteoporotic T-score at any site (aOR = 1.161; 95% CI, 1.105-1.22).

For patients exposed to PM10 at a level higher than 30 micrograms/m3, a 15% higher risk of osteoporotic T-score was observed (aOR = 1.148; 95% CI 1.098-1.2) for any site.

“These people from the University of Verona really found that there is a direct correlation between the number of small particles and the development of an autoimmune disease,” Schulze-Koops said, noting that associations were observed not only for osteoporosis, but rheumatoid arthritis, as well.

“Higher air pollution is associated with a lower bone mass, which is the definition of osteoporosis,” he said.

Schulze-Koops expressed hope that this information could be disseminated worldwide. “[Adami and colleagues] really put the warning and said that if you live close to something that gives increased, intense and chronic air pollution, you may be at risk for musculoskeletal diseases like osteoporosis,” he said.