title: Juvenile idiopathic arthritis and exposure to fine particulate air pollution.
abstract: OBJECTIVE
  Inhalation of fine particulate matter, including particles with an aerodynamic diameter less than or equal to a 2.5-microm cut point (PM2.5), has been associated with systemic inflammation and the clinical presentation of various cardiopulmonary heath events. The urban area along Utah's Wasatch Mountains has high PM2.5 concentrations during periods of stagnant air conditions. Short-term inhalation exposures may trigger inflammatory events presenting as symptom onset in new patients with juvenile idiopathic arthritis (JIA). This study evaluated potential associations between JIA symptom onset and temporal changes in regional air pollution measured by stagnant air conditions and PM2.5 concentrations.
  
  
  METHODS
  A case-crossover design was used to analyze associations of regional ambient PM2.5 concentrations with onset date of 338 JIA cases living on Utah's Wasatch Front. Patients were drawn from the Intermountain States Database of Childhood Rheumatic Diseases (1993-2006). Time trends, seasonality, month, and weekday were controlled for by matching. Selected exposure windows of PM2.5 and stagnant air days were used in the model to determine the effect of short term cumulative exposure on JIA symptom onset.
  
  
  RESULTS
  Increased concentrations of PM2.5 and stagnant air conditions in the preceding 14 days were associated with significantly elevated risk of JIA onset in preschool aged children (RR=1.60, 95% CI 1.00-2.54) but not older children. Elevated risk was larger in males and in systemic onset JIA.
  
  
  CONCLUSIONS
  Exposure to stagnant polluted air may be an environmental risk factor for JIA in young children, potentially triggered by pollution-induced pulmonary mediated inflammation.
authors.affiliation: Department of Pediatrics, University of Utah, Salt Lake City, 84158-1289, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Zeft
authors.forename: S
authors.initials: S
authors.lastname: Prahalad
authors.forename: S
authors.initials: S
authors.lastname: Lefevre
authors.forename: B
authors.initials: B
authors.lastname: Clifford
authors.forename: B
authors.initials: B
authors.lastname: McNally
authors.forename: J F
authors.initials: JF
authors.lastname: Bohnsack
authors.forename: C A
authors.initials: CA
authors.lastname: Pope
mesh_terms: D000367:Age Factors; D001171:Arthritis, Juvenile / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D052638:Particulate Matter / Q000009:adverse effects* / Q000032:analysis*; D012306:Risk; D012737:Sex Factors; D014589:Utah
chemical_list: D052638:Particulate Matter