title: Increased inflammation in rheumatoid arthritis patients living where farm soils contain high levels of copper.
abstract: OBJECTIVE
  Heavy metal pollution in farm soils is a problem in some parts of Taiwan. Copper can be a factor associated with increased disease activities of rheumatoid arthritis (RA). Thus, the aim of this study was to investigate whether copper pollution in farm soils is associated with worsened RA.
  
  
  METHODS
  Clinical parameters from 122 RA patients were collected from a medical center in central Taiwan. Levels of heavy metals in the blood were measured using inductively coupled plasma mass spectrometry. Levels of copper in farm soils were retrieved from a national survey. These data were analyzed to find the factors related to RA disease activities.
  
  
  RESULTS
  RA patients living where farm soils contained high levels of copper had increased white blood cell counts, erythrocyte sedimentation rate, and disease activity score 28, compared with patients living where copper levels were low. Among the nine types of heavy metal measured in the study, blood levels of copper and nickel correlated with erythrocyte sedimentation rate.
  
  
  CONCLUSIONS
  Our cross-sectional data suggest a correlation between RA disease activity and the level of copper at township farm soils samples. Further longitudinal studies using more rigorous methodologies are warranted to examine whether this correlation is causal.
authors.affiliation: Graduate Institute of Biotechnology, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Tao-Hsiang
authors.initials: TH
authors.lastname: Yang
authors.affiliation: Graduate Institute of Occupational Medicine & Industrial Hygiene, National Taiwan University, Taipei, Taiwan.
authors.forename: Tzu-Hsuen
authors.initials: TH
authors.lastname: Yuan
authors.affiliation: Graduate Institute of Occupational Medicine & Industrial Hygiene, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Yaw-Huei
authors.initials: YH
authors.lastname: Hwang
authors.affiliation: Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua, Taiwan.
authors.forename: Ie-Bin
authors.initials: IB
authors.lastname: Lian
authors.affiliation: Graduate Institute of Biotechnology, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Menghsiao
authors.initials: M
authors.lastname: Meng
authors.affiliation: Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua, Taiwan; Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Bioindustry Technology, Da-Yeh University, Datsuen, Changhua, Taiwan. Electronic address: 115025@cch.org.tw.
authors.forename: Che-Chun
authors.initials: CC
authors.lastname: Su
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000097:blood*; D003300:Copper / Q000097:blood*; D003430:Cross-Sectional Studies; D000072480:Farms; D005260:Female; D006073:Gout / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000097:blood*; D016014:Linear Models; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D012987:Soil / Q000737:chemistry*; D012989:Soil Pollutants / Q000009:adverse effects*; D013167:Spondylitis, Ankylosing / Q000097:blood; D011795:Surveys and Questionnaires; D013624:Taiwan; D055815:Young Adult
chemical_list: D012987:Soil; D012989:Soil Pollutants; D003300:Copper
keywords: copper; inflammation; rheumatoid arthritis; soil pollution