title: Incidence of anti-neutrophil cytoplasmic antibody-associated vasculitis before and after the February 2011 Christchurch Earthquake.
abstract: BACKGROUND
  It has been suggested that environmental pollution from an earthquake might be associated with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).
  
  
  OBJECTIVE
  To determine the incidence of AAV during the 3-year period before (period 1), and the 3 years following (period 2), the earthquake that occurred on 22 February 2011 in Christchurch, New Zealand.
  
  
  METHODS
  All ANCA tests performed in the Canterbury region for 3 years before the earthquake (period 1, 2007-2010), and for 3 years after the earthquake (period 2, 2011-2014) were examined. AAV was defined according to The European Medicines Agency classification algorithm. Medical records were reviewed and cases were included if they were newly diagnosed within the study period. Incidence was calculated using population data from the 2013 New Zealand census.
  
  
  RESULTS
  A total of 52 new cases of AAV was identified. The incidence in period 1 was 1.87/100 000/annum (95% C.I. 1.23-2.72), and for period 2 was 1.73/100 000/annum (95% C.I. 1.12-2.55). There was no statistically significant difference in incidence between the two study periods. There was no difference when analysing by myeloperoxidase (MPO) or proteinase-3 status, or restricting the analyses to those residing in an urban environment. The mean age at diagnosis for MPO AAV was significantly younger in period 2 than period 1 (61 years vs 71 years, P = 0.05). There were no other clinically important differences between the two groups.
  
  
  CONCLUSIONS
  This study does not support the hypothesis that an environmental agent, caused by dust pollution related to earthquake damage, has a causative role in the pathogenesis of AAV.
authors: Department of Rheumatology, Immunology and Allergy, Christchurch Hospital, Christchurch, New Zealand.
authors: H J
authors: HJ
authors: Farquhar
authors: Department of Immunology, Fiona Stanley Hospital, Perth, Western Australia, Australia.
authors: B
authors: B
authors: McGettigan
authors: Department of Rheumatology, Immunology and Allergy, Christchurch Hospital, Christchurch, New Zealand.
authors: P T
authors: PT
authors: Chapman
authors: Department of Rheumatology, Immunology and Allergy, Christchurch Hospital, Christchurch, New Zealand.
authors: J L
authors: JL
authors: O'Donnell
authors: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors: C
authors: C
authors: Frampton
authors: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors: L K
authors: LK
authors: Stamp
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000175:diagnosis / Q000453:epidemiology*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic
keywords: anti-neutrophil cytoplasmic antibodies; earthquakes; incidence; vasculitis