Prospective correlational time-series analysis of the influence of weather and air pollution on joint pain in chronic rheumatic diseases.

Nelly Ziadé, Maria Bouzamel, Myriam Mrad-Nakhlé, Ghada Abi Karam, Ihsane Hmamouchi, Redouane Abouqal, Wehbeh Farah

Clinical rheumatology 2021 Oct

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The primary objective was to evaluate the association between weather variables and joint pain in patients with chronic rheumatic diseases (CRD: rheumatoid arthritis (RA), osteoarthritis (OA), and spondyloarthritis (SpA)). A secondary objective was to study the impact of air pollution indicators on CRD pain. The study is prospective, correlational, with time-series analysis. Patients with CRD, living in a predefined catchment area, filled their level of pain daily using a 0-10 numerical scale (NS), for 1 year. Weather (temperature, relative humidity (H), atmospheric pressure (P)) and air pollution indicators (particulate matters (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3)) were recorded daily using monitoring systems positioned in the same area. Association between pain and weather and air pollution indicators was studied using Pearson's correlation. Time-series analysis methodology was applied to determine the temporal relationship between pain and indicators. The study included 94 patients, 82% reported they were weather-sensitive. Pain variation was similar across diseases over a year. Pain was associated negatively with temperature, H, and O3, and positively with P and NO2. However, the strength of correlation was moderate; temperature explained 22% of pain variance. A drop of 10°C in temperature corresponded to an increase of 0.5 points in pain NS. Also, there was a significant interaction among environmental factors. In time-series analysis, temperature and NO2 remained independently associated with pain. The perception of joint pain in patients with CRD was correlated with weather and air pollution. The strength of association was moderate and independent of underlying disease. Key Points •Weather variation was moderately correlated with joint pain in chronic rheumatic diseases, with an inverse association with temperature, humidity, and O3. • Air pollution indicators, mainly nitrogen dioxide and ozone, were correlated with joint pain; particulate matters were also correlated but to a lesser extent. • The influence of these environmental factors was independent of the type of rheumatic disease, thus raising the hypothesis of their impact on pain perception mechanisms. © 2021. International League of Associations for Rheumatology (ILAR).

Citation

Nelly Ziadé, Maria Bouzamel, Myriam Mrad-Nakhlé, Ghada Abi Karam, Ihsane Hmamouchi, Redouane Abouqal, Wehbeh Farah. Prospective correlational time-series analysis of the influence of weather and air pollution on joint pain in chronic rheumatic diseases. Clinical rheumatology. 2021 Oct;40(10):3929-3940