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Question: I have #lupus. When the National Weather Service reports an unhealthy Air Quality Index, stating that people with chronic conditions such as asthma use caution, do those cautions include me for having systemic lupus?
Answer from “The Lupus Encyclopedia” Don Thomas, MD: In my opinion, “yes”. In recent years, there have now been several studies showing the adverse effects of pollution on lupus.
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The Lupus Center at Johns Hopkins Hospital in Baltimore tracked specific weather and environmental conditions such as pollution, ozone concentrations, temperature, wind speed, humidity, and barometric pressure before flares. They found that different environmental conditions were associated with lupus flares in different parts of the body. No condition caused “whole body” lupus flares.
They reported their findings at the 2019 American College of Rheumatology meeting in Atlanta, GA. Similar to their 2012 study, they found that hot temperatures were especially followed by flares of lupus rashes and arthritis (and there were less flares of kidney inflammation, lupus nephritis). However, pleurisy, nervous system problems, and low blood counts also tended to flare more often after hotter temperatures. Windier periods were more closely associated with flares of arthritis, low blood counts, nerve problems, and lung inflammation from lupus. Higher humidity was seen during flares of arthritis and pleurisy, while periods of higher pollution saw flares of arthritis, rashes, pleurisy and low blood counts. Interestingly, changes in barometric pressure did not seem to predict lupus flares. It should be noted that these results reflect the conditions of Baltimore, Maryland and may not be representative of other climates and environmental associations. However, they do point out that the environment does play a role. These environmental and weather conditions and their effects on lupus should be measured and reported in other areas.
The role that pollution may play in causing lupus flares is receiving more notice (just like the Johns Hopkins findings above). A study from Montreal showed that some lupus lab abnormalities (notably elevated anti-dsDNA levels and the presence of casts in the urine, which can indicate kidney inflammation) tended to occur during increased periods of pollution.
A 2019 Chinese study showed signicantly increased hospital admissions for lupus flares during periods of increased pollution. These data suggest that when organizations such as the US’s National Weather Service puts out alerts on pollution (such as an unhealthy Air Quality Index) for people with chronic illnesses such as those with lung disease, SLE patients should also heed these warnings and take the recommended actions.
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by Don Thomas, MD
lupusencyclopedia@gmail.com
lupusencyclopedia.com
facebook.com/LupusEncyclopediastemic lupus? Answer from “The Lupus Encyclopedia” Don Thomas, MD: In my opinion, “yes”. In recent years, there have now been several studies showing the adverse effects of pollution on lupus. SHARE with everyone who has lupus The Lupus Center at Johns Hopkins Hospital in Baltimore tracked speci
