2013 Progress Report: Associations of Short-Term Pollution Exposures with Childhood Autoimmune Disease

EPA Grant Number: R834992
Title: Associations of Short-Term Pollution Exposures with Childhood Autoimmune Disease
Investigators: Zeft, Andrew S. , Pope, Clive Arden
Institution: Brigham Young University
Current Institution: Cleveland Clinic Foundation , Brigham Young University
EPA Project Officer: Ilacqua, Vito
Project Period: June 1, 2011 through May 31, 2014 (Extended to May 31, 2015)
Project Period Covered by this Report: June 1, 2013 through May 31,2014
Project Amount: $298,857
RFA: Exploring New Air Pollution Health Effects Links in Existing Datasets (2010) RFA Text |  Recipients Lists
Research Category: Air Quality and Air Toxics , Health Effects , Air


We are further testing the hypothesis that clinical autoimmune disease presentation and exacerbation are associated with exposures to short-term pollution, including PM2.5, constituents of PM2.5, and O3.  In Objective 1, we will further establish associations between short-term PM2.5 exposure and the clinical onset of Systemic Onset Juvenile Idiopathic Arthritics, a subtype of JIA. In Objective 2, we will establish associations between short-term ambient PM2.5 and O3 and the clinical onset of Kawasaki Disease. In Objective 3, we will establish associations between short-term PM2.5 and O3 exposures and clinical disease activity of Henoch Schonlein Purpura.  Cases come from various geographic metropolitan regions of the US and Canada (Toronto). 

Progress Summary:

  • We completed the process of subject data transfer from all collaborating centers, and collected usable case data sets for our analysis.
  •  We assembled PM2.5 exposure measurements from monitors and carefully imputed PM2.5 to provide day-to-day temporal variability and resolution for reliable time series indexes of pollution exposures for each metropolitan area (Philadelphia, Boston, Toronto, Chicago, Atlanta, Cincinnati, San Diego, Salt Lake City, Denver and Cleveland).
  • We performed the case-crossover analysis and interpretation of results.
  • Our multi-city case cross over study in systemic onset Juvenile Idiopathic Arthritis (Objective 1) has yielded results which essentially reproduce those we have previously published (1) and suggests that short-term exposure to ambient fine particulate matter (PM2.5) is a risk factor in the development and clinical presentation of systemic onset Juvenile Idiopathic Arthritis in young preschool aged children.
  • Our multi-city case cross over studies in Kawasaki Disease (Objective 2) and Henoch Schonlein Purpura (Objective 3) have yielded results which did not establish a risk of either the event dates of Kawasaki Disease clinical onset or hospitalization for exacerbation of pediatric HSP with short-term ambient particulate pollution exposure.

Future Activities:

In the coming year, we will take the important next step to further analyze and clarify our results prior to submitting them for publication.  Specifically, we need to accurately account for the effects of climate parameters in the analysis and will be collaborating with climatology researcher colleagues.


Zeft AS, Prahalad S, Lefevre S, Clifford B, McNally B, Bohnsack J, Pope CA. Juvenile Idiopathic Arthritis and Exposure to Fine Particulate Air Pollution.  Clin Exp Rheumatol. 2009 Sep-Oct;27(5):877-84.

Journal Articles:

No journal articles submitted with this report: View all 10 publications for this project

Supplemental Keywords:

Urban Air Quality; Climate; Personal Exposure; Health Risks; Air Toxics; Air Quality; Ambient Particle Properties; Atmospheric Monitoring; Cumulative Exposure; Children’s Health

Progress and Final Reports:

Original Abstract
  • 2011 Progress Report
  • 2012 Progress Report
  • Final Report