Influence of exposure to climate-related hazards in the phenotypic expression of primary Sjögren's syndrome

Identifier:  imarina:9443260

Handle: https://hdl.handle.net/20.500.11797/imarina9443260

Authors:  Flores-Chavez, A; Brito-Zeron, P; Ng, W -f; Szanto, A; Rasmussen, A; Priori, R; Baldini, C; Armagan, B; Ozkiziltas, B; Praprotnik, S; Suzuki, Y; Quartuccio, L; Hernandez-Molina, G; Inanc, N; Bartoloni, E; Rischmueller, M; Oliveira, F Reis-de; Trevisani, V Fernandes Moca; Jurcut, C; Nordmark, G; Carubbi, F; Hofauer, B; Valim, V; Pasoto, S G; Retamozo, S; Atzeni, F; Fonseca-Aizpuru, E; Lopez-Dupla, M; Giacomelli, R; Nakamura, H; Akasbi, M; Thompson, K; Horvath, I Fanny; Farris, A D; Simoncelli, E; Bombardieri, S; Kilic, L; Tufan, A; Pirkmajer, K Perdan; Fujisawa, Y; De Vita, S; Abacar, K; Ramos-Casals, M

Abstract:
Objective To analyse how the key components at the time of diagnosis of the Sjogren's phenotype (epidemiological profile, sicca symptoms, and systemic disease) can be influenced by the potential exposure to climate-related natural hazards. Methods For the present study, the following variables were selected for harmonisation and refinement: age, sex, country, fulfilment of 2002/2016 criteria items, dry eyes, dry mouth, and overall ESSDAI score. Climate-related hazards per country were defined according to the OECD and included seven climate-related hazard types: extreme temperature, extreme precipitation, drought, wildfire, wind threats, river flooding, and coastal flooding. Climatic variables were defined as dichotomous variables according to whether each country is ranked among the ten countries with the most significant exposure. Results After applying data-cleaning techniques and excluding people from countries not included in the OECD climate rankings, the database study analysed 16,042 patients from 23 countries. The disease was diagnosed between 1 and 3 years earlier in people living in countries included among the top 10 worst exposed to extreme precipitation, wildfire, wind threats, river flooding, and coastal flooding. A lower frequency of dry eyes was observed in people living in countries exposed to wind threats, river flooding, and coastal flooding, with a level of statistical association being classified as strong (p