CINXE.COM
(PDF) Air Pollution and Disease Activity in C-SLE
<!DOCTYPE html> <html > <head> <meta charset="utf-8"> <meta rel="search" type="application/opensearchdescription+xml" href="/open_search.xml" title="Academia.edu"> <meta content="width=device-width, initial-scale=1" name="viewport"> <meta name="google-site-verification" content="bKJMBZA7E43xhDOopFZkssMMkBRjvYERV-NaN4R6mrs"> <meta name="csrf-param" content="authenticity_token" /> <meta name="csrf-token" content="RqC2sAUlVvf7PSpmQHDnaugFNBmVbzu5uvWfOIxzWm6Dx4GBzLc9Y_wEbttfXfsV4-Cl9dhRKAOYwbKmdUVKEA" /> <meta name="citation_title" content="Exposure to air pollutants increased disease activity in childhood-onset systemic lupus erythematosus patients" /> <meta name="citation_publication_date" content="2015/01/17" /> <meta name="citation_journal_title" content="Arthritis care &amp; research" /> <meta name="citation_author" content="Alfésio Braga" /> <meta name="twitter:card" content="summary" /> <meta name="twitter:url" content="https://www.academia.edu/82359957/Exposure_to_air_pollutants_increased_disease_activity_in_childhood_onset_systemic_lupus_erythematosus_patients" /> <meta name="twitter:title" content="Exposure to air pollutants increased disease activity in childhood-onset systemic lupus erythematosus patients" /> <meta name="twitter:description" content="To investigate the association between exposure to air pollutants in the São Paulo metropolitan area and disease activity in childhood-onset systemic lupus erythematosus (C-SLE) patients. A longitudinal panel study was carried out based on 409" /> <meta name="twitter:image" content="http://a.academia-assets.com/images/twitter-card.jpeg" /> <meta property="fb:app_id" content="2369844204" /> <meta property="og:type" content="article" /> <meta property="og:url" content="https://www.academia.edu/82359957/Exposure_to_air_pollutants_increased_disease_activity_in_childhood_onset_systemic_lupus_erythematosus_patients" /> <meta property="og:title" content="Exposure to air pollutants increased disease activity in childhood-onset systemic lupus erythematosus patients" /> <meta property="og:image" content="http://a.academia-assets.com/images/open-graph-icons/fb-paper.gif" /> <meta property="og:description" content="To investigate the association between exposure to air pollutants in the São Paulo metropolitan area and disease activity in childhood-onset systemic lupus erythematosus (C-SLE) patients. A longitudinal panel study was carried out based on 409" /> <meta property="article:author" content="https://unisantos.academia.edu/Alf%C3%A9sioBraga" /> <meta name="description" content="To investigate the association between exposure to air pollutants in the São Paulo metropolitan area and disease activity in childhood-onset systemic lupus erythematosus (C-SLE) patients. A longitudinal panel study was carried out based on 409" /> <title>(PDF) Air Pollution and Disease Activity in C-SLE</title> <link rel="canonical" href="https://www.academia.edu/82359957/Exposure_to_air_pollutants_increased_disease_activity_in_childhood_onset_systemic_lupus_erythematosus_patients" /> <script async src="https://www.googletagmanager.com/gtag/js?id=G-5VKX33P2DS"></script> <script> window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'G-5VKX33P2DS', { cookie_domain: 'academia.edu', send_page_view: false, }); gtag('event', 'page_view', { 'controller': "single_work", 'action': "show", 'controller_action': 'single_work#show', 'logged_in': 'false', 'edge': 'unknown', // Send nil if there is no A/B test bucket, in case some records get logged // with missing data - that way we can distinguish between the two cases. // ab_test_bucket should be of the form <ab_test_name>:<bucket> 'ab_test_bucket': null, }) </script> <script> var $controller_name = 'single_work'; var $action_name = "show"; var $rails_env = 'production'; var $app_rev = 'dc2ad41da5d7ea682babd20f90650302fb0a3a36'; var $domain = 'academia.edu'; var $app_host = "academia.edu"; var $asset_host = "academia-assets.com"; var $start_time = new Date().getTime(); var $recaptcha_key = "6LdxlRMTAAAAADnu_zyLhLg0YF9uACwz78shpjJB"; var $recaptcha_invisible_key = "6Lf3KHUUAAAAACggoMpmGJdQDtiyrjVlvGJ6BbAj"; var $disableClientRecordHit = false; </script> <script> window.require = { config: function() { return function() {} } } </script> <script> window.Aedu = window.Aedu || {}; window.Aedu.hit_data = null; window.Aedu.serverRenderTime = new Date(1739709909000); window.Aedu.timeDifference = new Date().getTime() - 1739709909000; </script> <script type="application/ld+json">{"@context":"https://schema.org","@type":"ScholarlyArticle","abstract":"To investigate the association between exposure to air pollutants in the São Paulo metropolitan area and disease activity in childhood-onset systemic lupus erythematosus (C-SLE) patients. A longitudinal panel study was carried out based on 409 consecutive visits of C-SLE patients (ACR criteria) living in the São Paulo metropolitan area. Disease activity was evaluated according to Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), and the patients were divided in two groups: SLEDAI≤8 and SLEDAI\u0026amp;amp;gt;8. Daily concentrations of inhaled particulate matter (PM10 ), sulfur dioxide (SO2 ), nitrogen dioxide (NO2 ), ozone (O3 ) and carbon monoxide (CO) were evaluated on the 31 days preceding the medical visits. A generalized estimation equation (GEE) model was used to assess the impact of these measurements on the SLEDAI-2K score, considering the fixed effects for repetitive measurements. The models were adjusted for erythrocyte sedimentation rate (ESR), corticosteroid use (...","author":[{"@context":"https://schema.org","@type":"Person","name":"Alfésio Braga","url":"https://unisantos.academia.edu/Alf%C3%A9sioBraga"}],"contributor":[],"dateCreated":"2022-06-29","dateModified":"2025-02-01","datePublished":"2015-01-17","headline":"Exposure to air pollutants increased disease activity in childhood-onset systemic lupus erythematosus patients","image":"https://attachments.academia-assets.com/88095432/thumbnails/1.jpg","inLanguage":"en","keywords":["Psychology","Brazil","Adolescent","Medicine","Child","Systemic Lupus Erythematosus","Young Adult","Clinical Sciences","Longitudinal Studies","Particulate Matter","Urban Population","Disease Progression","Environmental Exposure","Air Pollutants"],"publication":"Arthritis care \u0026 research","publisher":{"@context":"https://schema.org","@type":"Organization","name":null},"sourceOrganization":[{"@context":"https://schema.org","@type":"EducationalOrganization","name":"unisantos"}],"thumbnailUrl":"https://attachments.academia-assets.com/88095432/thumbnails/1.jpg","url":"https://www.academia.edu/82359957/Exposure_to_air_pollutants_increased_disease_activity_in_childhood_onset_systemic_lupus_erythematosus_patients"}</script><style type="text/css">@media(max-width: 567px){:root{--token-mode: Rebrand;--dropshadow: 0 2px 4px 0 #22223340;--primary-brand: #0645b1;--error-dark: #b60000;--success-dark: #05b01c;--inactive-fill: #ebebee;--hover: #0c3b8d;--pressed: #082f75;--button-primary-fill-inactive: #ebebee;--button-primary-fill: #0645b1;--button-primary-text: #ffffff;--button-primary-fill-hover: #0c3b8d;--button-primary-fill-press: #082f75;--button-primary-icon: #ffffff;--button-primary-fill-inverse: #ffffff;--button-primary-text-inverse: #082f75;--button-primary-icon-inverse: #0645b1;--button-primary-fill-inverse-hover: #cddaef;--button-primary-stroke-inverse-pressed: #0645b1;--button-secondary-stroke-inactive: #b1b1ba;--button-secondary-fill: #eef2f9;--button-secondary-text: #082f75;--button-secondary-fill-press: #cddaef;--button-secondary-fill-inactive: #ebebee;--button-secondary-stroke: #cddaef;--button-secondary-stroke-hover: #386ac1;--button-secondary-stroke-press: #0645b1;--button-secondary-text-inactive: #b1b1ba;--button-secondary-icon: #082f75;--button-secondary-fill-hover: #e6ecf7;--button-secondary-stroke-inverse: #ffffff;--button-secondary-fill-inverse: rgba(255, 255, 255, 0);--button-secondary-icon-inverse: #ffffff;--button-secondary-icon-hover: #082f75;--button-secondary-icon-press: #082f75;--button-secondary-text-inverse: #ffffff;--button-secondary-text-hover: #082f75;--button-secondary-text-press: #082f75;--button-secondary-fill-inverse-hover: #043059;--button-xs-stroke: #141413;--button-xs-stroke-hover: #0c3b8d;--button-xs-stroke-press: #082f75;--button-xs-stroke-inactive: #ebebee;--button-xs-text: #141413;--button-xs-text-hover: #0c3b8d;--button-xs-text-press: #082f75;--button-xs-text-inactive: #91919e;--button-xs-icon: #141413;--button-xs-icon-hover: #0c3b8d;--button-xs-icon-press: #082f75;--button-xs-icon-inactive: #91919e;--button-xs-fill: #ffffff;--button-xs-fill-hover: #f4f7fc;--button-xs-fill-press: #eef2f9;--buttons-button-text-inactive: #91919e;--buttons-button-focus: #0645b1;--buttons-button-icon-inactive: #91919e;--buttons-small-buttons-corner-radius: 16px;--buttons-small-buttons-l-r-padding: 20px;--buttons-small-buttons-height: 48px;--buttons-small-buttons-gap: 8px;--buttons-small-buttons-icon-only-width: 48px;--buttons-small-buttons-icon-size: 20px;--buttons-small-buttons-stroke-default: 1px;--buttons-small-buttons-stroke-thick: 2px;--buttons-large-buttons-l-r-padding: 32px;--buttons-large-buttons-height: 64px;--buttons-large-buttons-icon-only-width: 64px;--buttons-large-buttons-icon-size: 20px;--buttons-large-buttons-gap: 8px;--buttons-large-buttons-corner-radius: 16px;--buttons-large-buttons-stroke-default: 1px;--buttons-large-buttons-stroke-thick: 2px;--buttons-extra-small-buttons-l-r-padding: 8px;--buttons-extra-small-buttons-height: 32px;--buttons-extra-small-buttons-icon-size: 16px;--buttons-extra-small-buttons-gap: 4px;--buttons-extra-small-buttons-corner-radius: 8px;--buttons-stroke-default: 1px;--buttons-stroke-thick: 2px;--background-beige: #f9f7f4;--error-light: #fff2f2;--text-placeholder: #6d6d7d;--stroke-dark: #141413;--stroke-light: #dddde2;--stroke-medium: #535366;--accent-green: #ccffd4;--accent-turquoise: #ccf7ff;--accent-yellow: #f7ffcc;--accent-peach: #ffd4cc;--accent-violet: #f7ccff;--accent-purple: #f4f7fc;--text-primary: #141413;--secondary-brand: #141413;--text-hover: #0c3b8d;--text-white: #ffffff;--text-link: #0645b1;--text-press: #082f75;--success-light: #f0f8f1;--background-light-blue: #f4f7fc;--background-white: #ffffff;--premium-dark: #877440;--premium-light: #f9f6ed;--stroke-white: #ffffff;--inactive-content: #b1b1ba;--annotate-light: #a35dff;--annotate-dark: #824acc;--grid: #eef2f9;--inactive-stroke: #ebebee;--shadow: rgba(34, 34, 51, 0.25);--text-inactive: #6d6d7d;--text-error: #b60000;--stroke-error: #b60000;--background-error: #fff2f2;--background-black: #141413;--icon-default: #141413;--icon-blue: #0645b1;--background-grey: #dddde2;--icon-grey: #b1b1ba;--text-focus: #082f75;--brand-colors-neutral-black: #141413;--brand-colors-neutral-900: #535366;--brand-colors-neutral-800: #6d6d7d;--brand-colors-neutral-700: #91919e;--brand-colors-neutral-600: #b1b1ba;--brand-colors-neutral-500: #c8c8cf;--brand-colors-neutral-400: #dddde2;--brand-colors-neutral-300: #ebebee;--brand-colors-neutral-200: #f8f8fb;--brand-colors-neutral-100: #fafafa;--brand-colors-neutral-white: #ffffff;--brand-colors-blue-900: #043059;--brand-colors-blue-800: #082f75;--brand-colors-blue-700: #0c3b8d;--brand-colors-blue-600: #0645b1;--brand-colors-blue-500: #386ac1;--brand-colors-blue-400: #cddaef;--brand-colors-blue-300: #e6ecf7;--brand-colors-blue-200: #eef2f9;--brand-colors-blue-100: #f4f7fc;--brand-colors-gold-500: #877440;--brand-colors-gold-400: #e9e3d4;--brand-colors-gold-300: #f2efe8;--brand-colors-gold-200: #f9f6ed;--brand-colors-gold-100: #f9f7f4;--brand-colors-error-900: #920000;--brand-colors-error-500: #b60000;--brand-colors-success-900: #035c0f;--brand-colors-green: #ccffd4;--brand-colors-turquoise: #ccf7ff;--brand-colors-yellow: #f7ffcc;--brand-colors-peach: #ffd4cc;--brand-colors-violet: #f7ccff;--brand-colors-error-100: #fff2f2;--brand-colors-success-500: #05b01c;--brand-colors-success-100: #f0f8f1;--text-secondary: #535366;--icon-white: #ffffff;--background-beige-darker: #f2efe8;--icon-dark-grey: #535366;--type-font-family-sans-serif: DM Sans;--type-font-family-serif: Gupter;--type-font-family-mono: IBM Plex Mono;--type-weights-300: 300;--type-weights-400: 400;--type-weights-500: 500;--type-weights-700: 700;--type-sizes-12: 12px;--type-sizes-14: 14px;--type-sizes-16: 16px;--type-sizes-18: 18px;--type-sizes-20: 20px;--type-sizes-22: 22px;--type-sizes-24: 24px;--type-sizes-28: 28px;--type-sizes-30: 30px;--type-sizes-32: 32px;--type-sizes-40: 40px;--type-sizes-42: 42px;--type-sizes-48-2: 48px;--type-line-heights-16: 16px;--type-line-heights-20: 20px;--type-line-heights-23: 23px;--type-line-heights-24: 24px;--type-line-heights-25: 25px;--type-line-heights-26: 26px;--type-line-heights-29: 29px;--type-line-heights-30: 30px;--type-line-heights-32: 32px;--type-line-heights-34: 34px;--type-line-heights-35: 35px;--type-line-heights-36: 36px;--type-line-heights-38: 38px;--type-line-heights-40: 40px;--type-line-heights-46: 46px;--type-line-heights-48: 48px;--type-line-heights-52: 52px;--type-line-heights-58: 58px;--type-line-heights-68: 68px;--type-line-heights-74: 74px;--type-line-heights-82: 82px;--type-paragraph-spacings-0: 0px;--type-paragraph-spacings-4: 4px;--type-paragraph-spacings-8: 8px;--type-paragraph-spacings-16: 16px;--type-sans-serif-xl-font-weight: 400;--type-sans-serif-xl-size: 32px;--type-sans-serif-xl-line-height: 46px;--type-sans-serif-xl-paragraph-spacing: 16px;--type-sans-serif-lg-font-weight: 400;--type-sans-serif-lg-size: 30px;--type-sans-serif-lg-line-height: 36px;--type-sans-serif-lg-paragraph-spacing: 16px;--type-sans-serif-md-font-weight: 400;--type-sans-serif-md-line-height: 30px;--type-sans-serif-md-paragraph-spacing: 16px;--type-sans-serif-md-size: 24px;--type-sans-serif-xs-font-weight: 700;--type-sans-serif-xs-line-height: 24px;--type-sans-serif-xs-paragraph-spacing: 0px;--type-sans-serif-xs-size: 18px;--type-sans-serif-sm-font-weight: 400;--type-sans-serif-sm-line-height: 32px;--type-sans-serif-sm-paragraph-spacing: 16px;--type-sans-serif-sm-size: 20px;--type-body-xl-font-weight: 400;--type-body-xl-size: 24px;--type-body-xl-line-height: 36px;--type-body-xl-paragraph-spacing: 0px;--type-body-sm-font-weight: 400;--type-body-sm-size: 14px;--type-body-sm-line-height: 20px;--type-body-sm-paragraph-spacing: 8px;--type-body-xs-font-weight: 400;--type-body-xs-size: 12px;--type-body-xs-line-height: 16px;--type-body-xs-paragraph-spacing: 0px;--type-body-md-font-weight: 400;--type-body-md-size: 16px;--type-body-md-line-height: 20px;--type-body-md-paragraph-spacing: 4px;--type-body-lg-font-weight: 400;--type-body-lg-size: 20px;--type-body-lg-line-height: 26px;--type-body-lg-paragraph-spacing: 16px;--type-body-lg-medium-font-weight: 500;--type-body-lg-medium-size: 20px;--type-body-lg-medium-line-height: 32px;--type-body-lg-medium-paragraph-spacing: 16px;--type-body-md-medium-font-weight: 500;--type-body-md-medium-size: 16px;--type-body-md-medium-line-height: 20px;--type-body-md-medium-paragraph-spacing: 4px;--type-body-sm-bold-font-weight: 700;--type-body-sm-bold-size: 14px;--type-body-sm-bold-line-height: 20px;--type-body-sm-bold-paragraph-spacing: 8px;--type-body-sm-medium-font-weight: 500;--type-body-sm-medium-size: 14px;--type-body-sm-medium-line-height: 20px;--type-body-sm-medium-paragraph-spacing: 8px;--type-serif-md-font-weight: 400;--type-serif-md-size: 32px;--type-serif-md-paragraph-spacing: 0px;--type-serif-md-line-height: 40px;--type-serif-sm-font-weight: 400;--type-serif-sm-size: 24px;--type-serif-sm-paragraph-spacing: 0px;--type-serif-sm-line-height: 26px;--type-serif-lg-font-weight: 400;--type-serif-lg-size: 48px;--type-serif-lg-paragraph-spacing: 0px;--type-serif-lg-line-height: 52px;--type-serif-xs-font-weight: 400;--type-serif-xs-size: 18px;--type-serif-xs-line-height: 24px;--type-serif-xs-paragraph-spacing: 0px;--type-serif-xl-font-weight: 400;--type-serif-xl-size: 48px;--type-serif-xl-paragraph-spacing: 0px;--type-serif-xl-line-height: 58px;--type-mono-md-font-weight: 400;--type-mono-md-size: 22px;--type-mono-md-line-height: 24px;--type-mono-md-paragraph-spacing: 0px;--type-mono-lg-font-weight: 400;--type-mono-lg-size: 40px;--type-mono-lg-line-height: 40px;--type-mono-lg-paragraph-spacing: 0px;--type-mono-sm-font-weight: 400;--type-mono-sm-size: 14px;--type-mono-sm-line-height: 24px;--type-mono-sm-paragraph-spacing: 0px;--spacing-xs-4: 4px;--spacing-xs-8: 8px;--spacing-xs-16: 16px;--spacing-sm-24: 24px;--spacing-sm-32: 32px;--spacing-md-40: 40px;--spacing-md-48: 48px;--spacing-lg-64: 64px;--spacing-lg-80: 80px;--spacing-xlg-104: 104px;--spacing-xlg-152: 152px;--spacing-xs-12: 12px;--spacing-page-section: 80px;--spacing-card-list-spacing: 48px;--spacing-text-section-spacing: 64px;--spacing-md-xs-headings: 40px;--corner-radius-radius-lg: 16px;--corner-radius-radius-sm: 4px;--corner-radius-radius-md: 8px;--corner-radius-radius-round: 104px}}@media(min-width: 568px)and (max-width: 1279px){:root{--token-mode: Rebrand;--dropshadow: 0 2px 4px 0 #22223340;--primary-brand: #0645b1;--error-dark: #b60000;--success-dark: #05b01c;--inactive-fill: #ebebee;--hover: #0c3b8d;--pressed: #082f75;--button-primary-fill-inactive: #ebebee;--button-primary-fill: #0645b1;--button-primary-text: #ffffff;--button-primary-fill-hover: #0c3b8d;--button-primary-fill-press: #082f75;--button-primary-icon: #ffffff;--button-primary-fill-inverse: #ffffff;--button-primary-text-inverse: #082f75;--button-primary-icon-inverse: #0645b1;--button-primary-fill-inverse-hover: #cddaef;--button-primary-stroke-inverse-pressed: #0645b1;--button-secondary-stroke-inactive: #b1b1ba;--button-secondary-fill: #eef2f9;--button-secondary-text: #082f75;--button-secondary-fill-press: #cddaef;--button-secondary-fill-inactive: #ebebee;--button-secondary-stroke: #cddaef;--button-secondary-stroke-hover: #386ac1;--button-secondary-stroke-press: #0645b1;--button-secondary-text-inactive: #b1b1ba;--button-secondary-icon: #082f75;--button-secondary-fill-hover: #e6ecf7;--button-secondary-stroke-inverse: #ffffff;--button-secondary-fill-inverse: rgba(255, 255, 255, 0);--button-secondary-icon-inverse: #ffffff;--button-secondary-icon-hover: #082f75;--button-secondary-icon-press: #082f75;--button-secondary-text-inverse: #ffffff;--button-secondary-text-hover: #082f75;--button-secondary-text-press: #082f75;--button-secondary-fill-inverse-hover: #043059;--button-xs-stroke: #141413;--button-xs-stroke-hover: #0c3b8d;--button-xs-stroke-press: #082f75;--button-xs-stroke-inactive: #ebebee;--button-xs-text: #141413;--button-xs-text-hover: #0c3b8d;--button-xs-text-press: #082f75;--button-xs-text-inactive: #91919e;--button-xs-icon: #141413;--button-xs-icon-hover: #0c3b8d;--button-xs-icon-press: #082f75;--button-xs-icon-inactive: #91919e;--button-xs-fill: #ffffff;--button-xs-fill-hover: #f4f7fc;--button-xs-fill-press: #eef2f9;--buttons-button-text-inactive: #91919e;--buttons-button-focus: #0645b1;--buttons-button-icon-inactive: #91919e;--buttons-small-buttons-corner-radius: 16px;--buttons-small-buttons-l-r-padding: 20px;--buttons-small-buttons-height: 48px;--buttons-small-buttons-gap: 8px;--buttons-small-buttons-icon-only-width: 48px;--buttons-small-buttons-icon-size: 20px;--buttons-small-buttons-stroke-default: 1px;--buttons-small-buttons-stroke-thick: 2px;--buttons-large-buttons-l-r-padding: 32px;--buttons-large-buttons-height: 64px;--buttons-large-buttons-icon-only-width: 64px;--buttons-large-buttons-icon-size: 20px;--buttons-large-buttons-gap: 8px;--buttons-large-buttons-corner-radius: 16px;--buttons-large-buttons-stroke-default: 1px;--buttons-large-buttons-stroke-thick: 2px;--buttons-extra-small-buttons-l-r-padding: 8px;--buttons-extra-small-buttons-height: 32px;--buttons-extra-small-buttons-icon-size: 16px;--buttons-extra-small-buttons-gap: 4px;--buttons-extra-small-buttons-corner-radius: 8px;--buttons-stroke-default: 1px;--buttons-stroke-thick: 2px;--background-beige: #f9f7f4;--error-light: #fff2f2;--text-placeholder: #6d6d7d;--stroke-dark: #141413;--stroke-light: #dddde2;--stroke-medium: #535366;--accent-green: #ccffd4;--accent-turquoise: #ccf7ff;--accent-yellow: #f7ffcc;--accent-peach: #ffd4cc;--accent-violet: #f7ccff;--accent-purple: #f4f7fc;--text-primary: #141413;--secondary-brand: #141413;--text-hover: #0c3b8d;--text-white: #ffffff;--text-link: #0645b1;--text-press: #082f75;--success-light: #f0f8f1;--background-light-blue: #f4f7fc;--background-white: #ffffff;--premium-dark: #877440;--premium-light: #f9f6ed;--stroke-white: #ffffff;--inactive-content: #b1b1ba;--annotate-light: #a35dff;--annotate-dark: #824acc;--grid: #eef2f9;--inactive-stroke: #ebebee;--shadow: rgba(34, 34, 51, 0.25);--text-inactive: #6d6d7d;--text-error: #b60000;--stroke-error: #b60000;--background-error: #fff2f2;--background-black: #141413;--icon-default: #141413;--icon-blue: #0645b1;--background-grey: #dddde2;--icon-grey: #b1b1ba;--text-focus: #082f75;--brand-colors-neutral-black: #141413;--brand-colors-neutral-900: #535366;--brand-colors-neutral-800: #6d6d7d;--brand-colors-neutral-700: #91919e;--brand-colors-neutral-600: #b1b1ba;--brand-colors-neutral-500: #c8c8cf;--brand-colors-neutral-400: #dddde2;--brand-colors-neutral-300: #ebebee;--brand-colors-neutral-200: #f8f8fb;--brand-colors-neutral-100: #fafafa;--brand-colors-neutral-white: #ffffff;--brand-colors-blue-900: #043059;--brand-colors-blue-800: #082f75;--brand-colors-blue-700: #0c3b8d;--brand-colors-blue-600: #0645b1;--brand-colors-blue-500: #386ac1;--brand-colors-blue-400: #cddaef;--brand-colors-blue-300: #e6ecf7;--brand-colors-blue-200: #eef2f9;--brand-colors-blue-100: #f4f7fc;--brand-colors-gold-500: #877440;--brand-colors-gold-400: #e9e3d4;--brand-colors-gold-300: #f2efe8;--brand-colors-gold-200: #f9f6ed;--brand-colors-gold-100: #f9f7f4;--brand-colors-error-900: #920000;--brand-colors-error-500: #b60000;--brand-colors-success-900: #035c0f;--brand-colors-green: #ccffd4;--brand-colors-turquoise: #ccf7ff;--brand-colors-yellow: #f7ffcc;--brand-colors-peach: #ffd4cc;--brand-colors-violet: #f7ccff;--brand-colors-error-100: #fff2f2;--brand-colors-success-500: #05b01c;--brand-colors-success-100: #f0f8f1;--text-secondary: #535366;--icon-white: #ffffff;--background-beige-darker: #f2efe8;--icon-dark-grey: #535366;--type-font-family-sans-serif: DM Sans;--type-font-family-serif: Gupter;--type-font-family-mono: IBM Plex Mono;--type-weights-300: 300;--type-weights-400: 400;--type-weights-500: 500;--type-weights-700: 700;--type-sizes-12: 12px;--type-sizes-14: 14px;--type-sizes-16: 16px;--type-sizes-18: 18px;--type-sizes-20: 20px;--type-sizes-22: 22px;--type-sizes-24: 24px;--type-sizes-28: 28px;--type-sizes-30: 30px;--type-sizes-32: 32px;--type-sizes-40: 40px;--type-sizes-42: 42px;--type-sizes-48-2: 48px;--type-line-heights-16: 16px;--type-line-heights-20: 20px;--type-line-heights-23: 23px;--type-line-heights-24: 24px;--type-line-heights-25: 25px;--type-line-heights-26: 26px;--type-line-heights-29: 29px;--type-line-heights-30: 30px;--type-line-heights-32: 32px;--type-line-heights-34: 34px;--type-line-heights-35: 35px;--type-line-heights-36: 36px;--type-line-heights-38: 38px;--type-line-heights-40: 40px;--type-line-heights-46: 46px;--type-line-heights-48: 48px;--type-line-heights-52: 52px;--type-line-heights-58: 58px;--type-line-heights-68: 68px;--type-line-heights-74: 74px;--type-line-heights-82: 82px;--type-paragraph-spacings-0: 0px;--type-paragraph-spacings-4: 4px;--type-paragraph-spacings-8: 8px;--type-paragraph-spacings-16: 16px;--type-sans-serif-xl-font-weight: 400;--type-sans-serif-xl-size: 42px;--type-sans-serif-xl-line-height: 46px;--type-sans-serif-xl-paragraph-spacing: 16px;--type-sans-serif-lg-font-weight: 400;--type-sans-serif-lg-size: 32px;--type-sans-serif-lg-line-height: 36px;--type-sans-serif-lg-paragraph-spacing: 16px;--type-sans-serif-md-font-weight: 400;--type-sans-serif-md-line-height: 34px;--type-sans-serif-md-paragraph-spacing: 16px;--type-sans-serif-md-size: 28px;--type-sans-serif-xs-font-weight: 700;--type-sans-serif-xs-line-height: 25px;--type-sans-serif-xs-paragraph-spacing: 0px;--type-sans-serif-xs-size: 20px;--type-sans-serif-sm-font-weight: 400;--type-sans-serif-sm-line-height: 30px;--type-sans-serif-sm-paragraph-spacing: 16px;--type-sans-serif-sm-size: 24px;--type-body-xl-font-weight: 400;--type-body-xl-size: 24px;--type-body-xl-line-height: 36px;--type-body-xl-paragraph-spacing: 0px;--type-body-sm-font-weight: 400;--type-body-sm-size: 14px;--type-body-sm-line-height: 20px;--type-body-sm-paragraph-spacing: 8px;--type-body-xs-font-weight: 400;--type-body-xs-size: 12px;--type-body-xs-line-height: 16px;--type-body-xs-paragraph-spacing: 0px;--type-body-md-font-weight: 400;--type-body-md-size: 16px;--type-body-md-line-height: 20px;--type-body-md-paragraph-spacing: 4px;--type-body-lg-font-weight: 400;--type-body-lg-size: 20px;--type-body-lg-line-height: 26px;--type-body-lg-paragraph-spacing: 16px;--type-body-lg-medium-font-weight: 500;--type-body-lg-medium-size: 20px;--type-body-lg-medium-line-height: 32px;--type-body-lg-medium-paragraph-spacing: 16px;--type-body-md-medium-font-weight: 500;--type-body-md-medium-size: 16px;--type-body-md-medium-line-height: 20px;--type-body-md-medium-paragraph-spacing: 4px;--type-body-sm-bold-font-weight: 700;--type-body-sm-bold-size: 14px;--type-body-sm-bold-line-height: 20px;--type-body-sm-bold-paragraph-spacing: 8px;--type-body-sm-medium-font-weight: 500;--type-body-sm-medium-size: 14px;--type-body-sm-medium-line-height: 20px;--type-body-sm-medium-paragraph-spacing: 8px;--type-serif-md-font-weight: 400;--type-serif-md-size: 40px;--type-serif-md-paragraph-spacing: 0px;--type-serif-md-line-height: 48px;--type-serif-sm-font-weight: 400;--type-serif-sm-size: 28px;--type-serif-sm-paragraph-spacing: 0px;--type-serif-sm-line-height: 32px;--type-serif-lg-font-weight: 400;--type-serif-lg-size: 58px;--type-serif-lg-paragraph-spacing: 0px;--type-serif-lg-line-height: 68px;--type-serif-xs-font-weight: 400;--type-serif-xs-size: 18px;--type-serif-xs-line-height: 24px;--type-serif-xs-paragraph-spacing: 0px;--type-serif-xl-font-weight: 400;--type-serif-xl-size: 74px;--type-serif-xl-paragraph-spacing: 0px;--type-serif-xl-line-height: 82px;--type-mono-md-font-weight: 400;--type-mono-md-size: 22px;--type-mono-md-line-height: 24px;--type-mono-md-paragraph-spacing: 0px;--type-mono-lg-font-weight: 400;--type-mono-lg-size: 40px;--type-mono-lg-line-height: 40px;--type-mono-lg-paragraph-spacing: 0px;--type-mono-sm-font-weight: 400;--type-mono-sm-size: 14px;--type-mono-sm-line-height: 24px;--type-mono-sm-paragraph-spacing: 0px;--spacing-xs-4: 4px;--spacing-xs-8: 8px;--spacing-xs-16: 16px;--spacing-sm-24: 24px;--spacing-sm-32: 32px;--spacing-md-40: 40px;--spacing-md-48: 48px;--spacing-lg-64: 64px;--spacing-lg-80: 80px;--spacing-xlg-104: 104px;--spacing-xlg-152: 152px;--spacing-xs-12: 12px;--spacing-page-section: 104px;--spacing-card-list-spacing: 48px;--spacing-text-section-spacing: 80px;--spacing-md-xs-headings: 40px;--corner-radius-radius-lg: 16px;--corner-radius-radius-sm: 4px;--corner-radius-radius-md: 8px;--corner-radius-radius-round: 104px}}@media(min-width: 1280px){:root{--token-mode: Rebrand;--dropshadow: 0 2px 4px 0 #22223340;--primary-brand: #0645b1;--error-dark: #b60000;--success-dark: #05b01c;--inactive-fill: #ebebee;--hover: #0c3b8d;--pressed: #082f75;--button-primary-fill-inactive: #ebebee;--button-primary-fill: #0645b1;--button-primary-text: #ffffff;--button-primary-fill-hover: #0c3b8d;--button-primary-fill-press: #082f75;--button-primary-icon: #ffffff;--button-primary-fill-inverse: #ffffff;--button-primary-text-inverse: #082f75;--button-primary-icon-inverse: #0645b1;--button-primary-fill-inverse-hover: #cddaef;--button-primary-stroke-inverse-pressed: #0645b1;--button-secondary-stroke-inactive: #b1b1ba;--button-secondary-fill: #eef2f9;--button-secondary-text: #082f75;--button-secondary-fill-press: #cddaef;--button-secondary-fill-inactive: #ebebee;--button-secondary-stroke: #cddaef;--button-secondary-stroke-hover: #386ac1;--button-secondary-stroke-press: #0645b1;--button-secondary-text-inactive: #b1b1ba;--button-secondary-icon: #082f75;--button-secondary-fill-hover: #e6ecf7;--button-secondary-stroke-inverse: #ffffff;--button-secondary-fill-inverse: rgba(255, 255, 255, 0);--button-secondary-icon-inverse: #ffffff;--button-secondary-icon-hover: #082f75;--button-secondary-icon-press: #082f75;--button-secondary-text-inverse: #ffffff;--button-secondary-text-hover: #082f75;--button-secondary-text-press: #082f75;--button-secondary-fill-inverse-hover: #043059;--button-xs-stroke: #141413;--button-xs-stroke-hover: #0c3b8d;--button-xs-stroke-press: #082f75;--button-xs-stroke-inactive: #ebebee;--button-xs-text: #141413;--button-xs-text-hover: #0c3b8d;--button-xs-text-press: #082f75;--button-xs-text-inactive: #91919e;--button-xs-icon: #141413;--button-xs-icon-hover: #0c3b8d;--button-xs-icon-press: #082f75;--button-xs-icon-inactive: #91919e;--button-xs-fill: #ffffff;--button-xs-fill-hover: #f4f7fc;--button-xs-fill-press: #eef2f9;--buttons-button-text-inactive: #91919e;--buttons-button-focus: #0645b1;--buttons-button-icon-inactive: #91919e;--buttons-small-buttons-corner-radius: 16px;--buttons-small-buttons-l-r-padding: 20px;--buttons-small-buttons-height: 48px;--buttons-small-buttons-gap: 8px;--buttons-small-buttons-icon-only-width: 48px;--buttons-small-buttons-icon-size: 20px;--buttons-small-buttons-stroke-default: 1px;--buttons-small-buttons-stroke-thick: 2px;--buttons-large-buttons-l-r-padding: 32px;--buttons-large-buttons-height: 64px;--buttons-large-buttons-icon-only-width: 64px;--buttons-large-buttons-icon-size: 20px;--buttons-large-buttons-gap: 8px;--buttons-large-buttons-corner-radius: 16px;--buttons-large-buttons-stroke-default: 1px;--buttons-large-buttons-stroke-thick: 2px;--buttons-extra-small-buttons-l-r-padding: 8px;--buttons-extra-small-buttons-height: 32px;--buttons-extra-small-buttons-icon-size: 16px;--buttons-extra-small-buttons-gap: 4px;--buttons-extra-small-buttons-corner-radius: 8px;--buttons-stroke-default: 1px;--buttons-stroke-thick: 2px;--background-beige: #f9f7f4;--error-light: #fff2f2;--text-placeholder: #6d6d7d;--stroke-dark: #141413;--stroke-light: #dddde2;--stroke-medium: #535366;--accent-green: #ccffd4;--accent-turquoise: #ccf7ff;--accent-yellow: #f7ffcc;--accent-peach: #ffd4cc;--accent-violet: #f7ccff;--accent-purple: #f4f7fc;--text-primary: #141413;--secondary-brand: #141413;--text-hover: #0c3b8d;--text-white: #ffffff;--text-link: #0645b1;--text-press: #082f75;--success-light: #f0f8f1;--background-light-blue: #f4f7fc;--background-white: #ffffff;--premium-dark: #877440;--premium-light: #f9f6ed;--stroke-white: #ffffff;--inactive-content: #b1b1ba;--annotate-light: #a35dff;--annotate-dark: #824acc;--grid: #eef2f9;--inactive-stroke: #ebebee;--shadow: rgba(34, 34, 51, 0.25);--text-inactive: #6d6d7d;--text-error: #b60000;--stroke-error: #b60000;--background-error: #fff2f2;--background-black: #141413;--icon-default: #141413;--icon-blue: #0645b1;--background-grey: #dddde2;--icon-grey: #b1b1ba;--text-focus: #082f75;--brand-colors-neutral-black: #141413;--brand-colors-neutral-900: #535366;--brand-colors-neutral-800: #6d6d7d;--brand-colors-neutral-700: #91919e;--brand-colors-neutral-600: #b1b1ba;--brand-colors-neutral-500: #c8c8cf;--brand-colors-neutral-400: #dddde2;--brand-colors-neutral-300: #ebebee;--brand-colors-neutral-200: #f8f8fb;--brand-colors-neutral-100: #fafafa;--brand-colors-neutral-white: #ffffff;--brand-colors-blue-900: #043059;--brand-colors-blue-800: #082f75;--brand-colors-blue-700: #0c3b8d;--brand-colors-blue-600: #0645b1;--brand-colors-blue-500: #386ac1;--brand-colors-blue-400: #cddaef;--brand-colors-blue-300: #e6ecf7;--brand-colors-blue-200: #eef2f9;--brand-colors-blue-100: #f4f7fc;--brand-colors-gold-500: #877440;--brand-colors-gold-400: #e9e3d4;--brand-colors-gold-300: #f2efe8;--brand-colors-gold-200: #f9f6ed;--brand-colors-gold-100: #f9f7f4;--brand-colors-error-900: #920000;--brand-colors-error-500: #b60000;--brand-colors-success-900: #035c0f;--brand-colors-green: #ccffd4;--brand-colors-turquoise: #ccf7ff;--brand-colors-yellow: #f7ffcc;--brand-colors-peach: #ffd4cc;--brand-colors-violet: #f7ccff;--brand-colors-error-100: #fff2f2;--brand-colors-success-500: #05b01c;--brand-colors-success-100: #f0f8f1;--text-secondary: #535366;--icon-white: #ffffff;--background-beige-darker: #f2efe8;--icon-dark-grey: #535366;--type-font-family-sans-serif: DM Sans;--type-font-family-serif: Gupter;--type-font-family-mono: IBM Plex Mono;--type-weights-300: 300;--type-weights-400: 400;--type-weights-500: 500;--type-weights-700: 700;--type-sizes-12: 12px;--type-sizes-14: 14px;--type-sizes-16: 16px;--type-sizes-18: 18px;--type-sizes-20: 20px;--type-sizes-22: 22px;--type-sizes-24: 24px;--type-sizes-28: 28px;--type-sizes-30: 30px;--type-sizes-32: 32px;--type-sizes-40: 40px;--type-sizes-42: 42px;--type-sizes-48-2: 48px;--type-line-heights-16: 16px;--type-line-heights-20: 20px;--type-line-heights-23: 23px;--type-line-heights-24: 24px;--type-line-heights-25: 25px;--type-line-heights-26: 26px;--type-line-heights-29: 29px;--type-line-heights-30: 30px;--type-line-heights-32: 32px;--type-line-heights-34: 34px;--type-line-heights-35: 35px;--type-line-heights-36: 36px;--type-line-heights-38: 38px;--type-line-heights-40: 40px;--type-line-heights-46: 46px;--type-line-heights-48: 48px;--type-line-heights-52: 52px;--type-line-heights-58: 58px;--type-line-heights-68: 68px;--type-line-heights-74: 74px;--type-line-heights-82: 82px;--type-paragraph-spacings-0: 0px;--type-paragraph-spacings-4: 4px;--type-paragraph-spacings-8: 8px;--type-paragraph-spacings-16: 16px;--type-sans-serif-xl-font-weight: 400;--type-sans-serif-xl-size: 42px;--type-sans-serif-xl-line-height: 46px;--type-sans-serif-xl-paragraph-spacing: 16px;--type-sans-serif-lg-font-weight: 400;--type-sans-serif-lg-size: 32px;--type-sans-serif-lg-line-height: 38px;--type-sans-serif-lg-paragraph-spacing: 16px;--type-sans-serif-md-font-weight: 400;--type-sans-serif-md-line-height: 34px;--type-sans-serif-md-paragraph-spacing: 16px;--type-sans-serif-md-size: 28px;--type-sans-serif-xs-font-weight: 700;--type-sans-serif-xs-line-height: 25px;--type-sans-serif-xs-paragraph-spacing: 0px;--type-sans-serif-xs-size: 20px;--type-sans-serif-sm-font-weight: 400;--type-sans-serif-sm-line-height: 30px;--type-sans-serif-sm-paragraph-spacing: 16px;--type-sans-serif-sm-size: 24px;--type-body-xl-font-weight: 400;--type-body-xl-size: 24px;--type-body-xl-line-height: 36px;--type-body-xl-paragraph-spacing: 0px;--type-body-sm-font-weight: 400;--type-body-sm-size: 14px;--type-body-sm-line-height: 20px;--type-body-sm-paragraph-spacing: 8px;--type-body-xs-font-weight: 400;--type-body-xs-size: 12px;--type-body-xs-line-height: 16px;--type-body-xs-paragraph-spacing: 0px;--type-body-md-font-weight: 400;--type-body-md-size: 16px;--type-body-md-line-height: 20px;--type-body-md-paragraph-spacing: 4px;--type-body-lg-font-weight: 400;--type-body-lg-size: 20px;--type-body-lg-line-height: 26px;--type-body-lg-paragraph-spacing: 16px;--type-body-lg-medium-font-weight: 500;--type-body-lg-medium-size: 20px;--type-body-lg-medium-line-height: 32px;--type-body-lg-medium-paragraph-spacing: 16px;--type-body-md-medium-font-weight: 500;--type-body-md-medium-size: 16px;--type-body-md-medium-line-height: 20px;--type-body-md-medium-paragraph-spacing: 4px;--type-body-sm-bold-font-weight: 700;--type-body-sm-bold-size: 14px;--type-body-sm-bold-line-height: 20px;--type-body-sm-bold-paragraph-spacing: 8px;--type-body-sm-medium-font-weight: 500;--type-body-sm-medium-size: 14px;--type-body-sm-medium-line-height: 20px;--type-body-sm-medium-paragraph-spacing: 8px;--type-serif-md-font-weight: 400;--type-serif-md-size: 40px;--type-serif-md-paragraph-spacing: 0px;--type-serif-md-line-height: 48px;--type-serif-sm-font-weight: 400;--type-serif-sm-size: 28px;--type-serif-sm-paragraph-spacing: 0px;--type-serif-sm-line-height: 32px;--type-serif-lg-font-weight: 400;--type-serif-lg-size: 58px;--type-serif-lg-paragraph-spacing: 0px;--type-serif-lg-line-height: 68px;--type-serif-xs-font-weight: 400;--type-serif-xs-size: 18px;--type-serif-xs-line-height: 24px;--type-serif-xs-paragraph-spacing: 0px;--type-serif-xl-font-weight: 400;--type-serif-xl-size: 74px;--type-serif-xl-paragraph-spacing: 0px;--type-serif-xl-line-height: 82px;--type-mono-md-font-weight: 400;--type-mono-md-size: 22px;--type-mono-md-line-height: 24px;--type-mono-md-paragraph-spacing: 0px;--type-mono-lg-font-weight: 400;--type-mono-lg-size: 40px;--type-mono-lg-line-height: 40px;--type-mono-lg-paragraph-spacing: 0px;--type-mono-sm-font-weight: 400;--type-mono-sm-size: 14px;--type-mono-sm-line-height: 24px;--type-mono-sm-paragraph-spacing: 0px;--spacing-xs-4: 4px;--spacing-xs-8: 8px;--spacing-xs-16: 16px;--spacing-sm-24: 24px;--spacing-sm-32: 32px;--spacing-md-40: 40px;--spacing-md-48: 48px;--spacing-lg-64: 64px;--spacing-lg-80: 80px;--spacing-xlg-104: 104px;--spacing-xlg-152: 152px;--spacing-xs-12: 12px;--spacing-page-section: 152px;--spacing-card-list-spacing: 48px;--spacing-text-section-spacing: 80px;--spacing-md-xs-headings: 40px;--corner-radius-radius-lg: 16px;--corner-radius-radius-sm: 4px;--corner-radius-radius-md: 8px;--corner-radius-radius-round: 104px}}</style><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/single_work_page/loswp-f29774c14b4e629cbb4375c919ad1c2b2891ac825d0a410ea6339ae17e481a55.css" /><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/design_system/body-170d1319f0e354621e81ca17054bb147da2856ec0702fe440a99af314a6338c5.css" /><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/design_system/button-bfbac2a470372e2f3a6661a65fa7ff0a0fbf7aa32534d9a831d683d2a6f9e01b.css" /><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/design_system/text_button-d1941ab08e91e29ee143084c4749da4aaffa350a2ac6eec2306b1d7a352d911a.css" /><link crossorigin="" href="https://fonts.gstatic.com/" rel="preconnect" /><link href="https://fonts.googleapis.com/css2?family=DM+Sans:ital,opsz,wght@0,9..40,100..1000;1,9..40,100..1000&family=Gupter:wght@400;500;700&family=IBM+Plex+Mono:wght@300;400&family=Material+Symbols+Outlined:opsz,wght,FILL,GRAD@20,400,0,0&display=swap" rel="stylesheet" /> </head> <body> <div id='react-modal'></div> <div class="js-upgrade-ie-banner" style="display: none; text-align: center; padding: 8px 0; background-color: #ebe480;"><p style="color: #000; font-size: 12px; margin: 0 0 4px;">Academia.edu no longer supports Internet Explorer.</p><p style="color: #000; font-size: 12px; margin: 0;">To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to <a href="https://www.academia.edu/upgrade-browser">upgrade your browser</a>.</p></div><script>// Show this banner for all versions of IE if (!!window.MSInputMethodContext || /(MSIE)/.test(navigator.userAgent)) { document.querySelector('.js-upgrade-ie-banner').style.display = 'block'; }</script> <div class="bootstrap login"><div class="modal fade login-modal" id="login-modal"><div class="login-modal-dialog modal-dialog"><div class="modal-content"><div class="modal-header"><button class="close close" data-dismiss="modal" type="button"><span aria-hidden="true">×</span><span class="sr-only">Close</span></button><h4 class="modal-title text-center"><strong>Log In</strong></h4></div><div class="modal-body"><div class="row"><div class="col-xs-10 col-xs-offset-1"><button class="btn btn-fb btn-lg btn-block btn-v-center-content" id="login-facebook-oauth-button"><svg style="float: left; width: 19px; line-height: 1em; margin-right: .3em;" aria-hidden="true" focusable="false" data-prefix="fab" data-icon="facebook-square" class="svg-inline--fa fa-facebook-square fa-w-14" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 448 512"><path fill="currentColor" d="M400 32H48A48 48 0 0 0 0 80v352a48 48 0 0 0 48 48h137.25V327.69h-63V256h63v-54.64c0-62.15 37-96.48 93.67-96.48 27.14 0 55.52 4.84 55.52 4.84v61h-31.27c-30.81 0-40.42 19.12-40.42 38.73V256h68.78l-11 71.69h-57.78V480H400a48 48 0 0 0 48-48V80a48 48 0 0 0-48-48z"></path></svg><small><strong>Log in</strong> with <strong>Facebook</strong></small></button><br /><button class="btn btn-google btn-lg btn-block btn-v-center-content" id="login-google-oauth-button"><svg style="float: left; width: 22px; line-height: 1em; margin-right: .3em;" aria-hidden="true" focusable="false" data-prefix="fab" data-icon="google-plus" class="svg-inline--fa fa-google-plus fa-w-16" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512"><path fill="currentColor" d="M256,8C119.1,8,8,119.1,8,256S119.1,504,256,504,504,392.9,504,256,392.9,8,256,8ZM185.3,380a124,124,0,0,1,0-248c31.3,0,60.1,11,83,32.3l-33.6,32.6c-13.2-12.9-31.3-19.1-49.4-19.1-42.9,0-77.2,35.5-77.2,78.1S142.3,334,185.3,334c32.6,0,64.9-19.1,70.1-53.3H185.3V238.1H302.2a109.2,109.2,0,0,1,1.9,20.7c0,70.8-47.5,121.2-118.8,121.2ZM415.5,273.8v35.5H380V273.8H344.5V238.3H380V202.8h35.5v35.5h35.2v35.5Z"></path></svg><small><strong>Log in</strong> with <strong>Google</strong></small></button><br /><style type="text/css">.sign-in-with-apple-button { width: 100%; height: 52px; border-radius: 3px; border: 1px solid black; cursor: pointer; } .sign-in-with-apple-button > div { margin: 0 auto; / This centers the Apple-rendered button horizontally }</style><script src="https://appleid.cdn-apple.com/appleauth/static/jsapi/appleid/1/en_US/appleid.auth.js" type="text/javascript"></script><div class="sign-in-with-apple-button" data-border="false" data-color="white" id="appleid-signin"><span ="Sign Up with Apple" class="u-fs11"></span></div><script>AppleID.auth.init({ clientId: 'edu.academia.applesignon', scope: 'name email', redirectURI: 'https://www.academia.edu/sessions', state: "81b130fd5c90227604f280a9b1dfac07c28f7813d664e378ed2ababf30855d94", });</script><script>// Hacky way of checking if on fast loswp if (window.loswp == null) { (function() { const Google = window?.Aedu?.Auth?.OauthButton?.Login?.Google; const Facebook = window?.Aedu?.Auth?.OauthButton?.Login?.Facebook; if (Google) { new Google({ el: '#login-google-oauth-button', rememberMeCheckboxId: 'remember_me', track: null }); } if (Facebook) { new Facebook({ el: '#login-facebook-oauth-button', rememberMeCheckboxId: 'remember_me', track: null }); } })(); }</script></div></div></div><div class="modal-body"><div class="row"><div class="col-xs-10 col-xs-offset-1"><div class="hr-heading login-hr-heading"><span class="hr-heading-text">or</span></div></div></div></div><div class="modal-body"><div class="row"><div class="col-xs-10 col-xs-offset-1"><form class="js-login-form" action="https://www.academia.edu/sessions" accept-charset="UTF-8" method="post"><input type="hidden" name="authenticity_token" value="izldv4i4TCWyN_65H_y9niCfHDHkTq61i8hG_A9-_FNOXmqOQSonsbUOugQA0aHhK3qN3alwvQ-p_Gti9kjsLQ" autocomplete="off" /><div class="form-group"><label class="control-label" for="login-modal-email-input" style="font-size: 14px;">Email</label><input class="form-control" id="login-modal-email-input" name="login" type="email" /></div><div class="form-group"><label class="control-label" for="login-modal-password-input" style="font-size: 14px;">Password</label><input class="form-control" id="login-modal-password-input" name="password" type="password" /></div><input type="hidden" name="post_login_redirect_url" id="post_login_redirect_url" value="https://www.academia.edu/82359957/Exposure_to_air_pollutants_increased_disease_activity_in_childhood_onset_systemic_lupus_erythematosus_patients" autocomplete="off" /><div class="checkbox"><label><input type="checkbox" name="remember_me" id="remember_me" value="1" checked="checked" /><small style="font-size: 12px; margin-top: 2px; display: inline-block;">Remember me on this computer</small></label></div><br><input type="submit" name="commit" value="Log In" class="btn btn-primary btn-block btn-lg js-login-submit" data-disable-with="Log In" /></br></form><script>typeof window?.Aedu?.recaptchaManagedForm === 'function' && window.Aedu.recaptchaManagedForm( document.querySelector('.js-login-form'), document.querySelector('.js-login-submit') );</script><small style="font-size: 12px;"><br />or <a data-target="#login-modal-reset-password-container" data-toggle="collapse" href="javascript:void(0)">reset password</a></small><div class="collapse" id="login-modal-reset-password-container"><br /><div class="well margin-0x"><form class="js-password-reset-form" action="https://www.academia.edu/reset_password" accept-charset="UTF-8" method="post"><input type="hidden" name="authenticity_token" value="-bDa1fHUtedPhScrYAFpHWrUHGTxjPZo2rM7GuzWBww81-3kOEbec0i8Y5Z_LHViYTGNiLyy5dL4hxaEFeAXcg" autocomplete="off" /><p>Enter the email address you signed up with and we'll email you a reset link.</p><div class="form-group"><input class="form-control" name="email" type="email" /></div><input class="btn btn-primary btn-block g-recaptcha js-password-reset-submit" data-sitekey="6Lf3KHUUAAAAACggoMpmGJdQDtiyrjVlvGJ6BbAj" type="submit" value="Email me a link" /></form></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/collapse-45805421cf446ca5adf7aaa1935b08a3a8d1d9a6cc5d91a62a2a3a00b20b3e6a.js"], function() { // from javascript_helper.rb $("#login-modal-reset-password-container").on("shown.bs.collapse", function() { $(this).find("input[type=email]").focus(); }); }); </script> </div></div></div><div class="modal-footer"><div class="text-center"><small style="font-size: 12px;">Need an account? <a rel="nofollow" href="https://www.academia.edu/signup">Click here to sign up</a></small></div></div></div></div></div></div><script>// If we are on subdomain or non-bootstrapped page, redirect to login page instead of showing modal (function(){ if (typeof $ === 'undefined') return; var host = window.location.hostname; if ((host === $domain || host === "www."+$domain) && (typeof $().modal === 'function')) { $("#nav_log_in").click(function(e) { // Don't follow the link and open the modal e.preventDefault(); $("#login-modal").on('shown.bs.modal', function() { $(this).find("#login-modal-email-input").focus() }).modal('show'); }); } })()</script> <div id="fb-root"></div><script>window.fbAsyncInit = function() { FB.init({ appId: "2369844204", version: "v8.0", status: true, cookie: true, xfbml: true }); // Additional initialization code. if (window.InitFacebook) { // facebook.ts already loaded, set it up. window.InitFacebook(); } else { // Set a flag for facebook.ts to find when it loads. window.academiaAuthReadyFacebook = true; } };</script> <div id="google-root"></div><script>window.loadGoogle = function() { if (window.InitGoogle) { // google.ts already loaded, set it up. window.InitGoogle("331998490334-rsn3chp12mbkiqhl6e7lu2q0mlbu0f1b"); } else { // Set a flag for google.ts to use when it loads. window.GoogleClientID = "331998490334-rsn3chp12mbkiqhl6e7lu2q0mlbu0f1b"; } };</script> <div class="header--container" id="main-header-container"><div class="header--inner-container header--inner-container-ds2"><div class="header-ds2--left-wrapper"><div class="header-ds2--left-wrapper-inner"><a data-main-header-link-target="logo_home" href="https://www.academia.edu/"><img class="hide-on-desktop-redesign" style="height: 24px; width: 24px;" alt="Academia.edu" src="//a.academia-assets.com/images/academia-logo-redesign-2015-A.svg" width="24" height="24" /><img width="145.2" height="18" class="hide-on-mobile-redesign" style="height: 24px;" alt="Academia.edu" src="//a.academia-assets.com/images/academia-logo-redesign-2015.svg" /></a><div class="header--search-container header--search-container-ds2"><form class="js-SiteSearch-form select2-no-default-pills" action="https://www.academia.edu/search" accept-charset="UTF-8" method="get"><svg style="width: 14px; height: 14px;" aria-hidden="true" focusable="false" data-prefix="fas" data-icon="search" class="header--search-icon svg-inline--fa fa-search fa-w-16" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512"><path fill="currentColor" d="M505 442.7L405.3 343c-4.5-4.5-10.6-7-17-7H372c27.6-35.3 44-79.7 44-128C416 93.1 322.9 0 208 0S0 93.1 0 208s93.1 208 208 208c48.3 0 92.7-16.4 128-44v16.3c0 6.4 2.5 12.5 7 17l99.7 99.7c9.4 9.4 24.6 9.4 33.9 0l28.3-28.3c9.4-9.4 9.4-24.6.1-34zM208 336c-70.7 0-128-57.2-128-128 0-70.7 57.2-128 128-128 70.7 0 128 57.2 128 128 0 70.7-57.2 128-128 128z"></path></svg><input class="header--search-input header--search-input-ds2 js-SiteSearch-form-input" data-main-header-click-target="search_input" name="q" placeholder="Search" type="text" /></form></div></div></div><nav class="header--nav-buttons header--nav-buttons-ds2 js-main-nav"><button class="ds2-5-button ds2-5-button--secondary js-header-login-url header-button-ds2 header-login-ds2 hide-on-mobile-redesign react-login-modal-opener" data-signup-modal="{"location":"login-button--header"}" rel="nofollow">Log In</button><button class="ds2-5-button ds2-5-button--secondary header-button-ds2 hide-on-mobile-redesign react-login-modal-opener" data-signup-modal="{"location":"signup-button--header"}" rel="nofollow">Sign Up</button><button class="header--hamburger-button header--hamburger-button-ds2 hide-on-desktop-redesign js-header-hamburger-button"><div class="icon-bar"></div><div class="icon-bar" style="margin-top: 4px;"></div><div class="icon-bar" style="margin-top: 4px;"></div></button></nav></div><ul class="header--dropdown-container js-header-dropdown"><li class="header--dropdown-row"><a class="header--dropdown-link" href="https://www.academia.edu/login" rel="nofollow">Log In</a></li><li class="header--dropdown-row"><a class="header--dropdown-link" href="https://www.academia.edu/signup" rel="nofollow">Sign Up</a></li><li class="header--dropdown-row js-header-dropdown-expand-button"><button class="header--dropdown-button">more<svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="caret-down" class="header--dropdown-button-icon svg-inline--fa fa-caret-down fa-w-10" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 320 512"><path fill="currentColor" d="M31.3 192h257.3c17.8 0 26.7 21.5 14.1 34.1L174.1 354.8c-7.8 7.8-20.5 7.8-28.3 0L17.2 226.1C4.6 213.5 13.5 192 31.3 192z"></path></svg></button></li><li><ul class="header--expanded-dropdown-container"><li class="header--dropdown-row"><a class="header--dropdown-link" href="https://www.academia.edu/about">About</a></li><li class="header--dropdown-row"><a class="header--dropdown-link" href="https://www.academia.edu/press">Press</a></li><li class="header--dropdown-row"><a class="header--dropdown-link" href="https://www.academia.edu/documents">Papers</a></li><li class="header--dropdown-row"><a class="header--dropdown-link" href="https://www.academia.edu/terms">Terms</a></li><li class="header--dropdown-row"><a class="header--dropdown-link" href="https://www.academia.edu/privacy">Privacy</a></li><li class="header--dropdown-row"><a class="header--dropdown-link" href="https://www.academia.edu/copyright">Copyright</a></li><li class="header--dropdown-row"><a class="header--dropdown-link" href="https://www.academia.edu/hiring"><svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="briefcase" class="header--dropdown-row-icon svg-inline--fa fa-briefcase fa-w-16" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512"><path fill="currentColor" d="M320 336c0 8.84-7.16 16-16 16h-96c-8.84 0-16-7.16-16-16v-48H0v144c0 25.6 22.4 48 48 48h416c25.6 0 48-22.4 48-48V288H320v48zm144-208h-80V80c0-25.6-22.4-48-48-48H176c-25.6 0-48 22.4-48 48v48H48c-25.6 0-48 22.4-48 48v80h512v-80c0-25.6-22.4-48-48-48zm-144 0H192V96h128v32z"></path></svg>We're Hiring!</a></li><li class="header--dropdown-row"><a class="header--dropdown-link" href="https://support.academia.edu/hc/en-us"><svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="question-circle" class="header--dropdown-row-icon svg-inline--fa fa-question-circle fa-w-16" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512"><path fill="currentColor" d="M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zM262.655 90c-54.497 0-89.255 22.957-116.549 63.758-3.536 5.286-2.353 12.415 2.715 16.258l34.699 26.31c5.205 3.947 12.621 3.008 16.665-2.122 17.864-22.658 30.113-35.797 57.303-35.797 20.429 0 45.698 13.148 45.698 32.958 0 14.976-12.363 22.667-32.534 33.976C247.128 238.528 216 254.941 216 296v4c0 6.627 5.373 12 12 12h56c6.627 0 12-5.373 12-12v-1.333c0-28.462 83.186-29.647 83.186-106.667 0-58.002-60.165-102-116.531-102zM256 338c-25.365 0-46 20.635-46 46 0 25.364 20.635 46 46 46s46-20.636 46-46c0-25.365-20.635-46-46-46z"></path></svg>Help Center</a></li><li class="header--dropdown-row js-header-dropdown-collapse-button"><button class="header--dropdown-button">less<svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="caret-up" class="header--dropdown-button-icon svg-inline--fa fa-caret-up fa-w-10" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 320 512"><path fill="currentColor" d="M288.662 352H31.338c-17.818 0-26.741-21.543-14.142-34.142l128.662-128.662c7.81-7.81 20.474-7.81 28.284 0l128.662 128.662c12.6 12.599 3.676 34.142-14.142 34.142z"></path></svg></button></li></ul></li></ul></div> <script src="//a.academia-assets.com/assets/webpack_bundles/fast_loswp-bundle-e5ca05062a7092a8f6f5af11f70589210af26f6a0030f102b0b21b22451b9d41.js" defer="defer"></script><script>window.loswp = {}; window.loswp.author = 10438406; window.loswp.bulkDownloadFilterCounts = {}; window.loswp.hasDownloadableAttachment = true; window.loswp.hasViewableAttachments = true; // TODO: just use routes for this window.loswp.loginUrl = "https://www.academia.edu/login?post_login_redirect_url=https%3A%2F%2Fwww.academia.edu%2F82359957%2FExposure_to_air_pollutants_increased_disease_activity_in_childhood_onset_systemic_lupus_erythematosus_patients%3Fauto%3Ddownload"; window.loswp.translateUrl = "https://www.academia.edu/login?post_login_redirect_url=https%3A%2F%2Fwww.academia.edu%2F82359957%2FExposure_to_air_pollutants_increased_disease_activity_in_childhood_onset_systemic_lupus_erythematosus_patients%3Fshow_translation%3Dtrue"; window.loswp.previewableAttachments = [{"id":88095432,"identifier":"Attachment_88095432","shouldShowBulkDownload":false}]; window.loswp.shouldDetectTimezone = true; window.loswp.shouldShowBulkDownload = true; window.loswp.showSignupCaptcha = false window.loswp.willEdgeCache = false; window.loswp.work = {"work":{"id":82359957,"created_at":"2022-06-29T09:55:26.457-07:00","from_world_paper_id":209490766,"updated_at":"2025-02-01T16:01:30.476-08:00","_data":{"abstract":"To investigate the association between exposure to air pollutants in the São Paulo metropolitan area and disease activity in childhood-onset systemic lupus erythematosus (C-SLE) patients. A longitudinal panel study was carried out based on 409 consecutive visits of C-SLE patients (ACR criteria) living in the São Paulo metropolitan area. Disease activity was evaluated according to Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), and the patients were divided in two groups: SLEDAI≤8 and SLEDAI\u0026gt;8. Daily concentrations of inhaled particulate matter (PM10 ), sulfur dioxide (SO2 ), nitrogen dioxide (NO2 ), ozone (O3 ) and carbon monoxide (CO) were evaluated on the 31 days preceding the medical visits. A generalized estimation equation (GEE) model was used to assess the impact of these measurements on the SLEDAI-2K score, considering the fixed effects for repetitive measurements. The models were adjusted for erythrocyte sedimentation rate (ESR), corticosteroid use (...","ai_title_tag":"Air Pollution and Disease Activity in C-SLE","publication_date":"2015,1,17","publication_name":"Arthritis care \u0026 research"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"en","title":"Exposure to air pollutants increased disease activity in childhood-onset systemic lupus erythematosus patients","broadcastable":false,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [10438406]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "control"; window.loswp.useOptimizedScribd4genScript = false; window.loginModal = {}; window.loginModal.appleClientId = 'edu.academia.applesignon'; window.userInChina = "false";</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":88095432,"attachmentType":"pdf"}"><img alt="First page of “Exposure to air pollutants increased disease activity in childhood-onset systemic lupus erythematosus patients”" class="ds-work-cover--cover-thumbnail" src="https://0.academia-photos.com/attachment_thumbnails/88095432/mini_magick20220629-14630-17w99x0.png?1656530176" /><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/images/single_work_splash/adobe_icon.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">Exposure to air pollutants increased disease activity in childhood-onset systemic lupus erythematosus patients</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="10438406" href="https://unisantos.academia.edu/Alf%C3%A9sioBraga"><img alt="Profile image of Alfésio Braga" class="ds-work-card--author-avatar" src="//a.academia-assets.com/images/s65_no_pic.png" />Alfésio Braga</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">2015, Arthritis care & research</p><div class="ds-work-card--work-metadata"><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">visibility</span><p class="ds2-5-body-sm" id="work-metadata-view-count">…</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">description</span><p class="ds2-5-body-sm">6 pages</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">link</span><p class="ds2-5-body-sm">1 file</p></div></div><script>(async () => { const workId = 82359957; const worksViewsPath = "/v0/works/views?subdomain_param=api&work_ids%5B%5D=82359957"; const getWorkViews = async (workId) => { const response = await fetch(worksViewsPath); if (!response.ok) { throw new Error('Failed to load work views'); } const data = await response.json(); return data.views[workId]; }; // Get the view count for the work - we send this immediately rather than waiting for // the DOM to load, so it can be available as soon as possible (but without holding up // the backend or other resource requests, because it's a bit expensive and not critical). const viewCount = await getWorkViews(workId); const updateViewCount = (viewCount) => { try { const viewCountNumber = parseInt(viewCount, 10); if (viewCountNumber === 0) { // Remove the whole views element if there are zero views. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); return; } const commaizedViewCount = viewCountNumber.toLocaleString(); const viewCountBody = document.getElementById('work-metadata-view-count'); if (!viewCountBody) { throw new Error('Failed to find work views element'); } viewCountBody.textContent = `${commaizedViewCount} views`; } catch (error) { // Remove the whole views element if there was some issue parsing. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); throw new Error(`Failed to parse view count: ${viewCount}`, error); } }; // If the DOM is still loading, wait for it to be ready before updating the view count. if (document.readyState === "loading") { document.addEventListener('DOMContentLoaded', () => { updateViewCount(viewCount); }); // Otherwise, just update it immediately. } else { updateViewCount(viewCount); } })();</script></div><p class="ds-work-card--work-abstract ds-work-card--detail ds2-5-body-md">To investigate the association between exposure to air pollutants in the São Paulo metropolitan area and disease activity in childhood-onset systemic lupus erythematosus (C-SLE) patients. A longitudinal panel study was carried out based on 409 consecutive visits of C-SLE patients (ACR criteria) living in the São Paulo metropolitan area. Disease activity was evaluated according to Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), and the patients were divided in two groups: SLEDAI≤8 and SLEDAI&gt;8. Daily concentrations of inhaled particulate matter (PM10 ), sulfur dioxide (SO2 ), nitrogen dioxide (NO2 ), ozone (O3 ) and carbon monoxide (CO) were evaluated on the 31 days preceding the medical visits. A generalized estimation equation (GEE) model was used to assess the impact of these measurements on the SLEDAI-2K score, considering the fixed effects for repetitive measurements. The models were adjusted for erythrocyte sedimentation rate (ESR), corticosteroid use (...</p><div class="ds-work-card--button-container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--work-card","attachmentId":88095432,"attachmentType":"pdf","workUrl":"https://www.academia.edu/82359957/Exposure_to_air_pollutants_increased_disease_activity_in_childhood_onset_systemic_lupus_erythematosus_patients"}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--work-card","attachmentId":88095432,"attachmentType":"pdf","workUrl":"https://www.academia.edu/82359957/Exposure_to_air_pollutants_increased_disease_activity_in_childhood_onset_systemic_lupus_erythematosus_patients"}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div><div class="ds-signup-banner-trigger-container"><div class="ds-signup-banner-trigger ds-signup-banner-trigger-premium-marketing"></div></div><div class="ds-signup-banner ds-signup-banner-premium-marketing"><div id="ds-signup-banner-close-button"><button class="ds2-5-button ds2-5-button--secondary ds2-5-button--inverse"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">close</span></button></div><div class="premium-banner-content"><div class="left"><img src="//a.academia-assets.com/images/academia-logo-capital-white.svg" /><span>Get access to the world's latest research</span></div><div class="right"><div class="card free"><div class="header">Free</div><div class="feature-list"><div class="feature"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">check</span><span>Download one paper at a time</span></div><div class="feature"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">check</span><span>Save papers to bookmarks</span></div><div class="feature"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">check</span><span>Basic search</span></div></div><button class="ds2-5-button ds2-5-button--secondary ds2-5-button--small ds2-5-button--inverse ds2-5-button--full-width js-swp-download-button" data-signup-modal="{"location":"premium-banner-desktop-free"}">Sign up for free</button></div><div class="card premium"><div class="pill">Recommended</div><div class="header premium">Premium</div><div class="feature-list"><div class="feature"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">check</span><span>Get highly curated PDF packages</span></div><div class="feature"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">check</span><span>Track your impact with Mentions</span></div><div class="feature"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">check</span><span>Access advanced search filters</span></div><div class="feature"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">check</span><span>Support Academia’s mission</span></div><div class="feature"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">check</span><span>Create your personal website</span></div></div><button class="ds2-5-button ds2-5-button--small ds2-5-button--inverse ds2-5-button--full-width js-swp-download-button" data-signup-modal="{"location":"premium-banner-desktop-upgrade","submitText":"Try Premium for $1"}">Try Premium for $1</button></div></div></div></div><script>(() => { // Set up signup banner show/hide behavior: // 1. If the signup banner trigger (a 242px-high* invisible div underneath the 'See Full PDF' / 'Download PDF' buttons) // is already fully scrolled above the viewport, show the banner by default // 2. If the signup banner trigger is fully visible, show the banner // 3. If the signup banner trigger has even a few pixels scrolled below the viewport, hide the banner // // * 242px is the empirically determined height of the signup banner. It's better to be a bit taller than // necessary than too short, so it's fine that the mobile (small breakpoint) banner is shorter. // First check session storage for the signup banner's visibility state const signupBannerHidden = sessionStorage.getItem('ds-signup-banner-hidden'); if (signupBannerHidden === 'true') { return; } const signupBanner = document.querySelector('.ds-signup-banner'); const signupBannerTrigger = document.querySelector('.ds-signup-banner-trigger'); if (!signupBannerTrigger) { window.Sentry.captureMessage("Signup banner trigger not found"); return; } let footerShown = false; window.addEventListener('load', () => { const rect = signupBannerTrigger.getBoundingClientRect(); // If page loaded up already scrolled below the trigger (via scroll restoration), show the banner by default if (rect.bottom < 0) { footerShown = true; signupBanner.classList.add('ds-signup-banner-visible'); } }); // Wait for trigger to fully enter viewport before showing banner (ensures PDF CTAs are never covered by banner) const observer = new IntersectionObserver((entries) => { entries.forEach(entry => { if (entry.isIntersecting && !footerShown) { footerShown = true; signupBanner.classList.add('ds-signup-banner-visible'); } else if (!entry.isIntersecting && footerShown) { if (signupBannerTrigger.getBoundingClientRect().bottom > 0) { footerShown = false; signupBanner.classList.remove('ds-signup-banner-visible'); } } }); }); observer.observe(signupBannerTrigger); // Set up signup banner close button event handler: const signupBannerCloseButton = document.querySelector('#ds-signup-banner-close-button'); signupBannerCloseButton.addEventListener('click', () => { signupBanner.classList.remove('ds-signup-banner-visible'); observer.unobserve(signupBannerTrigger); // Store the signup banner's visibility state in session storage sessionStorage.setItem('ds-signup-banner-hidden', 'true'); }); })();</script></div></div></div><div data-auto_select="false" data-client_id="331998490334-rsn3chp12mbkiqhl6e7lu2q0mlbu0f1b" data-doc_id="88095432" data-landing_url="https://www.academia.edu/82359957/Exposure_to_air_pollutants_increased_disease_activity_in_childhood_onset_systemic_lupus_erythematosus_patients" data-login_uri="https://www.academia.edu/registrations/google_one_tap" data-moment_callback="onGoogleOneTapEvent" id="g_id_onload"></div><div class="ds-top-related-works--grid-container"><div class="ds-related-content--container ds-top-related-works--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="0" data-entity-id="87660404" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/87660404/Is_air_pollution_affecting_the_disease_activity_in_patients_with_systemic_lupus_erythematosus_State_of_the_art_and_a_systematic_literature_review">Is air pollution affecting the disease activity in patients with systemic lupus erythematosus? State of the art and a systematic literature review</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="8207712" href="https://iuc.academia.edu/DarioPadovan">Dario Padovan</a></div><p class="ds-related-work--metadata ds2-5-body-xs">European Journal of Rheumatology, 2020</p><p class="ds-related-work--abstract ds2-5-body-sm">Objective: It has been documented that several major components of air pollution, including trace elements and polycyclic aromatic hydrocarbons, are associated with the prevalence of systemic lupus erythematosus (SLE). However, the impact of air pollution on the SLE disease activity is still elusive. In this paper, we review the current evidence investigating the link between air pollution, especially when measured as PM2.5, and SLE severity and activity. Methods: A detailed literature search was applied a priori to the Ovid MEDLINE In-Process and Other Non-Indexed Citation 1986 to present. Presented abstracts from the European League Against Rheumatism and American College of Rheumatology (ACR)/Association for Rheumatology Health Professionals (ARHP) Annual Meetings (2011-2018) were also screened. Results: Out of a total of 1354 papers retrieved from search and references list for detailed evaluation, data from 652 patients with SLE from three studies were analyzed. Two studies had an observational longitudinal design, counting for 348 patients with a follow-up of 24 months and 79 months. Retrieved studies differed for disease activity assessment and air pollution quantifications. Conclusion: Current evidence suggests that variations in air pollution may influence the disease activity in patients with SLE. However, the sample size, methodological biases, and differences across the studies make further research mandatory. Understanding the increased burden of SLE and its complications, not only from a medical, but also from a socio-demographic perspective, including an exposure to pollutants, should have implications for resource allocation and access to subspecialty care.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Is air pollution affecting the disease activity in patients with systemic lupus erythematosus? State of the art and a systematic literature review","attachmentId":91809840,"attachmentType":"pdf","work_url":"https://www.academia.edu/87660404/Is_air_pollution_affecting_the_disease_activity_in_patients_with_systemic_lupus_erythematosus_State_of_the_art_and_a_systematic_literature_review","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/87660404/Is_air_pollution_affecting_the_disease_activity_in_patients_with_systemic_lupus_erythematosus_State_of_the_art_and_a_systematic_literature_review"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="1" data-entity-id="55747353" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/55747353/Associations_between_Ambient_Fine_Particulate_Levels_and_Disease_Activity_in_Patients_with_Systemic_Lupus_Erythematosus_SLE_">Associations between Ambient Fine Particulate Levels and Disease Activity in Patients with Systemic Lupus Erythematosus (SLE)</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="41045808" href="https://independent.academia.edu/MulhollandJames">James Mulholland</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Environmental Health Perspectives, 2010</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Associations between Ambient Fine Particulate Levels and Disease Activity in Patients with Systemic Lupus Erythematosus (SLE)","attachmentId":71471736,"attachmentType":"pdf","work_url":"https://www.academia.edu/55747353/Associations_between_Ambient_Fine_Particulate_Levels_and_Disease_Activity_in_Patients_with_Systemic_Lupus_Erythematosus_SLE_","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/55747353/Associations_between_Ambient_Fine_Particulate_Levels_and_Disease_Activity_in_Patients_with_Systemic_Lupus_Erythematosus_SLE_"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="82359867" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/82359867/Are_prematurity_and_environmental_factors_determinants_for_developing_childhood_onset_systemic_lupus_erythematosus">Are prematurity and environmental factors determinants for developing childhood-onset systemic lupus erythematosus?</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="10438406" href="https://unisantos.academia.edu/Alf%C3%A9sioBraga">Alfésio Braga</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Modern rheumatology, 2017</p><p class="ds-related-work--abstract ds2-5-body-sm">The objective of this study is to evaluate the influence of exposure to air pollutants and inhalable environmental elements during pregnancy and after birth until childhood-onset systemic lupus erythematosus(cSLE) diagnosis. This case-control study comprised 30 cSLE patients and 86 healthy controls living in the Sao Paulo metropolitan area. A structured and reliable questionnaire (kappa index for test-retest was 0.78) assessed demographic data, gestational and perinatal-related-factors, and exposure to inhalable elements during pregnancy and after birth (occupational exposure to inhalable particles and/or volatile vapor, and/or tobacco, as well as, the presence of industrial activities or gas stations near the home/work/daycare/school). Tropospheric pollutants included: particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3) and carbon monoxide (CO). The median current age was similar between cSLE patients and healthy controls [16.0 (5-21) versus 15.0 (4-...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Are prematurity and environmental factors determinants for developing childhood-onset systemic lupus erythematosus?","attachmentId":88095392,"attachmentType":"pdf","work_url":"https://www.academia.edu/82359867/Are_prematurity_and_environmental_factors_determinants_for_developing_childhood_onset_systemic_lupus_erythematosus","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/82359867/Are_prematurity_and_environmental_factors_determinants_for_developing_childhood_onset_systemic_lupus_erythematosus"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="3" data-entity-id="112275290" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/112275290/FRI0656_ENVIRONMENTAL_and_Atmospheric_Factors_in_Systemic_Lupus_Erythematosus_A_Regression_Analysis">FRI0656 ENVIRONMENTAL and Atmospheric Factors in Systemic Lupus Erythematosus: A Regression Analysis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="6913164" href="https://independent.academia.edu/antonkvit">anton kvit</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Epidemiology, risk factors for disease or disease progression, 2019</p><p class="ds-related-work--abstract ds2-5-body-sm">and 31 patients. Patients with incident RA in 2000-09 had markedly lower cumulative incidence of any CVD events than patients diagnosed in 1990s and 1980s (Figure). Hazard ratios (HR) for any CVD events demonstrated significant reduction in CVD events among patients with incident RA in 2000s compared with incident RA in 1980s (HR: 0.52; 95% confidence interval (CI): 0.32-0.86) and a reduction approaching significance compared with incident RA in 1990s (HR: 0.65; 95% CI: 0.40-1.05). Patients with incident RA in 2000s were compared with 405 patients without RA in 2000s who experienced 30 CVD events during follow-up. Patients with incident RA in 2000s had no excess in CVD events over subjects without RA (HR: 0.88, 95% CI: 0.53-1.46). Results were similar for MI, stroke and CHD deaths when examined separately.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"FRI0656 ENVIRONMENTAL and Atmospheric Factors in Systemic Lupus Erythematosus: A Regression Analysis","attachmentId":109555410,"attachmentType":"pdf","work_url":"https://www.academia.edu/112275290/FRI0656_ENVIRONMENTAL_and_Atmospheric_Factors_in_Systemic_Lupus_Erythematosus_A_Regression_Analysis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/112275290/FRI0656_ENVIRONMENTAL_and_Atmospheric_Factors_in_Systemic_Lupus_Erythematosus_A_Regression_Analysis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="4" data-entity-id="125811247" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/125811247/Environmental_exposures_and_the_development_of_systemic_lupus_erythematosus">Environmental exposures and the development of systemic lupus erythematosus</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33441417" href="https://independent.academia.edu/KarenCostenbader">Karen Costenbader</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Current Opinion in Rheumatology, 2016</p><p class="ds-related-work--abstract ds2-5-body-sm">Purpose of Review-This review examines evidence relating environmental factors to the development of systemic lupus erythematosus (SLE). Recent findings-The strongest epidemiologic evidence exists for the associations of silica, cigarette smoking, oral contraceptives, postmenopausal hormone therapy, and endometriosis, with SLE incidence. Recent studies have also provided robust evidence of the association between alcohol consumption and decreased SLE risk. There are preliminary, conflicting or unsubstantiated data that other factors, including air pollution, ultraviolet light, infections, vaccinations, solvents, pesticides, and heavy metals such as mercury, are related to SLE risk. Biologic mechanisms linking environmental exposures and SLE risk include increased oxidative stress, systemic inflammation and inflammatory cytokine upregulation, and hormonal triggers, as well as epigenetic modifications resulting from exposure that could lead to SLE. Summary-Identifying the environmental risk factors related to risk of SLE is essential as it will lead to increased understanding of pathogenesis of this complex disease and will also make risk factor modification possible for those at increased risk.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Environmental exposures and the development of systemic lupus erythematosus","attachmentId":119786479,"attachmentType":"pdf","work_url":"https://www.academia.edu/125811247/Environmental_exposures_and_the_development_of_systemic_lupus_erythematosus","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/125811247/Environmental_exposures_and_the_development_of_systemic_lupus_erythematosus"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="88587150" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/88587150/Understanding_the_role_of_environmental_factors_in_the_development_of_systemic_lupus_erythematosus">Understanding the role of environmental factors in the development of systemic lupus erythematosus</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33441417" href="https://independent.academia.edu/KarenCostenbader">Karen Costenbader</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Best Practice &amp; Research Clinical Rheumatology, 2017</p><p class="ds-related-work--abstract ds2-5-body-sm">Systemic lupus erythematosus (SLE) is a multisystem disease with a complex etiology. Risk is higher among women, racial and ethnic minorities, and individuals with a family history of SLE or related autoimmune diseases. It is thought that genetic factors interact with environmental exposures throughout the lifespan to influence susceptibility to developing SLE. The strongest epidemiologic evidence exists for increased risk of SLE associated with exposure to crystalline silica, current cigarette smoking, use of oral contraceptives and postmenopausal hormone replacement therapy, while there is an inverse association with alcohol use. Emerging research results suggest possible associations of SLE risk with exposure to solvents, residential and agricultural pesticides, heavy metals, and air pollution. Ultraviolet light, certain infections, and vaccinations have also been hypothesized to be related to SLE risk. Mechanisms linking environmental exposures and SLE include epigenetic modifications resulting from exposures, and increased oxidative stress, systemic inflammation and inflammatory cytokine upregulation, and hormonal effects. Research needs to include new studies of environmental risk factors for SLE generally, with a focus on lifetime exposure assessment, and studies in susceptible subgroups, such as family members or based on genetic risk profiles, or in individuals with evidence of pre-clinical autoimmunity based on detection of specific auto-antibodies. Understanding the role of</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Understanding the role of environmental factors in the development of systemic lupus erythematosus","attachmentId":92531856,"attachmentType":"pdf","work_url":"https://www.academia.edu/88587150/Understanding_the_role_of_environmental_factors_in_the_development_of_systemic_lupus_erythematosus","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/88587150/Understanding_the_role_of_environmental_factors_in_the_development_of_systemic_lupus_erythematosus"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="6" data-entity-id="20708794" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/20708794/Occupational_and_environmental_exposures_as_risk_factors_for_systemic_lupus_erythematosus">Occupational and environmental exposures as risk factors for systemic lupus erythematosus</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="42009732" href="https://independent.academia.edu/ChristineParks">Christine Parks</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Current Rheumatology Reports, 2004</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Occupational and environmental exposures as risk factors for systemic lupus erythematosus","attachmentId":41931320,"attachmentType":"pdf","work_url":"https://www.academia.edu/20708794/Occupational_and_environmental_exposures_as_risk_factors_for_systemic_lupus_erythematosus","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/20708794/Occupational_and_environmental_exposures_as_risk_factors_for_systemic_lupus_erythematosus"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="7" data-entity-id="68251034" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/68251034/Environmental_Pollutants_and_Odds_of_Hospitalization_for_Asthma_in_Children_S%C3%A3o_Jos%C3%A9_Dos_Campos_Brazil_in_the_Years_2004_2005">Environmental Pollutants and Odds of Hospitalization for Asthma in Children-São José Dos Campos , Brazil , in the Years 2004-2005</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="181331818" href="https://independent.academia.edu/Camilaamancio">Camila amancio</a></div><p class="ds-related-work--metadata ds2-5-body-xs">2012</p><p class="ds-related-work--abstract ds2-5-body-sm">Objective: to estimate the association between exposure to air pollutants and hospital admissions for asthma. Methods: this is an ecological study of time series, which included individuals from 0 to10 years living in Sao Jose dos Campos, for the period 2004 to 2005.Data of hospitalizations for asthma were obtained from DATASUS. The data of ambient levels of particulate matter, sulfur dioxideand ozone were obtained from the Company of Technology of Environmental Sanitation (CETESB) and temperature and humidity from the Foundation for Science, Technology and Space Applications(FUNCATE). Lag models have been made from 0 to 7 days and analyzed by binary logistic regression,yielding odds ratios and their confidence intervals of 95% by SPSS 15.0. Results: there were 809admissions, ranging from 0 to 7. It was possible to identify an association of the particulate matterboth on the same day of exposure and the next third, fifth and sixth days with the admissions; sulfurdioxide was associat...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Environmental Pollutants and Odds of Hospitalization for Asthma in Children-São José Dos Campos , Brazil , in the Years 2004-2005","attachmentId":78794020,"attachmentType":"pdf","work_url":"https://www.academia.edu/68251034/Environmental_Pollutants_and_Odds_of_Hospitalization_for_Asthma_in_Children_S%C3%A3o_Jos%C3%A9_Dos_Campos_Brazil_in_the_Years_2004_2005","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/68251034/Environmental_Pollutants_and_Odds_of_Hospitalization_for_Asthma_in_Children_S%C3%A3o_Jos%C3%A9_Dos_Campos_Brazil_in_the_Years_2004_2005"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="8" data-entity-id="126063866" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/126063866/Long_term_exposure_to_fine_particulate_matter_and_ozone_and_the_onset_of_systemic_autoimmune_rheumatic_diseases_an_open_cohort_study_in_Quebec_Canada">Long-term exposure to fine particulate matter and ozone and the onset of systemic autoimmune rheumatic diseases: an open cohort study in Quebec, Canada</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="31997236" href="https://independent.academia.edu/SoniaJean">Sonia Jean</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Arthritis Research & Therapy, 2022</p><p class="ds-related-work--abstract ds2-5-body-sm">Objectives: To estimate associations between fine particulate matter (PM 2.5) and ozone and the onset of systemic autoimmune rheumatic diseases (SARDs). Methods: An open cohort of over 6 million adults was constructed from provincial physician billing and hospitalization records between 2000 and 2013. We defined incident SARD cases (SLE, Sjogren's syndrome, scleroderma, polymyositis, dermatomyositis, polyarteritis nodosa and related conditions, polymyalgia rheumatic, other necrotizing vasculopathies, and undifferentiated connective tissue disease) based on at least two relevant billing diagnostic codes (within 2 years, with at least 1 billing from a rheumatologist), or at least one relevant hospitalization diagnostic code. Estimated PM 2.5 and ozone concentrations (derived from remote sensing and/or chemical transport models) were assigned to subjects based on residential postal codes, updated throughout follow-up. Cox proportional hazards models with annual exposure levels were used to calculate hazard ratios (HRs) for SARDs incidence, adjusting for sex, age, urban-versus-rural residence, and socioeconomic status. Results: The adjusted HR for SARDS related to one interquartile range increase in PM 2.5 (3.97 µg/m 3) was 1.12 (95% confidence interval 1.08-1.15), but there was no clear association with ozone. Indirectly controlling for smoking did not alter the findings. Conclusions: We found associations between SARDs incidence and PM 2.5 , but no relationships with ozone. Additional studies are needed to better understand interplays between the many constituents of air pollution and rheumatic diseases.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Long-term exposure to fine particulate matter and ozone and the onset of systemic autoimmune rheumatic diseases: an open cohort study in Quebec, Canada","attachmentId":119998470,"attachmentType":"pdf","work_url":"https://www.academia.edu/126063866/Long_term_exposure_to_fine_particulate_matter_and_ozone_and_the_onset_of_systemic_autoimmune_rheumatic_diseases_an_open_cohort_study_in_Quebec_Canada","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/126063866/Long_term_exposure_to_fine_particulate_matter_and_ozone_and_the_onset_of_systemic_autoimmune_rheumatic_diseases_an_open_cohort_study_in_Quebec_Canada"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="9" data-entity-id="13392854" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/13392854/Atmospheric_pollution_and_the_prevalence_of_asthma_study_among_schoolchildren_of_2_areas_in_Rio_de_Janeiro_Brazil">Atmospheric pollution and the prevalence of asthma: study among schoolchildren of 2 areas in Rio de Janeiro, Brazil</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="32617371" href="https://independent.academia.edu/AlfeuFran%C3%A7a">Alfeu França</a><span>, </span><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="61468820" href="https://ufrj.academia.edu/ClemaxSantAnna">Clemax Sant'Anna</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Annals of Allergy, Asthma & Immunology, 2004</p><p class="ds-related-work--abstract ds2-5-body-sm">Background: Air pollutants have been associated with the exacerbation of respiratory diseases. They may intensify the inflammatory allergic response and airways reactivity to inhaled allergens. However, it is still not clear if air pollution contributes to the increased prevalence of asthma.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Atmospheric pollution and the prevalence of asthma: study among schoolchildren of 2 areas in Rio de Janeiro, Brazil","attachmentId":45392401,"attachmentType":"pdf","work_url":"https://www.academia.edu/13392854/Atmospheric_pollution_and_the_prevalence_of_asthma_study_among_schoolchildren_of_2_areas_in_Rio_de_Janeiro_Brazil","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/13392854/Atmospheric_pollution_and_the_prevalence_of_asthma_study_among_schoolchildren_of_2_areas_in_Rio_de_Janeiro_Brazil"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div></div><div class="ds-sticky-ctas--wrapper js-loswp-sticky-ctas hidden"><div class="ds-sticky-ctas--grid-container"><div class="ds-sticky-ctas--container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--sticky-ctas","attachmentId":88095432,"attachmentType":"pdf","workUrl":null}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--sticky-ctas","attachmentId":88095432,"attachmentType":"pdf","workUrl":null}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div><div class="ds-below-fold--grid-container"><div class="ds-work--container js-loswp-embedded-document"><div class="attachment_preview" data-attachment="Attachment_88095432" style="display: none"><div class="js-scribd-document-container"><div class="scribd--document-loading js-scribd-document-loader" style="display: block;"><img alt="Loading..." src="//a.academia-assets.com/images/loaders/paper-load.gif" /><p>Loading Preview</p></div></div><div style="text-align: center;"><div class="scribd--no-preview-alert js-preview-unavailable"><p>Sorry, preview is currently unavailable. You can download the paper by clicking the button above.</p></div></div></div></div><div class="ds-sidebar--container js-work-sidebar"><div class="ds-related-content--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="0" data-entity-id="21603143" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/21603143/Elevated_risk_of_chronic_obstructive_pulmonary_disease_in_systemic_lupus_erythematosus_a_population_based_study">Elevated risk of chronic obstructive pulmonary disease in systemic lupus erythematosus: a population-based study</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="42738772" href="https://independent.academia.edu/AntonioAvi%C3%B1aZubieta">Antonio Aviña-Zubieta</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Arthritis Research & Therapy, 2014</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Elevated risk of chronic obstructive pulmonary disease in systemic lupus erythematosus: a population-based study","attachmentId":42162960,"attachmentType":"pdf","work_url":"https://www.academia.edu/21603143/Elevated_risk_of_chronic_obstructive_pulmonary_disease_in_systemic_lupus_erythematosus_a_population_based_study","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/21603143/Elevated_risk_of_chronic_obstructive_pulmonary_disease_in_systemic_lupus_erythematosus_a_population_based_study"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="1" data-entity-id="41567514" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/41567514/Influence_of_Ambient_Air_Pollution_on_Rheumatoid_Arthritis_Disease_Activity_Score_Index_Kuwait_Registry_for_Rheumatic_Diseases_KRRD_Group_Members">Influence of Ambient Air Pollution on Rheumatoid Arthritis Disease Activity Score Index † Kuwait Registry for Rheumatic Diseases (KRRD) Group Members</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="141352827" href="https://strathclyde.academia.edu/AhmadAlsaber">Ahmad Alsaber</a></div><p class="ds-related-work--metadata ds2-5-body-xs">2020</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Influence of Ambient Air Pollution on Rheumatoid Arthritis Disease Activity Score Index † Kuwait Registry for Rheumatic Diseases (KRRD) Group Members","attachmentId":61723909,"attachmentType":"pdf","work_url":"https://www.academia.edu/41567514/Influence_of_Ambient_Air_Pollution_on_Rheumatoid_Arthritis_Disease_Activity_Score_Index_Kuwait_Registry_for_Rheumatic_Diseases_KRRD_Group_Members","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/41567514/Influence_of_Ambient_Air_Pollution_on_Rheumatoid_Arthritis_Disease_Activity_Score_Index_Kuwait_Registry_for_Rheumatic_Diseases_KRRD_Group_Members"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="2" data-entity-id="14679425" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/14679425/Increased_Risk_of_Chronic_Obstructive_Pulmonary_Disease_in_Patients_with_Systemic_Lupus_Erythematosus_A_Population_Based_Cohort_Study">Increased Risk of Chronic Obstructive Pulmonary Disease in Patients with Systemic Lupus Erythematosus: A Population-Based Cohort Study</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33627045" href="https://cmu-tw.academia.edu/ChuenmingShih">Chuen-ming Shih</a></div><p class="ds-related-work--metadata ds2-5-body-xs">PLoS ONE, 2014</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Increased Risk of Chronic Obstructive Pulmonary Disease in Patients with Systemic Lupus Erythematosus: A Population-Based Cohort Study","attachmentId":43983754,"attachmentType":"pdf","work_url":"https://www.academia.edu/14679425/Increased_Risk_of_Chronic_Obstructive_Pulmonary_Disease_in_Patients_with_Systemic_Lupus_Erythematosus_A_Population_Based_Cohort_Study","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/14679425/Increased_Risk_of_Chronic_Obstructive_Pulmonary_Disease_in_Patients_with_Systemic_Lupus_Erythematosus_A_Population_Based_Cohort_Study"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="3" data-entity-id="50544597" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/50544597/Sole_D_Camelo_Nunes_IC_Wandalsen_GF_et_al_Prevalence_of_symptoms_of_asthma_rhinitis_and_atopic_eczema_in_Brazilian_adolescents_related_to_exposure_to_gaseous_air_pollutants_and_socioeconomic_status_J_Investig_Allergol_Clin_Immunol_17_6_13">Sole D, Camelo-Nunes IC, Wandalsen GF et al.Prevalence of symptoms of asthma, rhinitis, and atopic eczema in Brazilian adolescents related to exposure to gaseous air pollutants and socioeconomic status. J Investig Allergol Clin Immunol 17:6-13</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="22190891" href="https://independent.academia.edu/ANTONIOCARLOSPastorino">ANTONIO CARLOS Pastorino</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Sole D, Camelo-Nunes IC, Wandalsen GF et al.Prevalence of symptoms of asthma, rhinitis, and atopic eczema in Brazilian adolescents related to exposure to gaseous air pollutants and socioeconomic status. J Investig Allergol Clin Immunol 17:6-13","attachmentId":68485827,"attachmentType":"pdf","work_url":"https://www.academia.edu/50544597/Sole_D_Camelo_Nunes_IC_Wandalsen_GF_et_al_Prevalence_of_symptoms_of_asthma_rhinitis_and_atopic_eczema_in_Brazilian_adolescents_related_to_exposure_to_gaseous_air_pollutants_and_socioeconomic_status_J_Investig_Allergol_Clin_Immunol_17_6_13","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/50544597/Sole_D_Camelo_Nunes_IC_Wandalsen_GF_et_al_Prevalence_of_symptoms_of_asthma_rhinitis_and_atopic_eczema_in_Brazilian_adolescents_related_to_exposure_to_gaseous_air_pollutants_and_socioeconomic_status_J_Investig_Allergol_Clin_Immunol_17_6_13"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="4" data-entity-id="29415990" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/29415990/Long_term_exposure_to_background_air_pollution_related_to_respiratory_and_allergic_health_in_schoolchildren">Long-term exposure to background air pollution related to respiratory and allergic health in schoolchildren</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="38629837" href="https://independent.academia.edu/DenisCaillaud">Denis Caillaud</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Clinical <html_ent glyph="@amp;" ascii="&amp;"/> Experimental Allergy, 2005</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Long-term exposure to background air pollution related to respiratory and allergic health in schoolchildren","attachmentId":49859623,"attachmentType":"pdf","work_url":"https://www.academia.edu/29415990/Long_term_exposure_to_background_air_pollution_related_to_respiratory_and_allergic_health_in_schoolchildren","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/29415990/Long_term_exposure_to_background_air_pollution_related_to_respiratory_and_allergic_health_in_schoolchildren"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="5" data-entity-id="50544616" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/50544616/Prevalence_of_symptoms_of_asthma_rhinitis_and_atopic_eczema_in_Brazilian_adolescents_related_to_exposure_to_gaseous_air_pollutants_and_socioeconomic_status">Prevalence of symptoms of asthma, rhinitis, and atopic eczema in Brazilian adolescents related to exposure to gaseous air pollutants and socioeconomic status</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="22190891" href="https://independent.academia.edu/ANTONIOCARLOSPastorino">ANTONIO CARLOS Pastorino</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Investigational Allergology Clinical Immunology Official Organ of the International Association of Asthmology and Sociedad Latinoamericana De Alergia E Inmunologia, 2007</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Prevalence of symptoms of asthma, rhinitis, and atopic eczema in Brazilian adolescents related to exposure to gaseous air pollutants and socioeconomic status","attachmentId":68485784,"attachmentType":"pdf","work_url":"https://www.academia.edu/50544616/Prevalence_of_symptoms_of_asthma_rhinitis_and_atopic_eczema_in_Brazilian_adolescents_related_to_exposure_to_gaseous_air_pollutants_and_socioeconomic_status","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/50544616/Prevalence_of_symptoms_of_asthma_rhinitis_and_atopic_eczema_in_Brazilian_adolescents_related_to_exposure_to_gaseous_air_pollutants_and_socioeconomic_status"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="6" data-entity-id="50584124" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/50584124/Asthma_and_ambient_pollutants_a_time_series_study">Asthma and ambient pollutants: a time series study</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="181331818" href="https://independent.academia.edu/Camilaamancio">Camila amancio</a></div><p class="ds-related-work--metadata ds2-5-body-xs">2012</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Asthma and ambient pollutants: a time series study","attachmentId":68510843,"attachmentType":"pdf","work_url":"https://www.academia.edu/50584124/Asthma_and_ambient_pollutants_a_time_series_study","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/50584124/Asthma_and_ambient_pollutants_a_time_series_study"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="7" data-entity-id="57281873" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/57281873/THU0012_Elevated_Risk_of_Chronic_Obstructive_Pulmonary_Disease_in_Systemic_Lupus_Erythematosus_A_Population_Based_Study">THU0012 Elevated Risk of Chronic Obstructive Pulmonary Disease in Systemic Lupus Erythematosus: A Population-Based Study</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="42769050" href="https://independent.academia.edu/MarkoYurkovich">Marko Yurkovich</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Annals of the Rheumatic Diseases, 2014</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"THU0012 Elevated Risk of Chronic Obstructive Pulmonary Disease in Systemic Lupus Erythematosus: A Population-Based Study","attachmentId":72257389,"attachmentType":"pdf","work_url":"https://www.academia.edu/57281873/THU0012_Elevated_Risk_of_Chronic_Obstructive_Pulmonary_Disease_in_Systemic_Lupus_Erythematosus_A_Population_Based_Study","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/57281873/THU0012_Elevated_Risk_of_Chronic_Obstructive_Pulmonary_Disease_in_Systemic_Lupus_Erythematosus_A_Population_Based_Study"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="8" data-entity-id="113983338" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/113983338/Effects_of_exposure_to_air_pollutants_on_childrens_health_in_Cuiab%C3%A1_Mato_Grosso_State_Brazil">Effects of exposure to air pollutants on children's health in Cuiabá, Mato Grosso State, Brazil</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="293642191" href="https://independent.academia.edu/AdrianBlancoMachin">Adrian Blanco Machin</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Cadernos De Saude Publica, 2018</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Effects of exposure to air pollutants on children's health in Cuiabá, Mato Grosso State, Brazil","attachmentId":110802346,"attachmentType":"pdf","work_url":"https://www.academia.edu/113983338/Effects_of_exposure_to_air_pollutants_on_childrens_health_in_Cuiab%C3%A1_Mato_Grosso_State_Brazil","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/113983338/Effects_of_exposure_to_air_pollutants_on_childrens_health_in_Cuiab%C3%A1_Mato_Grosso_State_Brazil"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="9" data-entity-id="16367902" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/16367902/Air_pollution_and_respiratory_illness_in_children_in_S%C3%A3o_Paulo_Brazil">Air pollution and respiratory illness in children in São Paulo Brazil</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="35498300" href="https://independent.academia.edu/CHINANLIN">CHIN AN LIN</a></div><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Air pollution and respiratory illness in children in São Paulo Brazil","attachmentId":38965603,"attachmentType":"pdf","work_url":"https://www.academia.edu/16367902/Air_pollution_and_respiratory_illness_in_children_in_S%C3%A3o_Paulo_Brazil","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/16367902/Air_pollution_and_respiratory_illness_in_children_in_S%C3%A3o_Paulo_Brazil"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="10" data-entity-id="56529190" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/56529190/Poluentes_Ambientais_e_Chance_De_Interna%C3%A7%C3%B5es_Por_Asma_Em_Crian%C3%A7as_S%C3%A3o_Jos%C3%A9_Dos_Campos_Brasil_Nos_Anos_2004_2005_Environmental_Pollutants_and_Odds_of_Hospitalization_for_Asthma_in_Children_Sao_Jose_Dos_Campos_Brazil_in_the_Years_2004_2005">Poluentes Ambientais e Chance De Internações Por Asma Em Crianças-São José Dos Campos, Brasil, Nos Anos 2004-2005 Environmental Pollutants and Odds of Hospitalization for Asthma in Children-Sao Jose Dos Campos, Brazil, in the Years 2004-2005</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="181331818" href="https://independent.academia.edu/Camilaamancio">Camila amancio</a></div><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Poluentes Ambientais e Chance De Internações Por Asma Em Crianças-São José Dos Campos, Brasil, Nos Anos 2004-2005 Environmental Pollutants and Odds of Hospitalization for Asthma in Children-Sao Jose Dos Campos, Brazil, in the Years 2004-2005","attachmentId":71871882,"attachmentType":"pdf","work_url":"https://www.academia.edu/56529190/Poluentes_Ambientais_e_Chance_De_Interna%C3%A7%C3%B5es_Por_Asma_Em_Crian%C3%A7as_S%C3%A3o_Jos%C3%A9_Dos_Campos_Brasil_Nos_Anos_2004_2005_Environmental_Pollutants_and_Odds_of_Hospitalization_for_Asthma_in_Children_Sao_Jose_Dos_Campos_Brazil_in_the_Years_2004_2005","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/56529190/Poluentes_Ambientais_e_Chance_De_Interna%C3%A7%C3%B5es_Por_Asma_Em_Crian%C3%A7as_S%C3%A3o_Jos%C3%A9_Dos_Campos_Brasil_Nos_Anos_2004_2005_Environmental_Pollutants_and_Odds_of_Hospitalization_for_Asthma_in_Children_Sao_Jose_Dos_Campos_Brazil_in_the_Years_2004_2005"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="11" data-entity-id="30808060" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/30808060/Health_effects_of_air_pollution_exposure_on_children_and_adolescents_in_S_o_Paulo_Brazil">Health effects of air pollution exposure on children and adolescents in S�o Paulo, Brazil</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="35498300" href="https://independent.academia.edu/CHINANLIN">CHIN AN LIN</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Pediat Pulm, 2001</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Health effects of air pollution exposure on children and adolescents in S�o Paulo, Brazil","attachmentId":51241014,"attachmentType":"pdf","work_url":"https://www.academia.edu/30808060/Health_effects_of_air_pollution_exposure_on_children_and_adolescents_in_S_o_Paulo_Brazil","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/30808060/Health_effects_of_air_pollution_exposure_on_children_and_adolescents_in_S_o_Paulo_Brazil"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="12" data-entity-id="6526228" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/6526228/Health_effects_of_air_pollution_exposure_on_children_and_adolescents_in_S%C3%A3o_Paulo_Brazil">Health effects of air pollution exposure on children and adolescents in São Paulo, Brazil</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="10438406" href="https://unisantos.academia.edu/Alf%C3%A9sioBraga">Alfésio Braga</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Pediatric Pulmonology, 2001</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Health effects of air pollution exposure on children and adolescents in São Paulo, Brazil","attachmentId":48824358,"attachmentType":"pdf","work_url":"https://www.academia.edu/6526228/Health_effects_of_air_pollution_exposure_on_children_and_adolescents_in_S%C3%A3o_Paulo_Brazil","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/6526228/Health_effects_of_air_pollution_exposure_on_children_and_adolescents_in_S%C3%A3o_Paulo_Brazil"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="13" data-entity-id="26700541" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/26700541/Air_Pollution_and_Outpatient_Treatment_and_Hospital_Admissions_for_Respiratory_Diseases_in_Children_in_Southeast_Region_of_Brazil">Air Pollution and Outpatient Treatment and Hospital Admissions for Respiratory Diseases in Children in Southeast Region of Brazil</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="54742066" href="https://independent.academia.edu/WashingtonLeite">Washington Leite</a><span>, </span><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="12602722" href="https://fiocruz.academia.edu/HermanoDeCastro">Hermano De Castro</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Advanced Topics in Environmental Health and Air Pollution Case Studies, 2011</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Air Pollution and Outpatient Treatment and Hospital Admissions for Respiratory Diseases in Children in Southeast Region of Brazil","attachmentId":46982326,"attachmentType":"pdf","work_url":"https://www.academia.edu/26700541/Air_Pollution_and_Outpatient_Treatment_and_Hospital_Admissions_for_Respiratory_Diseases_in_Children_in_Southeast_Region_of_Brazil","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/26700541/Air_Pollution_and_Outpatient_Treatment_and_Hospital_Admissions_for_Respiratory_Diseases_in_Children_in_Southeast_Region_of_Brazil"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="14" data-entity-id="60991369" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/60991369/Air_pollution_and_subclinical_airway_inflammation_in_the_SALIA_cohort_study">Air pollution and subclinical airway inflammation in the SALIA cohort study</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="171914031" href="https://tu-dresden.academia.edu/TomTeichert">Tom Teichert</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Immunity & Ageing, 2014</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Air pollution and subclinical airway inflammation in the SALIA cohort study","attachmentId":74192841,"attachmentType":"pdf","work_url":"https://www.academia.edu/60991369/Air_pollution_and_subclinical_airway_inflammation_in_the_SALIA_cohort_study","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/60991369/Air_pollution_and_subclinical_airway_inflammation_in_the_SALIA_cohort_study"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="15" data-entity-id="95340950" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/95340950/Allergic_rhinitis_is_associated_with_atmospheric_SO2_Follow_up_study_of_children_from_elementary_schools_in_Ulsan_Korea">Allergic rhinitis is associated with atmospheric SO2: Follow-up study of children from elementary schools in Ulsan, Korea</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="254094180" href="https://independent.academia.edu/JihoLee47">Jiho Lee</a></div><p class="ds-related-work--metadata ds2-5-body-xs">PLOS ONE, 2021</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Allergic rhinitis is associated with atmospheric SO2: Follow-up study of children from elementary schools in Ulsan, Korea","attachmentId":97549562,"attachmentType":"pdf","work_url":"https://www.academia.edu/95340950/Allergic_rhinitis_is_associated_with_atmospheric_SO2_Follow_up_study_of_children_from_elementary_schools_in_Ulsan_Korea","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/95340950/Allergic_rhinitis_is_associated_with_atmospheric_SO2_Follow_up_study_of_children_from_elementary_schools_in_Ulsan_Korea"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="16" data-entity-id="48678735" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/48678735/_Air_pollution_and_respiratory_diseases_among_children_in_the_city_of_Curitiba_Brazil_">[Air pollution and respiratory diseases among children in the city of Curitiba, Brazil]</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="10438406" href="https://unisantos.academia.edu/Alf%C3%A9sioBraga">Alfésio Braga</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Revista de saúde pública, 2004</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"[Air pollution and respiratory diseases among children in the city of Curitiba, Brazil]","attachmentId":67166738,"attachmentType":"pdf","work_url":"https://www.academia.edu/48678735/_Air_pollution_and_respiratory_diseases_among_children_in_the_city_of_Curitiba_Brazil_","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/48678735/_Air_pollution_and_respiratory_diseases_among_children_in_the_city_of_Curitiba_Brazil_"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="17" data-entity-id="41514913" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/41514913/Risk_Factors_Associated_with_Systemic_Lupus_Erythematosus_in_Oman">Risk Factors Associated with Systemic Lupus Erythematosus in Oman</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="1995811" href="https://squ.academia.edu/ALIYAALANSARI">ALIYA ALANSARI</a><span>, </span><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="59236323" href="https://utexas.academia.edu/FortuneJournals">Fortune Journals</a></div><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Risk Factors Associated with Systemic Lupus Erythematosus in Oman","attachmentId":61681762,"attachmentType":"pdf","work_url":"https://www.academia.edu/41514913/Risk_Factors_Associated_with_Systemic_Lupus_Erythematosus_in_Oman","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/41514913/Risk_Factors_Associated_with_Systemic_Lupus_Erythematosus_in_Oman"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="18" data-entity-id="117163300" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/117163300/Asthma_and_air_pollutants_a_time_series_study">Asthma and air pollutants: a time series study</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="54435441" href="https://independent.academia.edu/LuizRobertoCoelhoNascimento">Luiz Roberto Coelho Nascimento</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Revista da Associação Médica Brasileira (English Edition), 2012</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Asthma and air pollutants: a time series study","attachmentId":113093263,"attachmentType":"pdf","work_url":"https://www.academia.edu/117163300/Asthma_and_air_pollutants_a_time_series_study","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/117163300/Asthma_and_air_pollutants_a_time_series_study"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div><div class="ds-related-content--container"><h2 class="ds-related-content--heading">Related topics</h2><div class="ds-research-interests--pills-container"><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="221" rel="nofollow" href="https://www.academia.edu/Documents/in/Psychology">Psychology</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="9821" rel="nofollow" href="https://www.academia.edu/Documents/in/Brazil">Brazil</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="22506" rel="nofollow" href="https://www.academia.edu/Documents/in/Adolescent">Adolescent</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="26327" rel="nofollow" href="https://www.academia.edu/Documents/in/Medicine">Medicine</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="64933" rel="nofollow" href="https://www.academia.edu/Documents/in/Child">Child</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="66614" rel="nofollow" href="https://www.academia.edu/Documents/in/Systemic_Lupus_Erythematosus">Systemic Lupus Erythematosus</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="133057" rel="nofollow" href="https://www.academia.edu/Documents/in/Young_Adult">Young Adult</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="244814" rel="nofollow" href="https://www.academia.edu/Documents/in/Clinical_Sciences">Clinical Sciences</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="330953" rel="nofollow" href="https://www.academia.edu/Documents/in/Longitudinal_Studies">Longitudinal Studies</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="518609" rel="nofollow" href="https://www.academia.edu/Documents/in/Particulate_Matter">Particulate Matter</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="570668" rel="nofollow" href="https://www.academia.edu/Documents/in/Urban_Population">Urban Population</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="584615" rel="nofollow" href="https://www.academia.edu/Documents/in/Disease_Progression">Disease Progression</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="1312021" rel="nofollow" href="https://www.academia.edu/Documents/in/Environmental_Exposure">Environmental Exposure</a><a class="js-related-research-interest ds-research-interests--pill" data-entity-id="1656539" rel="nofollow" href="https://www.academia.edu/Documents/in/Air_Pollutants">Air Pollutants</a></div></div></div></div></div><div class="footer--content"><ul class="footer--main-links hide-on-mobile"><li><a href="https://www.academia.edu/about">About</a></li><li><a href="https://www.academia.edu/press">Press</a></li><li><a href="https://www.academia.edu/documents">Papers</a></li><li><a href="https://www.academia.edu/topics">Topics</a></li><li><a href="https://www.academia.edu/hiring"><svg style="width: 13px; height: 13px; position: relative; bottom: -1px;" aria-hidden="true" focusable="false" data-prefix="fas" data-icon="briefcase" class="svg-inline--fa fa-briefcase fa-w-16" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512"><path fill="currentColor" d="M320 336c0 8.84-7.16 16-16 16h-96c-8.84 0-16-7.16-16-16v-48H0v144c0 25.6 22.4 48 48 48h416c25.6 0 48-22.4 48-48V288H320v48zm144-208h-80V80c0-25.6-22.4-48-48-48H176c-25.6 0-48 22.4-48 48v48H48c-25.6 0-48 22.4-48 48v80h512v-80c0-25.6-22.4-48-48-48zm-144 0H192V96h128v32z"></path></svg> <strong>We're Hiring!</strong></a></li><li><a href="https://support.academia.edu/hc/en-us"><svg style="width: 12px; height: 12px; position: relative; bottom: -1px;" aria-hidden="true" focusable="false" data-prefix="fas" data-icon="question-circle" class="svg-inline--fa fa-question-circle fa-w-16" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512"><path fill="currentColor" d="M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zM262.655 90c-54.497 0-89.255 22.957-116.549 63.758-3.536 5.286-2.353 12.415 2.715 16.258l34.699 26.31c5.205 3.947 12.621 3.008 16.665-2.122 17.864-22.658 30.113-35.797 57.303-35.797 20.429 0 45.698 13.148 45.698 32.958 0 14.976-12.363 22.667-32.534 33.976C247.128 238.528 216 254.941 216 296v4c0 6.627 5.373 12 12 12h56c6.627 0 12-5.373 12-12v-1.333c0-28.462 83.186-29.647 83.186-106.667 0-58.002-60.165-102-116.531-102zM256 338c-25.365 0-46 20.635-46 46 0 25.364 20.635 46 46 46s46-20.636 46-46c0-25.365-20.635-46-46-46z"></path></svg> <strong>Help Center</strong></a></li></ul><ul class="footer--research-interests"><li>Find new research papers in:</li><li><a href="https://www.academia.edu/Documents/in/Physics">Physics</a></li><li><a href="https://www.academia.edu/Documents/in/Chemistry">Chemistry</a></li><li><a href="https://www.academia.edu/Documents/in/Biology">Biology</a></li><li><a href="https://www.academia.edu/Documents/in/Health_Sciences">Health Sciences</a></li><li><a href="https://www.academia.edu/Documents/in/Ecology">Ecology</a></li><li><a href="https://www.academia.edu/Documents/in/Earth_Sciences">Earth Sciences</a></li><li><a href="https://www.academia.edu/Documents/in/Cognitive_Science">Cognitive Science</a></li><li><a href="https://www.academia.edu/Documents/in/Mathematics">Mathematics</a></li><li><a href="https://www.academia.edu/Documents/in/Computer_Science">Computer Science</a></li></ul><ul class="footer--legal-links hide-on-mobile"><li><a href="https://www.academia.edu/terms">Terms</a></li><li><a href="https://www.academia.edu/privacy">Privacy</a></li><li><a href="https://www.academia.edu/copyright">Copyright</a></li><li>Academia ©2025</li></ul></div> </body> </html>