Systemic Lupus Erythematosus in Relation to Environmental Pollution: An Investigation in an African-American Community in North Georgia

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Abstract
The etiology of systemic lupus erythematosus is not well understood, although gender, race, genetic predisposition, and certain drugs are risk factors. Several environmental exposures have been implicated. In this study, we examined the prevalence and incidence of lupus in an African-American community that experienced long-standing exposures to industrial emissions. We hypothesized that lupus was elevated among residents of a specific community in Gainesville, Georgia. We included both a retrospective cohort study and a cross-sectional study designed to assess the incidence and prevalence, respectively, of lupus. The prevalence of lupus was 3 cases/300 persons (1 000/100 000). Compared with the highest reported prevalence, this represents a 6-fold increase. The incidence of lupus was 3 cases/4 709 person-years (63.7 cases/100 000 person-years). Compared with the highest reported incidence, this represents a 9-fold increase. The hypothesis that environmental toxins may induce lupus is consistent with the known ability of certain medications to do the same. The results suggest that long-standing exposure to industrial emissions may be associated with an increased risk of lupus.