The exposome is the total load of chemicals good and bad that we are exposed to in daily life, and it continues to make headlines with a study showing that flares of rheumatoid arthritis joint inflammation may be triggered by increased levels of particulate matter in our air. Having found connections linking the development of rheumatoid arthritis to various other environmental toxins (including air pollution in a South Korean study), researchers wanted to know if such air pollution could worsen the symptoms too. This South Korean study found a particular type of air pollution had the highest correlation with rheumatoid arthritis severity.
Impact of Pollution
With up to 1% of the worldwide population suffering from rheumatoid arthritis, the potential impact of identifying triggers and exacerbating factors is huge. While genetics and various immune factors play a role, prior research indicates that environmental triggers play a major role in triggering these genetics to produce the disease. We talk about this in functional medicine all the time.
Looking at approximately 1000 patients with a rheumatoid arthritis diagnosis over the course of over 12,000 total office visits, the researchers compared the severity of reported symptoms and lab markers of inflammation with the exposure to various environmental air pollutants. They looked at the effects of sulfur dioxide, nitrogen dioxide, ozone, carbon monoxide, and two particulate matter sizes (PM10 and PM 2.5). From this limited list, only the PM2.5 (2.5 refers to the size of the particles) was statistically significant for symptoms and inflammation blood markers.
Mechanisms That Impact Rheumatoid Arthritis
While other studies have shown the other pollutants correlate with disease activity, indicating that other factors play a role, we have a number of proposed or suspected mechanisms for the connections. Some of these pollutants contribute to the production of inflammatory markers in our immune system, like tumor necrosis factor alpha and interleukin-1, that could increase inflammation of the patient’s joint lining. The pollution may also increase lymphoid immune reactivity in the lung, leading to the antibodies often found in rheumatoid arthritis patients. The production of reactive oxygen species may also play a role in worsening inflammation. The paper lists further downstream effects of these oxygen radicals.
Reminders
All in all, it serves as another reminder that both as a society and as individuals, we should think about the air we breathe, regardless of individual diagnoses and struggles. Our bodies were designed to handle some toxins but have limits there, just like there are limits to how much weight we can carry. At some point, the toxins overwhelm the detox and we see adverse effects in symptoms and diseases. Pursuing healthier, more abundant lives (and helping others do so) requires acknowledgement of the medical facts followed by actions to mitigate these effects.
More articles about Air Pollution in our blog:
Original Materials from:
Sung Cheol Jung, Jeffrey R Curtis, Seojin Yang, Yunhee Choi, Min Hyuk Lim, Saram Lee, Sung Ik Cho, Jin Kyun Park, Jun Won Park, Eun Bong Lee. Effects of air pollution on disease activity in patients with rheumatoid arthritis. Annals of the Rheumatic Diseases, 2026; DOI: 10.1016/j.ard.2026.06.018
Thanks to Science Daily:
Elsevier. “Dirty air may trigger painful rheumatoid arthritis flares.” ScienceDaily. ScienceDaily, 5 August 2026. <www.sciencedaily.com/releases/2026/08/260805082452.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
Dr. Eric Potter graduated from Vanderbilt Medical School and then went on to specialize in internal medicine (adult) and pediatric care, spending significant time and effort in growing his medical understanding while caring for patients from all walks of life.
