Project 458815

In autoimmune disease a person's immune system mistakenly attacks healthy tissue and in the past 30 years, the incidence has increased significantly. Interestingly the frequency varies greatly by the geographic location, which suggests that environmental influences and exposures could act as triggers in genetically susceptible individuals. For example, air pollution and silica exposure, along with several other chemicals have been proposed to play a role in the development of systemic sclerosis (SSc), a severe progressive scarring disease that involves the skin and many internal organs. Only ~60% of SSc patients survive longer than 10 years and there are no safe and effective treatments to improve this course. The goal of our study is to determine environmental factors associated with SSc development to help counsel patients, have a better understanding of the clinical course, and advocate for medical resource distribution to areas with a high disease burden. To achieve this, we will obtain data from the provincial databases that collect medical patient information from doctors and hospitals. First, the cases of SSc in Québec will be mapped using the Forward Sortation Area (first 3 digits of a postal code) to determine if there is uneven geographic distribution and which areas have significantly higher rates compared to the national average. Then, air pollution levels, industry density, and neighbourhood characteristics will be compared between areas with high levels of disease to those with low levels to identify possible environmental factors which could lead to SSc development. Using a similar methodology, the relationship between the incidence of psoriasis, atopic dermatitis, and lupus and contributing environmental and socioeconomic status factors will be evaluated. These studies will help improve our understanding of contributing factors to disease development and help with patient counselling and preventative strategies.