{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:53:56Z","timestamp":1788872036426,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,9,25]],"date-time":"2014-09-25T00:00:00Z","timestamp":1411603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Conselho Nacional de Desenvolvimento Cient\u00ef\u00bf\u00bdfico e Tecnol\u00ef\u00bf\u00bdgico -CNPq","award":["302724\/2011-7"],"award-info":[{"award-number":["302724\/2011-7"]}]},{"name":"Conselho Nacional de Desenvolvimento Cient\u00ef\u00bf\u00bdfico e Tecnol\u00ef\u00bf\u00bdgico -CNPq","award":["472155\/2012-1"],"award-info":[{"award-number":["472155\/2012-1"]}]},{"name":"Federico Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the influence of exposure to inhaled environmental factors during pregnancy on the diagnosis of juvenile dermatomyositis (DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a case\u2013control study comprising 20 juvenile DM patients and 56 healthy controls matched by age and sex who were residents in the metropolitan region of a large city. A questionnaire assessed demographic data and environmental inhalation exposure during pregnancy (occupational exposure to demolition, chalk, construction and\/or quarry dust, paints, varnish, gasoline vapor, and\/or battery fluids; stationary sources of inhaled pollution near the mother's home; and maternal tobacco exposure). Daily concentrations of inhaled particulate matter, SO\n                      <jats:sub>2<\/jats:sub>\n                      , NO\n                      <jats:sub>2<\/jats:sub>\n                      , O\n                      <jats:sub>3<\/jats:sub>\n                      , and carbon monoxide (CO) were evaluated throughout the gestational period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Maternal occupational exposure to school chalk dust\/gasoline vapor in the juvenile DM group was significantly higher compared with controls (50% versus 4.6%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.001). Smoking mothers and secondhand smoke exposure at home during pregnancy were significantly higher in the juvenile DM group versus controls (smoking mothers: 20% versus 1.7%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.01, and secondhand smoke: 35% versus 19%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.07). In univariate logistic regression models, maternal smoking, occupational exposure to inhaled agents, and the highest tertile of tropospheric CO (3.2\u20135.4 parts per million) in the third trimester were significantly associated with juvenile DM (\n                      <jats:italic>P<\/jats:italic>\n                      \u2264 0.05). In the multivariate analysis, smoking mother (odds ratio [OR] 13.26 [95% confidence interval (95% CI) 1.21\u2013144.29],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.03), occupational exposure (OR 35.39 [95% CI 1.97\u2013632.80],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.01), and CO (third tertile) exposure in the third trimester of gestation (OR 12.21 [95% CI 1.28\u2013115.96],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.03) remained risk factors for juvenile DM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Inhaled pollutants and tobacco smoking during fetal development may contribute to juvenile DM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.22358","type":"journal-article","created":{"date-parts":[[2014,4,22]],"date-time":"2014-04-22T13:58:36Z","timestamp":1398175116000},"page":"1571-1575","source":"Crossref","is-referenced-by-count":48,"title":["Risk Factors for Juvenile Dermatomyositis: Exposure to Tobacco and Air Pollutants During Pregnancy"],"prefix":"10.1002","volume":"66","author":[{"given":"Maria Ang\u00e9lica M.","family":"Orione","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo, S\u00e3o Paulo, and Universidade Federal de Mato Grosso Mato Grosso Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clovis A.","family":"Silva","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana M. E.","family":"Sallum","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00facia M. A.","family":"Campos","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa H.","family":"Omori","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alf\u00e9sio L. F.","family":"Braga","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo and Universidade Cat\u00f3lica de Santos Santos Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia C. L.","family":"Farhat","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,9,25]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"126","article-title":"Organ\u2010specific autoantibodies and autoimmune diseases in juvenile systemic lupus erythematosus and juvenile dermatomyositis patients","volume":"30","author":"Aikawa NE","year":"2012","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq277"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2011.06.008"},{"key":"e_1_2_7_5_1","first-page":"877","article-title":"Juvenile idiopathic arthritis and exposure to fine particulate air pollution","volume":"27","author":"Zeft AS","year":"2009","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197502132920706"},{"key":"e_1_2_7_7_1","unstructured":"PilliL. Crit\u00e9rio Padr\u00e3o de Classifica\u00e7\u00e3o Econ\u00f4mica Brasil2013 Jan. 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