Apart from choking lungs, Delhi’s toxic air linked to rheumatoid arthritis: Experts

Delhi’s toxic air, long known for choking lungs, may also be taking a toll on the joints.

Speaking at the 40th annual conference of the Indian Rheumatology Association (IRACON 2025) at Yashobhoomi in Dwarka, rheumatology experts warned that exposure to air pollution has emerged as a significant trigger for rheumatoid arthritis (RA), an autoimmune disease that causes painful and disabling joint inflammation.

Rheumatoid arthritis is a chronic condition in which the body’s immune system attacks its own joints, leading to pain, swelling and stiffness. While it has traditionally been associated with genetics and immune system dysfunction, new evidence suggests that air pollution — particularly fine particulate matter or PM2.5 — may be a major environmental trigger.

Dr Uma Kumar, head of Rheumatology at AIIMS, said doctors had observed rise in the RA cases among patients with no family history. “Pollutants induce inflammatory reactions, exacerbating joint damage and promoting disease progression. These toxins trigger systemic inflammation and oxidative stress, causing an overactive immune response,” she said.

Dr Bimlesh Dhar Pandey, organising secretary of the IRACON 2025 and director of Rheumatology at Fortis Hospital, said studies show strong associations between exposure to PM2.5, nitrogen oxides and ozone with an increased risk of developing RA. “Living near busy roads, which means constant exposure to pollution, has also been linked to higher RA risk,” he said.

Dr Neeraj Jain, vice-chairman of the Department of Rheumatology at Sir Ganga Ram Hospital, said, “We used to think of RA as mainly genetic, but pollution is rewriting that narrative. The fact that young people with no family history are developing RA should set alarm bells ringing.”

Doctors also noted that patients exposed to high levels of PM2.5 are reporting more severe disease. “Reduced green spaces in urban areas are worsening the problem, depriving residents of protective environmental buffers,” said Dr Pulin Gupta, professor of Rheumatology at Dr Ram Manohar Lohia Hospital.

The RA affects 1 per cent of India’s adult population, but experts warned that these numbers could rise in polluted regions. Dr Rohini Handa, conference chairman and senior consultant at Indraprastha Apollo Hospitals, said, “Unless pollution levels are curbed, we are looking at a generation facing preventable autoimmune diseases. The cost in terms of suffering and healthcare burden will be high.”