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Environmental Factor, January 2013

Uranium exposure linked to increased lupus rate

By Amanda Harper

Pai-Yue Lu, M.D.

Lead researcher Lu is shown outside Cincinnati Children’s Hospital Medical Center (CCHMC). (Photo courtesy of CCHMC)

Susan Pinney, Ph.D.

Senior author Pinney also serves as a member of the Fernald Medical Monitoring Program staff. (http://intmed.uc.edu/fmmp/global_tpl.cfm?SecId=Staff%20Information&SubId=Staff%20Information)  (Photo courtesy of CCHMC)

People living near a former uranium ore processing facility in Ohio are experiencing a higher than average rate of lupus, according to a new NIEHS-funded study conducted by scientists at the University of Cincinnati (UC) and Cincinnati Children’s Hospital Medical Center.

Systemic lupus erythematosus, or lupus, is a chronic inflammatory disease that can affect the skin, joints, kidneys, lungs, nervous system, and other organs of the body. The underlying causes of lupus are unknown, but it is much more common in women.

For this new study, a collaborative team of UC and Cincinnati Children’s researchers compared lupus rates in people who were exposed to uranium to rates in those who were not, in an effort to explain the high number of lupus cases reported in a suburban Cincinnati community.

Environmental exposures from a former uranium processing plant

In their extensive review of medical records and serum antibody analysis, to verify the cases, the researchers found that people who were exposed to higher levels of uranium, based on their living in close proximity to a former uranium ore processing plant, had lupus rates four times higher than the average population.

“Former studies have suggested that people with lupus may be more sensitive to radiation, and that both genetics and environmental exposures play a role in disease development,” said Pai-Yue Lu, M.D., a pediatric rheumatology fellow at Cincinnati Children’s and lead researcher for the study.  “Our study shows a strong correlation between exposure to uranium, a radioactive substance, and an increased lupus rate that merits further investigation.”

“With more research in this area, we may gain additional insight on the types of environmental factors that contribute to lupus development and the mechanisms by which they work,” Lu added. “There could be other effects of uranium and related exposures that could contribute to or help explain our findings.”

Lu presented this finding and its potential implications in November 2012 at the American College of Rheumatology annual meeting in Washington, D.C. She completed the project as part of her master’s degrees in clinical and translational research training (http://www.eh.uc.edu/Clinicalresearch/)  at UC.

The Cincinnati-based team’s research is based on nearly two decades of data collected through the Fernald Medical Monitoring Program, (http://intmed.uc.edu/fmmp/global_tpl.cfm?SecId=Overview&SubId=Overview)  the first and largest legally mandated comprehensive medical monitoring program in the U.S. The program was established in 1990, after a federal investigation revealed that National Lead of Ohio’s Feed Materials Production Center in the Hamilton County, Ohio, community of Fernald, was emitting dangerous levels of uranium dust and gases into surrounding communities.

“The availability of this cohort, and carefully collected data and biospecimens, provides a great setting to ask research questions,” said Susan Pinney, Ph.D., (http://www.eh.uc.edu/dir_individual_details.asp?qcontactid=81)  UC professor of environmental health and principal investigator on the Fernald study.

Almost 10,000 community residents enrolled in the Fernald Medical Monitoring Program. Community residents were classified into several exposure groups — high exposure, moderate exposure, low exposure, and no exposure. Uranium plant workers were not part of this study, since the focus of the study was environmental rather than occupational exposure.

“Typical U.S. incidence rates for lupus are 1.8 to 7.6 cases per 100,000. Among the 25 confirmed lupus cases we identified through the Fernald community cohort, 12 were in the high exposure group, eight experienced moderate exposure, and five were in the low exposure group,” Lu explained.

Research was supported by a pilot grant from the Center for Environmental Genetics (CEG), (http://www.eh.uc.edu/ceg/project_overview.asp)  an NIEHS-funded program to support core facilities and technologies needed to conduct innovative research that focuses on how environmental agents interact with genetic and epigenetic factors to influence disease risk and outcome. Shuk-mei Ho, Ph.D., (http://www.eh.uc.edu/dir_individual_details.asp?qcontactid=702)  the Jacob A. Schmidlapp Endowed Chair and professor in the UC Department of Environmental Health, serves as director of the CEG.

Citation: Lu P-Y, Kottyan LC, Pinney SM, James JA, Xie C, Buckholz JM, Harley JB. 2012. Identifying a Link Between Uranium Exposure and Systemic Lupus Erythematosus in a Community Living near a Uranium Plant. Arthritis Rheum 64:(10Suppl) (http://www.rheumatology.org/education/annual/2012_Abstract_Supplement.pdf#toolbar=1)  :S686.

(Amanda Harper is a public information officer in the Office of Public Relations and Communications at the UC Academic Health Center. For more information about this study, contact Harper by phone at 513-558-4657 or by email at  amanda.harper@uc.edu)


Fernald Environmental Management Project

This map shows the one-mile increments that defined uranium exposure levels for subjects in the study of residents of Fernald, located just outside Cincinnati.(Photo courtesy of Fernald Environmental Management Project)




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