Association Between Chronic Pain and Fatigue Severity with Weather and Air Pollution Among Females with [ME/CFS], 2024, Jones et al

Association Between Chronic Pain and Fatigue Severity with Weather and Air Pollution Among Females with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Chloe Lisette Jones, Olivia Haskin, Jarred Wayne Younger

Abstract
Weather and air quality conditions have been anecdotally reported to be related to symptom fluctuations in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), but this has never been empirically investigated. This exploratory study aims to examine the effects of weather and air quality on daily fluctuations of chronic pain and fatigue in women with ME/CFS.

In an intensive longitudinal design, 58 participants with ME/CFS provided daily pain and fatigue ratings for an average of 61 days. Daily weather and air quality data were obtained from the National Oceanic and Atmospheric Administration and the US Environmental Protection Agency for the Birmingham, AL area.

Linear mixed models revealed a significant relationship between days with more severe pain and worse Air Quality Indices (AQI, p < 0.001), lower wind speeds (p = 0.009), greater particulate matter (p = 0.037), and lower carbon monoxide (p = 0.004), sulfur dioxide (p = 0.003), and ozone levels (p = 0.015).

Greater fatigue was associated with more particulates (p = 0.023) and lower barometric pressure (p = 0.048). These results suggest that air quality and weather can have small effects on ME/CFS symptom severity.

Link | PDF (International Journal of Environmental Research and Public Health) [Open Access]

 

Very quickly glanced at this - I don't see that they've reported effect sizes & have analysed a large number of predictors without correction for multiple comparisons?

 

How were, if they were, the subjects blinded to the air pollution stats during the days of testing (were they not allowed internet use?).

During distant fires when winds blew smoke our way and the small particle pollution (and ozone) were in the high moderate (yellow flag), I could sense some restriction in my breathing (this sensation beginning at 75 ppm; [100 being unhealthy for sensitive people]).

But my FM pain levels? Seldom a correlation with anything other than lifting and carrying an object that weighs a certain amount or being over-stimulated or by emotional stress. These are the most reliable correlations with increased pain.

The day before a storm I used to think my pain increased hugely, but now I'm not so sure.Sometimes yes, sometimes no.

FM pain is quite hard to tack into cause and effect.

 

I'm just guessing that non-ME females would also "feel worse" on days with unpleasant weather or air quality. Those poor air quality days probably also coincide with heat and mugginess, which puts everyone in bad moods, and being in a bad mood seems to amplify all of life's irritations, such as minor pains or fatigue.

I expect a similar study would show that line-ups are longer and slower-moving on days with unpleasant weather or air quality, compared with days with nice weather and fresh air.

 

"043 - New paper published! Air quality affects pain and fatigue.

Here is our new paper on air quality and chronic pain and fatigue. Just click the download button at: https://www.mdpi.com/1660-4601/21/12/1560

The real-time air quality map I used for this presentation can be found at: https://www2.purpleair.com/ . You can click on one of the map links on that page.

Jarred Younger"

https://www.youtube.com/watch?v=wqoSZwUZ2EM

 

I don't think too many patients check AQI, PM, CO, etc. on regular basis. I'd guess that there is sufficient blinding. Except for obvious events like wildfire or air quality warning, of course. I suppose they could exclude such days from data and see if the correlation stands.

My guess is that particulate matters could elevate the ambient inflammation level, and a slight elevation could worsen fatigue/pain if you are sensitive to low grade inflammation.

 

My quips are these: test subjects who were functional enough to show up for twice weekly blood draws, no controls. Also, the bio/emotional effect of weather (a sunny day vs a cloudy day, or high humidity vs low humidity).

From the discussion section of the paper:

"...This study is also limited in that the amount of time participants spent per day outside was not collected or estimated....research has suggested that weather sensitivity may differ among individuals...Additionally, without a control group, we cannot contrast or compare the effects of pollution and weather parameters on healthy individuals to individuals with ME/CFS.

Lastly, it is difficult to disentangle the multidirectional relationships between weather, pollution, fatigue, pain, and other psychological factors. Some investigators have suggested that the relationship between weather and symptoms is better explained by a patient’s belief in weather sensitivity, rather than by weather itself [42]."

(my bolding)

 

It's true that they may not be able to extrapolate the result to severely ill patients. But it would be still valid, at least for moderate-to-mildly ill patients.

Healthy people don't report chronic fatigue or pain, but I'd agree that it would be informative to compare if ME/CFS patients are more or less sensitive to the air quality than the healthy people.

They could narrow the study to AQI or PM within the invisible range only and discard other variables. Then they can control factors like weather that cannot be blinded, and see the relationship between AQI/PM and fatigue. If the relationship stands, why would AQI or particulate matter make fatigue/pain worse? That could provide an interesting clue to ME/CFS.