Residents of Roxbury and Mattapan are more likely than people in any other Boston neighborhood to suffer from the painful auto-immune disease lupus, according to a state health report released last night at a community forum.
The study, conducted by the Department of Public Health, could not determine conclusively why lupus rates are higher in Roxbury, but offered a provocative theory involving exposure to petroleum products in the environment.
After analyzing data on the incidence of lupus and the location of dangerous environmental sites, the researchers asked: Could African-Americans, already known to be predisposed to the disease, be placed at even greater risk if they once lived near gasoline stations or sites where petroleum products were dumped?
The study was prompted by concerns voiced by women living in Roxbury, Mattapan, and Dorchester. Why, they wanted to know, are so many of our friends and relatives coming down with this disease? The report represents the first time that public health authorities in Massachusetts have attempted to measure the impact of lupus neighborhood by neighborhood.
"All of a sudden, we saw see all these women in the black community who developed lupus," said Beverly Soares , a lupus patient and executive director of Women of Courage, an advocacy and educational group. "And we found out there were a lot of dump sites in the area."
In patients with lupus, the immune system cannot distinguish between dangerous, invading germs and healthy cells. In effect, the body attacks itself, with disease fighters known as antibodies taking aim at healthy tissue and muscles. The result can be howling pain, ricocheting from skin to joints to the heart, lungs, kidneys, and brain.
The cause of lupus remains a mystery, but its victims are not, according to national figures: Women are nine times more likely than men to be diagnosed with the illness. And African-American women are at the greatest risk of all, suffering the disease at a rate three to four times higher than white, non-Hispanic women.
"As with most complex human diseases, lupus is probably caused by a combination of genes and environments," said Dr. Elizabeth Wood Karlson , a rheumatologist and epidemiologist at Brigham and Women's Hospital who conducted a separate lupus study. "We just need a lot more research on the genetic factors and the environmental factors."
The Department of Public Health study -- which reviewed six years of medical records from hospitals, clinics, and physician offices -- found that Roxbury and Mattapan had the highest rates of lupus in Boston. Citywide, five out of every 100,000 residents are diagnosed each year with lupus. The rate in Roxbury is 10.4 and in Mattapan, 7.9.
During the period covered in the study, 1999 through 2004, the researchers found 178 patients with definite or probable lupus diagnoses in Boston's 17 neighborhoods. Roxbury accounted for 37 of the cases. Nationwide, 239,000 people have been diagnosed with the disease, according to federal figures.
State researchers said the elevated rates of lupus in Roxbury and Mattapan are almost certainly a reflection of the significant African- American populations in those two neighborhoods. But, the researchers said, that is only part of the story.
According to the 2000 US Census, blacks accounted for 83 percent of Mattapan's population and 52 percent of Roxbury's. But Roxbury's lupus rate was higher.
That's where environmental factors may come into play, researchers said.
Scientific studies performed elsewhere suggest that exposure to petroleum products and other toxins may heighten the prospects of developing lupus.
As part of their study, the Depart ment of Public Health researchers scoured state records for information about toxic waste sites in Boston. They found that, historically, Roxbury had more of those sites than Mattapan.
"So this study seems to suggest part of the explanation for that added risk that occurs in Roxbury may be environmentally related," Massachusetts Public Health Commissioner John Auerbach said in an interview. "It suggests that there may be an environmental factor that is worth studying more and worth being more alert to."
But the environmental threat may largely have subsided, said Suzanne Condon , director of environmental health at the state agency.
If there is a link between lupus and environmental exposure, Condon said, "it's more likely the result of exposures that occurred in the past when industries were still operational and when the air emissions and other environmental standards weren't as stringent as they are today."
Stephen Smith can be reached at stsmith@globe.com.
© Copyright 2007 Globe Newspaper Company.
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