Exposure to air pollution and incidence of atopic dermatitis in the general population: A national population-based retrospective cohort study

• Published in: Journal of the American Academy of Dermatology Vol. 87; no. 6; pp. 1321 - 1327
• Main Authors: Park, Se Kwang, Kim, Joung Soo, Seo, Hyun-Min
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2022
• Subjects: air pollutants; Air Pollutants - adverse effects; Air Pollutants - analysis; Air Pollution - adverse effects; Air Pollution - analysis; allergic comorbidities; atopic dermatitis; Cohort Studies; Dermatitis, Atopic - epidemiology; disease; Environmental Exposure - adverse effects; fine particulate matter; Humans; Incidence; national health program; Nitrogen Dioxide - analysis; Particulate Matter - adverse effects; Particulate Matter - analysis; Retrospective Studies; national health program; NHIS-NSC; disease; AD; ICD-10; ppb; fine particulate matter; aOR; atopic dermatitis; HR; ppm; allergic comorbidities; PM2.5; PM10; PM; air pollutants
• ISSN: 0190-9622; 1097-6787; 1097-6787
• DOI: 10.1016/j.jaad.2021.05.061

To date, little evidence is available to determine whether atopic dermatitis (AD) can be caused by exposure to air pollutants, including gases and particulate matter. We aimed to evaluate the relationship between air pollutants and incidence of AD using the National Health Insurance Service-National Sample Cohort database. We included 209,168 subjects from the general population previously not diagnosed with AD between 2008 and 2013. Long-term average concentration of air pollutants before diagnosis was calculated for each subject. For 1,030,324 person-years, incident cases of AD were observed in 3203 subjects. There was a significant positive association between incidence of AD and long-term average concentration of particulate matter smaller than 2.5 μm in diameter (hazard ratio [HR], 1.420; 95% CI, 1.392-1.448; for 1 μg/m3), particulate matter smaller than 10 μm in diameter (HR, 1.333, 95% CI, 1.325-1.341; for 1 μg/m3), sulfur dioxide (HR, 1.626; 95% CI, 1.559-1.695; for 1 parts per billion), nitrogen dioxide (HR, 1.200; 95% CI, 1.187-1.212; for 1 parts per billion), and carbon monoxide (HR, 1.005; 95% CI, 1.004-1.005; for 1 parts per billion) after adjusting for age, sex, income, comorbid diseases, and meteorologic variables. The National Health Insurance Service database lacks detailed information on individual subjects. This study demonstrated that long-term exposure to air pollutants, including gases and particulate matter, is an independent risk factor for developing AD.