Association between exposure to ambient air pollution, meteorological factors and atopic dermatitis consultations in Singapore—a stratified nationwide time-series analysis

• Published in: Scientific reports Vol. 14; no. 1; p. 10320
• Main Authors: Mailepessov, Diyar, Ong, Janet, Nasir, Muhammad Zafir Mohamad, Aik, Joel, Woo, Maye, Zhao, Xiahong, Tey, Hong Liang, Yew, Yik Weng
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 06.05.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/700; 704/106; 704/172; Adolescent; Adult; Air Pollutants - adverse effects; Air Pollutants - analysis; Air pollution; Air Pollution - adverse effects; Air Pollution - analysis; Air quality; Atopic dermatitis; Autocorrelation; Binomial distribution; Child; Child, Preschool; Dermatitis; Dermatitis, Atopic - epidemiology; Dermatitis, Atopic - etiology; Environmental Exposure - adverse effects; Female; Gender; Humanities and Social Sciences; Humans; Incidence; Infant; Infant, Newborn; Male; Meteorological Concepts; Middle Aged; multidisciplinary; Outdoor air quality; Particulate matter; Particulate Matter - adverse effects; Particulate Matter - analysis; Precipitation; Rainfall; Referral and Consultation - statistics & numerical data; Science; Science (multidisciplinary); Seasonal variation; Seasonal variations; Seasonality; Seasons; Singapore - epidemiology; Skin diseases; Suspended particulate matter; Time series; Tropical environments; Weather; Young Adult; Singapore
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-60712-4

Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting approximately 20% of children globally. While studies have been conducted elsewhere, air pollution and weather variability is not well studied in the tropics. This time-series study examines the association between air pollution and meteorological factors with the incidence of outpatient visits for AD obtained from the National Skin Centre (NSC) in Singapore. The total number of 1,440,844 consultation visits from the NSC from 2009 to 2019 was analysed. Using the distributed lag non-linear model and assuming a negative binomial distribution, the short-term temporal association between outpatient visits for AD and air quality and meteorological variability on a weekly time-scale were examined, while adjusting for long-term trends, seasonality and autocorrelation. The analysis was also stratified by gender and age to assess potential effect modification. The risk of AD consultation visits was 14% lower (RR 10th percentile : 0.86, 95% CI 0.78–0.96) at the 10th percentile (11.9 µg/m 3 ) of PM 2.5 and 10% higher (RR 90th percentile : 1.10, 95% CI 1.01–1.19) at the 90th percentile (24.4 µg/m 3 ) compared to the median value (16.1 µg/m 3 ). Similar results were observed for PM 10 with lower risk at the 10th percentile and higher risk at the 90th percentile (RR 10th percentile : 0.86, 95% CI 0.78–0.95, RR 90th percentile : 1.10, 95% CI 1.01–1.19). For rainfall for values above the median, the risk of consultation visits was higher up to 7.4 mm in the PM 2.5 model (RR 74th percentile : 1.07, 95% CI 1.00–1.14) and up to 9 mm in the PM 10 model (RR 80th percentile : 1.12, 95% CI 1.00–1.25). This study found a close association between outpatient visits for AD with ambient particulate matter concentrations and rainfall. Seasonal variations in particulate matter and rainfall may be used to alert healthcare providers on the anticipated rise in AD cases and to time preventive measures to reduce the associated health burden.