Exposure of patients with atopic dermatitis to air pollutants such as particulate matter, sulfur dioxide (SO2), nitrogen dioxide (NO2) is associated with acute flare up of disease requiring increased healthcare visits in the form of emergency department and clinic visits as well as hospital admissions, suggests a study published in the Journal of the European Academy of Dermatology and Venereology.¹

A systematic review of studies relating to hospital visits for atopic dermatitis was conducted by a team of researchers from the United States. Their objective was to examine the relationship between exposure to air pollution and healthcare use for atopic dermatitis. After screening 390 studies obtained from PubMed, MEDLINE, Web of Science and EMBASE databases for relevant articles that had been published before January 2022, 18 were included for the final analysis. Together, these studies accounted for at least 5,197,643 total medical visits related to atopic dermatitis/eczema. PM2.5, PM10, ozone, SO2, NO2 and carbon monoxide (CO) were the air pollutants taken into consideration.

Analysis of data revealed a positive association between exposure to PM2.5 and atopic dermatitis-related hospital visits in 10 out of 11 studies; 11 of 13 studies showed a positive association between exposure to PM10 and atopic dermatitis-related hospital visits. For NO2, association was seen in 12 of 14 studies and for sulfur dioxide in 10 of 13 studies.

The results for association with ozone were ambiguous with 4 out of 8 studies showing a positive association, while there was limited evidence for CO with 1 out of 4 studies reporting an association. Temperature was found to have an impact on the associations with particulate matter, NO2 and ozone. 

These findings add to the accumulating evidence about the impact of the environment on health. It highlights the impact of ambient air quality on atopic dermatitis. Poor air quality was associated with worsening of the skin condition necessitating increasing healthcare utilization. The study has also identified specific air pollutants such as PM2.5, PM10, NO2 and SO2.

Reference

1. Fadadu RP, et al. Air pollution and health care use for atopic dermatitis: a systematic review.J Eur Acad Dermatol Venereol. 2023 May 15. doi: 10.1111/jdv.19193.