Skin and Cosmetic Research Department, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
Program in Public Health, University of California, Irvine, California, USA.
Dermatology. 2022;238(5):939-949. doi: 10.1159/000522491. Epub 2022 Mar 21.
Non-optimum weather conditions and air pollution have the potential to increase the risk of atopic dermatitis (AD), but the associations are rarely evaluated, especially in developing countries.
To investigate the independent influence and interaction effects of meteorological factors and air pollutants on the onset of AD.
Daily data on outpatient visits of AD were obtained from Shanghai Dermatology Hospital and comprised 34,633 patients during the period from January 2013 to December 2018. Meteorological conditions and air pollutant concentrations in Shanghai, China, during the 6-year period were collected. We applied the overdispersed generalized additive model and the distributed lag model to explore the short-term cumulative effects of environmental factors on AD.
AD symptoms were aggravated by extreme low temperature (1st percentile, 0.5°C) (RR = 1.32, 95% CI: 1.16-1.51) and per 10 unit decrease of humidity (RR = 1.10, 95% CI: 1.12-2.47). The increased concentration of air pollutants except ozone (O3) contributed to the increased risk of AD outpatients. A 10 μg/m3 increase in sulfur dioxide (SO2) and nitrogen dioxide (NO2) were associated with 6.03% (95% CI: 2.29%, 9.91%), and 1.96% (95% CI: 0.46%, 3.48%) increase of AD outpatients. AD patients in the 8- to 17-year-old group were most susceptible to extreme low temperature, and patients in the 0- to 7-year-old group were most susceptible to air pollutants, including particulate matter (PM10), SO2, and NO2. Men were more sensitive to the effects of extreme low temperature than women, while women were more vulnerable to air pollutants. The adverse effects of SO2 and NO2 on AD can be enhanced significantly by the warm season or other pollutants.
Exposure to a lower temperature, lower humidity, and higher levels of air pollutants is significantly associated with increased risks of AD incidence. These impacts were more pronounced in children less than 7 years old, women, and warm seasons.
非最佳天气条件和空气污染有可能增加特应性皮炎（AD）的风险，但这些关联很少被评估，尤其是在发展中国家。
调查气象因素和空气污染物对 AD 发病的独立影响和交互作用。
从上海皮肤科医院获得了 2013 年 1 月至 2018 年 12 月期间 34633 名 AD 门诊患者的每日就诊数据。收集了中国上海 6 年间的气象条件和空气污染物浓度数据。我们应用过度分散广义加性模型和分布滞后模型来探讨环境因素对 AD 的短期累积影响。
极端低温（第 1 百分位数，0.5°C）（RR=1.32，95%CI：1.16-1.51）和每降低 10 个单位湿度（RR=1.10，95%CI：1.12-2.47）可加重 AD 症状。除臭氧（O3）以外的空气污染物浓度增加会增加 AD 门诊患者的风险。SO2 和 NO2 浓度每增加 10μg/m3，与 AD 门诊患者增加 6.03%（95%CI：2.29%，9.91%）和 1.96%（95%CI：0.46%，3.48%）有关。8-17 岁组 AD 患者对极端低温最敏感，0-7 岁组 AD 患者对 PM10、SO2 和 NO2 等空气污染物最敏感。男性对极端低温的敏感性高于女性，而女性对空气污染物的敏感性更高。SO2 和 NO2 对 AD 的不利影响可因暖季或其他污染物而显著增强。
暴露于较低温度、较低湿度和较高水平的空气污染物与 AD 发病率增加显著相关。这些影响在 7 岁以下儿童、女性和暖季更为明显。
