Ambient air pollution and emergency department visits for skin conditions

Abstract

that ambient air pollution exposure may affect skin barrier function and allow exogenous bacteria to penetrate in the cutaneous tissues. In addition, recent studies have documented a strong correlation between cellulitis and ozone exposure for the parts of cutaneous tissues that are less covered by clothes [21]. The hypothesis that stronger associations for cellulitis are observed in area that are in direct contact with air pollutants was proposed and verified by the first author of this work [21].In this study, a case-crossover (CC) technique was used to evaluate any potential association between emergency department ED visits for cellulitis and other skin conditions with ambient air pollution [25]. The CC method allows to adjust the results for time trend and the seasonal variability. ED visits for a wide range of skin conditions, including urticaria (hives), cellulitis, dermatitis and rashes, were used to represent health outcomes. The CC method was realized on clusters defined by individual cases-control strata to avoid potential bias [26].This work assesses potential impacts of ambient air pollution to human skin condition development. From our data we can propose that increase in ambient air pollution levels can exacerbate various health conditions, among them the ones related to skin as well. In addition, it is possible that skin chronic exposure to air pollution can IntroductionThe human skin is the body's first and main barrier of defense against environmental stressors such as air pollution and ultraviolet irradiation (UV) [1]. The upper layer of the epidermis is mainly one of the first and major targets of air pollutants. Ground-level ozone (O 3 ) is one of the most reactive environmental oxidants and the main component of photochemical smog. Many studies have shown that O 3 affects respiratory health [2][3][4][5][6][7][8][9][10][11], is a risk factor for respiratory conditions such as asthma [12,13] and may even be linked to nonrespiratory conditions [13][14][15][16]. Moreover exposure to ambient O 3 has been associated with skin stress-responses and also various skin conditions [17][18][19][20] including cellulitis [21,22]. Human skin acts as a protective and active biological shield against pro-oxidative chemical products and air pollutants [23]. Exposure of the skin to ambient air pollution may have negative impact on the skin health condition and affect skin homeostasis.In this study short-term exposure to ambient air pollution is considered. The aim of this study was to investigate potential correlation between ambient air pollution exposures, especially ozone, and emergency department (ED) visits for skin conditions during the period from April 2004 to December 2011 in nine cities across the province of Ontario, Canada: Algoma (district), Halton (municipality), Hamilton, London, Ottawa, Peel (municipality), Toronto, Windsor and York. It has been shown that results from multi-city studies are more reliable and are less susceptible to biases than those from single locations [24].In this study ED...

The interactive effects between air pollution and meteorological factors on the hospital outpatient visits for atopic dermatitis in Beijing, China: a time‐series analysis

“…The use of Emollients, topical corticosteroids and calcineurin inhibitors is the mainstay of the treatment for AD, meaning that AD rarely lead to hospitalization and are more suitable for outpatient treatment. Outpatient visits were used as outcomes to estimate the effects of air pollution and meteorological factors on skin conditions in several previous studies . Considering the above‐mentioned, this study was conducted to explore the interactive effects between air pollutants (PM 2.5 , PM 10 , NO 2 and SO 2 ) and meteorological factors (temperature and relative humidity) on the number of outpatient visits for AD in a dermatological hospital in Beijing, China.…”

“…Outpatient visits were used as outcomes to estimate the effects of air pollution and meteorological factors on skin conditions in several previous studies. [20][21][22] Considering the above-mentioned, this study was conducted to explore the interactive effects between air pollutants (PM 2.5 , PM 10 , NO 2 and SO 2 ) and meteorological factors (temperature and relative humidity) on the number of outpatient visits for AD in a dermatological hospital in Beijing, China.…”

Cardiopulmonary Mortality and Temperature

“…It is assumed that it represents the most common and frequent environment conditions. These types of results indicate that temperature affects health outcomes [3]. …”

“…In one such type of study, a non-parametric approach was proposed to cluster the days using 15 parameters [3]. There were considered five ambient air pollutants lagged by 0, 1 and 2 days.…”

“…A new pattern in temperature values, often their extreme values, raises important concerns for public health. Epidemiological studies have reported that extreme hot and cold temperatures have associations with an increase in daily emergency department (ED) visits, hospitalization, morbidity and mortality.In one such type of study, a non-parametric approach was proposed to cluster the days using 15 parameters [3]. There were considered five ambient air pollutants lagged by 0, 1 and 2 days.…”