Effects of Exposure to Indoor Fine Particulate Matter on Atopic Dermatitis in Children

Abstract

This study aimed to investigate the short-term effect of exposure to indoor fine particulate matter (PM2.5) on atopic dermatitis (AD) symptoms in children. Sixty-four children (40 boys and 24 girls) with moderate-to-severe AD, aged under 18 years were enrolled in the study. They were followed up from February 2019 through November 2020. Exposure to indoor PM2.5 in each household of the enrolled children and their AD symptoms were measured daily. The generalized linear mixed model was utilized for statistical analysis. Subdivision analysis was performed by stratifying the patients by age, sex, season, severity, the presence of family allergic diseases, sensitization, and indoor environment conditions including temperature and relative humidity. A total of 9,321 person-days of AD symptom data were collected. The average PM2.5 concentration was 28.7 ± 24.3 µg/m3, with the highest value in winter (47.1 ± 29.6 µg/m3). The overall effect of PM2.5 on AD symptoms was not statistically significant. However, an increase of 10 µg/m3 in indoor PM2.5 concentration increased AD symptom scores by 16.5% (95% CI: 6.5, 27.5) in spring and12.6% (95% CI: 4.3, 21.5) in winter, 6.7% (95% CI: 2.3, 11.3) at indoor temperatures of <25.5 °C, and by 15.0% (95% CI: 3.5, 27.7) with no use of an air purifier. The harmful effect of PM2.5 in boys, in children aged ≥6 years, and in children with inhalant allergen sensitization was significant, showing an increase in AD symptoms of 4.9% (95% CI: 1.4, 8.6), 12.0% (95% CI: 5.3, 19.1), and 7.0% (95% CI: 1.9, 12.3) per 10 µg/m3 of PM2.5, respectively. Furthermore, children with inhalant allergen sensitization plus severe symptoms (SCORing Atopic Dermatitis, SCORAD ≥ 30.7, median value) showed more harmful effects from exposure to PM2.5 (15.7% (95% CI: 4.5, 28.1) increase in AD symptom scores per 10 µg/m3 of PM2.5 increase). Indoor exposure to PM2.5 exacerbated AD symptoms in children in spring, winter, and at indoor temperatures of < 25.5 °C. In particular, this harmful effect was prominent in children with inhalant allergen sensitization and severe symptoms. Minimizing exposure to indoor PM2.5 is needed for the proper management of AD.

The Prevalence of Atopic Dermatitis and Food Allergy in Children Living in an Urban Agglomeration—Is There a Current Relationship?

“…It has been recently shown that indoor exposure to PM2.5 exacerbated AD symptoms in children, particularly children with inhalant allergies and severe symptoms. Minimizing exposure to indoor PM2.5 is essential for the proper management of AD [ 22 ].…”

Preventative Effects of Antioxidants against PM10 on Serum IgE Concentration, Mast Cell Counts, Inflammatory Cytokines, and Keratinocyte Differentiation Markers in DNCB-Induced Atopic Dermatitis Mouse Model

“…Wang et al reported that PM 2.5 promotes the IgE-mediated mast cell activation of ROS [ 40 ]. Several groups [ 41 , 42 , 43 ] reported that air pollution, including PM 10 , is associated with an increased risk of atopic dermatitis. The study showed that cytotoxic effects and PM concentrations were not always correlated.…”

Air Pollution and Atopic Dermatitis, from Molecular Mechanisms to Population-Level Evidence: A Review

“…Additionally, a reduction in the indoor PM 10 concentrations following the implementation of a 7-month school program to improve the indoor air quality was strongly associated with a reduced prevalence of AD and mean eczema area and severity index (EASI) scores [66]. Another study showed that indoor air pollution exposure exacerbated the AD symptoms in children during the spring, winter, and cooler temperatures, with a greater risk in patients with inhalant allergen sensitization and pre-existing severe AD [96].…”