Preventive Effect of Residential Green Space on Infantile Atopic Dermatitis Associated with Prenatal Air Pollution Exposure

Abstract

Few birth cohort studies have examined the role of traffic-related air pollution (TRAP) in the development of infantile atopic dermatitis (AD), but none have investigated the role of preventive factors such as green spaces. The aim of this study was to investigate whether exposure to nitrogen dioxide (NO2) and particulate matter with an aerodynamic diameter of <10 μm (PM10) during pregnancy is associated with increased risk of development of AD in 6-month-old children and also to examine how this association changes with residential green space. This study used prospective data from 659 participants of the Mothers and Children’s Environmental Health study. Subjects were geocoded to their residential addresses and matched with air pollution data modeled using land-use regression. Information on infantile AD was obtained by using a questionnaire administered to the parents or guardians of the children. The association between infantile AD and exposure to NO2 and PM10 was determined using logistic regression models. We assessed the effects of residential green spaces using stratified analyses and by entering product terms into the logistic regression models. The risk of infantile AD significantly increased with an increase in air pollution exposure during the first trimester of pregnancy. The adjusted odds ratio (OR) and 95% confidence interval (CI) were 1.219 (1.023–1.452) per 10 μg/m3 increase in PM10 and 1.353 (1.027–1.782) per 10 ppb increase in NO2. An increase in the green space within 200 m of residence was associated with a decreased risk of AD (OR = 0.996, 95% CI: 0.993–0.999). The stratified analysis of residential green space revealed stronger associations between infantile AD and PM10 and NO2 exposure during the first trimester in the areas in the lower tertiles of green space. This study indicated that exposure to TRAP during the first trimester of pregnancy is associated with infantile AD. Less residential green space may intensify the association between TRAP exposure and infantile AD.

The Role of the Environmental Risk Factors in the Pathogenesis and Clinical Outcome of Atopic Dermatitis

“…In particular, AD got worse in spring with high levels of styrene, in summer with high levels of toluene and NO2, in autumn with high levels of volatile organic compounds, and in winter with high levels of fine particulate matter [80]. These data were confirmed by other researches [84–88].…”

Impact of airborne particulate matter on skin: a systematic review from epidemiology to in vitro studies

“…However, with an odds ratio of 1.05 and the small quantity of observational, cohort studies, and individual studies, the statistical power of this meta-analysis is limited. Several new studies have been published that were not included in this meta-analysis [54][55][56][57][58][59][60]. More recently, Krämer and co-workers have reviewed this evidence by combining data from 57 environmental epidemiological studies in a systematic review [61].…”

Involvement of 4‐hydroxy‐2‐nonenal in pollution‐induced skin damage

“…In addition, a study conducted in the Munich metropolitan area revealed a strong positive association between the distance to the nearest main road and eczema; in particular, it was found that NO 2 was positively associated with eczema in children exposed to traffic‐related air pollution . In a more recent work, PM 10 and NO 2 exposure during the first trimester of pregnancy was associated with the development of infantile AD . It has also been demonstrated that maternal smoking during pregnancy and/or in the first year after birth is a major risk factor for the development of AD among children aged between 6 and 13 years .…”

“…19 In a more recent work, PM 10 and NO 2 exposure during the first trimester of pregnancy was associated with the development of infantile AD. 20 It has also been demonstrated that maternal smoking during pregnancy and/or in the first year after birth is a major risk factor for the development of AD among children aged between 6 and 13 years. 21 Similarly, fetal tobacco smoke exposure during the third trimester of pregnancy was positively associated with a higher cumulative incidence of atopic eczema/dermatitis syndrome in exposed infants in a Japanese study; the authors suggest that maternal smoking might induce epigenetic changes in the fetal allergen-specific immune responses, promoting development of AD.…”