Short-term effect of NO2 on outpatient visits for dermatologic diseases in Xinxiang, China: a time-series study

Abstract

Objectives As the largest organ of the human body, the skin is the major exposure route of NO 2. However, the evidence for a relationship between NO 2 exposure and dermatologic diseases (DMs) is limited. This time-series study was conducted to assess the shortterm effect of nitrogen dioxide (NO 2) exposure on DMs outpatient visits in Xinxiang, China. Methods Daily recordings of NO 2 concentrations, meteorological data, and the outpatient visits data for DMs were collected in Xinxiang from January 1st, 2015, to December 31st, 2018. The analysis method used was based on the generalized additive model (GAM) with quasi-Poisson regression to investigate the relationship between NO 2 exposure and DMs outpatient visits. Several covariates, such as long-term trends, seasonality, and weather conditions were controlled. Results A total of 164,270 DMs outpatients were recorded. A 10 lg/m 3 increase in NO 2 concentrations during the period was associated with a 1.86% increase in DMs outpatient visits (95% confidence intervals [Cl]: 1.06-2.66%). The effect was stronger (around 6 times) in the cool seasons than in warmer seasons and younger patients (\ 15 years of age) appeared to be more vulnerable. Conclusions The findings of this study indicate that short-term exposure to NO 2 increases the risk of DMs in Xinxiang, China, especially in the cool seasons. Policymakers should implement more stringent air quality standards to improve air quality.

Association Between Air Pollution and Incidence of Psoriasis: A Nationwide Population-based Case-control Study

“…Chao et al have shown that short-term exposure to NO 2 increases patient visits in relation to psoriasis. (25) The toxic effect of NO 2 is in line with the results of several epidemiologic studies that have reported correlations between NO 2 and other skin diseases, including vitiligo (25), atopic eczema(26), and acne (27). From a physiological perspective, NO 2 can act as an oxidative stressor that produces free radicals in cells(28), increases trans-epidermal water loss, and damages the skin barrier function in keratinocytes.…”

Effects of Ambient Exposure to Nitrogen Dioxide on Outpatient Visits for Psoriasis in Rapidly Urbanizing Areas

“…This result supports our hypothesis that the effect of NO2 on psoriasis is acute because a 10-µg m -3 increase in NO2 concentration (lag 0 day) was associated with a 3.1% (95% CI:2.5-3.7%) increase in the number of outpatient visits for psoriasis. A previous study (Chao et al, 2021) conducted in Xinxiang, China, reported that a 10μg m -3 increase in NO2 concentrations was associated with a 1.86% increase in the number of outpatient visits for multiple dermatologic diseases; for psoriasis, the increment risk of outpatient visits was 3.09% (95% CI:1.26-4.92%). The study (Chao et al, 2021) was conducted in an industrial city in North China with a relatively low population density, where the most considerable source of NO2 was coal combustion (Zong et al, 2018).…”

“…A previous study (Chao et al, 2021) conducted in Xinxiang, China, reported that a 10μg m -3 increase in NO2 concentrations was associated with a 1.86% increase in the number of outpatient visits for multiple dermatologic diseases; for psoriasis, the increment risk of outpatient visits was 3.09% (95% CI:1.26-4.92%). The study (Chao et al, 2021) was conducted in an industrial city in North China with a relatively low population density, where the most considerable source of NO2 was coal combustion (Zong et al, 2018). Our study was conducted in rapidly urbanizing areas with high population densities in China, where NO2 is mainly derived from vehicular-and household-related emissions (Shao et al, 2009).…”

“…Being the largest organ of the human body, the skin can be exposed to air pollutants from the external environment under different weather conditions. When the amount of air pollution exposure exceeds the resilience threshold for self protection, it may result in skin diseases (Szyszkowicz et al, 2010;Xu et al, 2011;Li et al, 2016;Liu et al, 2018;Ren et al, 2019;Chao et al, 2021;Zhang et al, 2021). Thus, the effects of NO2 exposure on skin diseases have received increasing attention.…”

Short-term effect of ambient air pollution on outpatient visits for children in Guangzhou, China

“…A time-series quasi-Poisson generalized additive model was introduced to verify the relationships between ambient air pollution and children's outpatient visits. According to the results of previous time-series studies (25,26), several covariates were adjusted in the model. In this main smoothing model, degrees of freedom (df) were set on the basis of previous studies (24, 27):…”