Abstract

Although previous ecological studies investigating the association between air pollution and allergic diseases accounted for temporal or seasonal relationships, few studies address spatial non-stationarity or autocorrelation explicitly. Our objective was to examine bivariate correlation between outdoor air pollutants and the prevalence of allergic diseases, highlighting the limitation of a non-spatial correlation measure, and suggesting an alternative to address spatial autocorrelation. The 5-year prevalence data (2011–2015) of allergic rhinitis, atopic dermatitis, and asthma were integrated with the measures of four major air pollutants (SO2, NO2, CO, and PM10) for each of the 423 sub-districts of Seoul. Lee’s L statistics, which captures how much bivariate associations are spatially clustered, was calculated and compared with Pearson’s correlation coefficient for each pair of the air pollutants and allergic diseases. A series of maps showing spatiotemporal patterns of allergic diseases at the sub-district level reveals a substantial degree of spatial heterogeneity. A high spatial autocorrelation was observed for all pollutants and diseases, leading to significant dissimilarities between the two bivariate association measures. The local L statistics identifies the areas where a specific air pollutant is considered to be contributing to a type of allergic disease. This study suggests that a bivariate correlation measure between air pollutants and allergic diseases should capture spatially-clustered phenomenon of the association, and detect the local instability in their relationships. It highlights the role of spatial analysis in investigating the contribution of the local-level spatiotemporal dynamics of air pollution to trends and the distribution of allergic diseases.

Highlights

  • Numerous studies report that genetic factors play a critical role in determining susceptibility or exacerbation of allergic diseases such as atopic dermatitis, asthma, and allergic rhinitis [1], recent work has been dedicated to environmental exposure to better understand the prevalence of allergic diseases, since a significant change in human genetics could not occur in such a short period [2]

  • A series of spatiotemporal maps for allergic disease patient counts in Seoul confirmed that our findings followed the national trend of decreasing prevalence of atopic dermatitis and asthma and the increasing prevalence of allergic rhinitis in South Korea [28,29]

  • As this study focuses on the bivariate association between air pollution and allergic diseases, it rules out various environmental and socioeconomic variables or risk factors which may be related to at least one of the allergic diseases

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Summary

Introduction

Numerous studies report that genetic factors play a critical role in determining susceptibility or exacerbation of allergic diseases such as atopic dermatitis, asthma, and allergic rhinitis [1], recent work has been dedicated to environmental exposure to better understand the prevalence of allergic diseases, since a significant change in human genetics could not occur in such a short period [2]. Public Health 2018, 15, 1625; doi:10.3390/ijerph15081625 www.mdpi.com/journal/ijerph

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