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.
Highlights
Particulate matter (PM), one of the major air pollutants, is an environmental threat to human health
To the best of our knowledge, this was the first study on the association between indoor PM2.5 and atopic dermatitis (AD) symptoms in children based on real-time indoor PM2.5 measurements in residential places
We observed that AD symptom scores were significantly increased by an increase in indoor PM2.5 levels in specific seasons such as spring and winter, at indoor temperatures of
Summary
Particulate matter (PM), one of the major air pollutants, is an environmental threat to human health. The biological effects of PM on health are determined largely by the size and the composition of the PM. Long-term exposure to PM with a diameter of less than 2.5 μm (PM2.5 ) has been attributed to up to 4.2 million annual premature deaths, representing 7.6%. Of the total global mortality [1]. PM2.5 deposits in the respiratory bronchioles and alveoli stimulate local and systemic inflammation as well as oxidative stress [2]. PM is associated with the increased risk of allergic diseases, such as asthma and atopic dermatitis (AD). Increased exposure to ambient PM2.5 significantly increased the risk of AD symptoms [3,4]
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