Exposure to air pollution and incidence of atopic dermatitis in the general population: A national population-based retrospective cohort study

Abstract

To date, little evidence is available to determine whether atopic dermatitis (AD) can be caused by exposure to air pollutants, including gases and particulate matter. We aimed to evaluate the relationship between air pollutants and incidence of AD using the National Health Insurance Service-National Sample Cohort database. We included 209,168 subjects from the general population previously not diagnosed with AD between 2008 and 2013. Long-term average concentration of air pollutants before diagnosis was calculated for each subject. For 1,030,324 person-years, incident cases of AD were observed in 3203 subjects. There was a significant positive association between incidence of AD and long-term average concentration of particulate matter smaller than 2.5μm in diameter (hazard ratio [HR], 1.420; 95% CI, 1.392-1.448; for 1μg/m3), particulate matter smaller than 10μm in diameter (HR, 1.333, 95% CI, 1.325-1.341; for 1μg/m3), sulfur dioxide (HR, 1.626; 95% CI, 1.559-1.695; for 1parts per billion), nitrogen dioxide (HR, 1.200; 95% CI, 1.187-1.212; for 1parts per billion), and carbon monoxide (HR, 1.005; 95% CI, 1.004-1.005; for 1parts per billion) after adjusting for age, sex, income, comorbid diseases, and meteorologic variables. The National Health Insurance Service database lacks detailed information on individual subjects. This study demonstrated that long-term exposure to air pollutants, including gases and particulate matter, is an independent risk factor for developing AD.