Modeling of Temporal Exposure to the Ambient Environment and Eczema Severity

Bjorn R Thomas,Xiang L Tan,Shagayegh Javadzadeh,Elizabeth J Robinson,Bryan S Mcdonald,Malvina A Krupiczojc,Syedia R Rahman,Samiha Rahman,Rehana A Ahmed,Rubina Begum,Habiba Khanam,David P Kelsell,Jonathan Grigg,Robert J Knell,Edel A O’Toole

doi:10.1016/j.xjidi.2021.100062

Bjorn R Thomas, Xiang L Tan + Show 13 more

Open Access

https://doi.org/10.1016/j.xjidi.2021.100062

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Abstract

Atopic eczema is a common and complex disease. Missing genetic hereditability and increasing prevalence in industrializing nations point toward an environmental driver. We investigated the temporal association of weather and pollution parameters with eczema severity. This cross-sectional clinical study was performed between May 2018 and March 2020 and is part of the Tower Hamlets Eczema Assessment. All participants had a diagnosis of eczema, lived in East London, were of Bangladeshi ethnicity, and were aged <31 years. The primary outcome was the probability of having an Eczema Area and Severity Index score > 10 after previous ambient exposure to commonly studied meteorological variables and pollutants. There were 430 participants in the groups with Eczema Area and Severity Index ≤ 10 and 149 in those with Eczema Area and Severity Index > 10. Using logistic generalized additive models and a model selection process, we found that tropospheric ozone averaged over the preceding 270 days was strongly associated with eczema severity alongside the exposure to fine particles with diameters of 2.5 μm or less (fine particulate matter) averaged over the preceding 120 days. In our models and analyses, fine particulate matter appeared to largely act in a supporting role to ozone. We show that long-term exposure to ground-level ozone at high levels has the strongest association with eczema severity.

Highlights

IntroductionLarge population studies have shown that the prevalence of eczema is rising in developing countries, as they ‘industrialise’, suggesting an environmental effect (Odhiambo et al 2009; Williams et al 2008)
Eczema is the most common inflammatory skin disease (Karimkhani et al 2017)
Studies have shown that fine particles with diameters of 10 μm or less (PM10) are associated with a decrease in prevalence (Kathuria and Silverberg 2016) whereas others have demonstrated these to be associated with an increase in disease incidence (Belugina et al 2018)

Summary

Introduction

Large population studies have shown that the prevalence of eczema is rising in developing countries, as they ‘industrialise’, suggesting an environmental effect (Odhiambo et al 2009; Williams et al 2008). Journal Pre-proof Meteorological factors and ambient air pollution have been reported to be associated with the severity and prevalence of eczema (Ahn 2014; Kathuria and Silverberg 2016; Kim et al 2017; Langan et al 2006; Silverberg et al 2013). Studies have shown that fine particles with diameters of 10 μm or less (PM10) are associated with a decrease in prevalence (Kathuria and Silverberg 2016) whereas others have demonstrated these to be associated with an increase in disease incidence (Belugina et al 2018). A complicating feature when studying the effect of pollution on disease is that the composition of pollutants varies between countries and cities, PM2.5, making comparisons difficult (Li et al 2019b)

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