Adult atopic dermatitis and exposure to air pollutants—a nationwide population-based study
Abstract
Background There is a trend toward an increased worldwide prevalence of allergic diseases. It is speculated that industrialization with resultant air pollution plays a role. However, there are sparse epidemiologic data on the relation between air pollution and atopic dermatitis (AD) in adults.Objective To investigate the relation between exposure to air pollutants and adult AD in a cross-sectional study based on data from the National Health Insurance Research Database in Taiwan.Methods We identified 1,023 adult patients with AD and 4,092 age- and sex-matched controls without allergic diseases in 2011. Using data from 71 Environmental Protection Agency monitoring stations across Taiwan, levels of exposure to air pollutants were determined by the location of a subject's place of residence. Multivariate logistic regression analysis, adjusted for age, sex, levels of urbanization, and family income, was performed.Results We found an association between particulate matter <2.5 μm in diameter or the Pollutant Standards Index (the highest sub-index of the concentrations of 5 main air pollutants after transformation) and the development of adult AD. The adjusted odds ratios were 1.05 (95% confidence interval 1.02-1.08) and 1.02 (95% confidence interval 1.01-1.03), respectively.Conclusion These results demonstrated that air pollution, represented by particulate matter <2.5 μm in diameter or the Pollutant Standards Index, was modestly associated with the development of AD in adults.
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Across epidemiological studies, evidence regarding the relationship between air pollution and skin diseases remains fragmented and difficult to interpret, and a majority of studies yield inconclusive evidence.
“Because of substantial variability in research designs, statistical methods, exposure and outcome assessments, geographic regions, and other factors, across epidemiological studies, the evidence regarding the relationship between AP and skin diseases remains fragmented and difficult to interpret, and a majority of studies yield inconclusive evidence [17–21].”
From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [20]
Other studies reported male individuals at higher risk of developing atopic dermatitis with association with PM.
“While some studies reported women at a higher risk of developing AD on exposure to air pollutants [32, 49, 59, 60], other studies reported male individuals at higher risk of developing AD with association with PM [20, 61].”
From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [20]
Skin phenotypes result from the interplay of a wide range of different exposomal and genetic factors.
“Skin phenotypes result from the interplay of a wide range of different exposomal and genetic factors [20].”
From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [20]
PM2.5 is significantly associated with the development and exacerbation of skin diseases such as AD.
“Recent meta-analysis (21) and epidemiologic studies (22, 23) showed PM2.5 is significantly associated with the development and the exacerbation of skin diseases such as AD.”
From Particulate matter causes skin barrier dysfunction. (2021) · cites this paper as [23]
PM2.5 is considered more harmful than PM10.
“the latter of which is considered more harmful, 58”
From Association of Wildfire Air Pollution and Health Care Use for Atopic Dermatitis and Itch (2021) · cites this paper as [58]
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“While some studies reported women at a higher risk of developing AD on exposure to air pollutants [32, 49, 59, 60], other studies reported male individuals at higher risk of developing AD with association with PM [20, 61].”
- Authors
- Tang, K.-T., Ku, K.-C., Chen, D.-Y., Lin, C.-H., Tsuang, B.-J., & Chen, Y.-H.
- Affiliations
- National Chung Hsing University (TW)
- Taichung Veterans General Hospital (TW)
- Corresponding author
- Chen, Yi-Hsing
- Venue
- Annals of Allergy, Asthma & Immunology
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 118
- Issue
- 3
- Pages
- 351-355
- ISSN
- 1081-1206 (ISSN-L)
- OpenAlex
- W2582755369
- Cited by
- 73
- References
- 30
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 14 · 2023: 7 · 2022: 9 · 2021: 10 · 2020: 5 · 2019: 8 · 2018: 6 · 2017: 3
- FWCI
- 3.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Allergy Asthma & Immunology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Taichung Veterans General Hospital
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Keywords
- adult atopic dermatitis, air pollution, allergic diseases, industrialization, residential air pollution exposure, Taiwan
- MeSH terms
- Adult, Aged, Aged, 80 and over, Air Pollutants, Air Pollution, Cross-Sectional Studies, Dermatitis, Atopic, Environmental Exposure, Female, Humans, Male, Middle Aged, Population Surveillance, Risk Factors, Socioeconomic Factors, Taiwan, Urbanization, Case-Control Studies, Young Adult
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