Association of air quality index (AQI) with incidence of atopic dermatitis in Taiwan: A nationwide population-based cohort study
Abstract
Background Air pollutants may aggravate atopic dermatitis (AD). However, the association between Air Quality Index (AQI) and incidence of AD remains unknown. Objective To investigate association between AQI and incidence of AD, using the nationwide cohort in the Taiwan National Health Insurance Research Database (NHIRD). Methods We included 21,278,938 participants from the NHIRD not diagnosed with AD before 2008. Long-term average AQI value, obtained from the Taiwan Air Quality Monitoring System Network, before AD diagnosis was calculated and linked for each participant. Results 199,205 incident cases of AD were identified from 2008 to 2018. Participants were classified into 4 quantiles (Q) by AQI value. With the lowest quantile, Q1, as reference, the AD risk increased significantly in the Q2 group (adjusted hazard ratio [aHR]: 1.29, 95% confidence interval [CI]: 1.04-1.65), Q3 group (aHR: 4.71, 95% CI: 3.78-6.04), and was highest in the Q4 group (aHR: 13.20, 95% CI: 10.86-16.60). As AQI treated as a continuous variable, an increase of 1 unit of AQI value added 7% of AD risk (aHR, 1.07, 95% CI: 1.07-1.08). Limitations The NHIRD lacks detailed information on individual subjects. Conclusions The results demonstrated a significant positive association between AQI and incidence of AD with a clear dose-response relationship.
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Some studies reported women at a higher risk of developing atopic dermatitis on exposure to air pollutants.
“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 [60]
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- Authors
- Wu, C.-Y., Wu, C.-Y., Li, M.-C., Ho, H. J., & Ao, C.-K.
- Affiliations
- National Yang Ming Chiao Tung University (TW)
- Chang Gung Memorial Hospital (TW)
- National Cheng Kung University (TW)
- Corresponding author
- Wu, Chen-Yi
- Ao, Chon-Kit
- Venue
- Journal of the American Academy of Dermatology
- Publisher
- Elsevier BV
- Published
- 2024-06
- Volume
- 90
- Issue
- 6
- Pages
- 1218-1225
- ISSN
- 0190-9622 (ISSN-L)
- OpenAlex
- W4391487195
- Cited by
- 7
- References
- 31
- Citations by year
- 2026: 2 · 2025: 5
- FWCI
- 1.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Science and Technology, Taiwan (111-2314-B-A49A-508-MY3)
- 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
- air quality index, atopic dermatitis, air pollution, incidence, dose-response relationship, environmental risk factors, Taiwan
- MeSH terms
- Adolescent, Adult, Aged, Air Pollutants, Air Pollution, Child, Child, Preschool, Dermatitis, Atopic, Female, Humans, Infant, Male, Middle Aged, Taiwan, Cohort Studies, Incidence, Databases, Factual, Young Adult
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