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Cited by 7Air Quality and Health ImpactsClimate Change and Health ImpactsDermatology and Skin Diseases

Association between exposure to ambient air pollution, meteorological factors and atopic dermatitis consultations in Singapore—a stratified nationwide time-series analysis

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Mailepessov, Diyar, Ong, Janet, Nasir, Muhammad Zafir Mohamad, Aik, Joel, Woo, Maye, Zhao, Xiahong, Tey, Hong Liang, Yew, Yik Weng·2024·Scientific Reports
DOI 10.1038/s41598-024-60712-4PMC PMC11074125
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Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting approximately 20% of children globally. While studies have been conducted elsewhere, air pollution and weather variability is not well studied in the tropics. This time-series study examines the association between air pollution and meteorological factors with the incidence of outpatient visits for AD obtained from the National Skin Centre (NSC) in Singapore. The total number of 1,440,844 consultation visits from the NSC from 2009 to 2019 was analysed. Using the distributed lag non-linear model and assuming a negative binomial distribution, the short-term temporal association between outpatient visits for AD and air quality and meteorological variability on a weekly time-scale were examined, while adjusting for long-term trends, seasonality and autocorrelation. The analysis was also stratified by gender and age to assess potential effect modification. The risk of AD consultation visits was 14% lower (RR 10th percentile: 0.86, 95% CI 0.78–0.96) at the 10th percentile (11.9 µg/m 3) of PM 2.5 and 10% higher (RR 90th percentile: 1.10, 95% CI 1.01–1.19) at the 90th percentile (24.4 µg/m 3) compared to the median value (16.1 µg/m 3). Similar results were observed for PM 10 with lower risk at the 10th percentile and higher risk at the 90th percentile (RR 10th percentile: 0.86, 95% CI 0.78–0.95, RR 90th percentile: 1.10, 95% CI 1.01–1.19). For rainfall for values above the median, the risk of consultation visits was higher up to 7.4 mm in the PM 2.5 model (RR 74th percentile: 1.07, 95% CI 1.00–1.14) and up to 9 mm in the PM 10 model (RR 80th percentile: 1.12, 95% CI 1.00–1.25). This study found a close association between outpatient visits for AD with ambient particulate matter concentrations and rainfall. Seasonal variations in particulate matter and rainfall may be used to alert healthcare providers on the anticipated rise in AD cases and to time preventive measures to reduce the associated health burden.

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  • Studies showed a higher association between atopic dermatitis and air pollutants in children.

    “Studies showed a higher association between AD and air pollutants in children [33, 42, 49, 58].”

    From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [42]

    The Discussion (Gender and age effect modification; no page listed) reports a significant age-group difference for PM2.5, but says the association in children aged 8–12 was largely not statistically significant, while the adult effect resembled the overall effect. This does not support the claimed higher association in children; it points in the opposite direction for this study. (LLM, conf=0.86)

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  • In the present review, atopic dermatitis has shown a significant association with different criteria pollutants in both short- and long-term relationships, but the strength of association might vary.

    “In the present review, we [37] found that AD has shown a significant association with different criteria pollutants; both in short- [19, 38–42] and long-term relationships [32, 43–46]; however, the strength of the association might vary.”

    From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [42]

    The Results (Meteorological and air quality effects; page unavailable) find significant associations between AD consultation visits and two particulate pollutants, PM2.5 and PM10, but explicitly report none for NO2, SO2, O3 or CO. The Methods (Statistical analyses; page unavailable) describe a short-term analysis with lags up to six weeks, not a long-term exposure relationship. In the citing sentence, separate citations accompany the short- and long-term claims, so this source supports the narrower finding about particulate pollutants, not the full breadth of the quoted claim. (LLM, conf=0.88)

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  • Several studies reported no remarkable differences across age and sex in the risk for atopic dermatitis in association with air pollution.

    “Moreover, several studies reported no remarkable differences across age and sex in the risk for AD in association with AP [37, 40, 42, 48].”

    From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [42]

    The Discussion section (‘Gender and age effect modification’) reports no statistically significant difference between sexes, supporting the sex-related part of the claim. The same section reports a statistically significant age-group difference for PM2.5, so this study does not support an unqualified claim of no differences across age. (LLM, conf=0.90)

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Cited by

Sorted by citations

Authors
Mailepessov, D., Ong, J., Nasir, M. Z. M., Aik, J., Woo, M., Zhao, X., Tey, H. L., & Yew, Y. W.
Affiliations
  • National Environment Agency (SG)
  • National Skin Centre (SG)
Corresponding author
Aik, Joel
ORCID
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2024-05-06
Volume
14
Issue
1
Pages
10320-10320
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-024-60712-4
PMC
PMC11074125
OpenAlex
W4396664301
Cited by
7
References
7
Citations by year
2026: 1 · 2025: 3 · 2024: 3
FWCI
1.24
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • DR-NTU (Nanyang Technological University) (submittedVersion, cc-by)
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
Keywords
atopic dermatitis, ambient air pollution, particulate matter, PM2.5, PM10, meteorological factors, rainfall, outpatient visits, tropics, Singapore, seasonal variation, short-term exposure effects, distributed lag non-linear model, negative binomial regression, stratified analysis
MeSH terms
Adolescent, Adult, Air Pollutants, Air Pollution, Child, Child, Preschool, Dermatitis, Atopic, Environmental Exposure, Female, Humans, Infant, Infant, Newborn, Male, Meteorological Concepts, Middle Aged, Referral and Consultation, Seasons, Singapore, Weather, Incidence, Particulate Matter, Young Adult

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