CoChat
Sign Up
Cited by 12Air Quality and Health ImpactsDermatology and Skin DiseasesAsthma and respiratory diseases

The relationship between outdoor air pollutants and atopic dermatitis of adults: A systematic review and meta-analysis

Open access
Yu-Yu Hsiao, Yi‐Hsing Chen, Wei‐Ting Hung, Kuo‐Tung Tang·2022·Asian Pacific Journal of Allergy and Immunology
DOI 10.12932/ap-060922-1448
Open this paper in CoChat — free account

Abstract

BACKGROUND: Atopic dermatitis (AD) poses a significant disease burden in adults. Environmental factors are essential in its pathogenesis. OBJECTIVE: Given the possible role of air pollutants in allergic diseases, it is worthwhile to summarize the effects of outdoor air pollution on adult AD. METHODS: We undertook a systematic review based on PubMed and EMBASE as of August 16, 2021, and found 20 relevant studies. A random-effects meta-analysis was carried out. RESULTS: Regarding long-term effects (within months to years), traffic-related air pollution and particulate matter < 2.5 μm in diameter (PM2.5, per 10 μg/m³ increment) are associated with the prevalence of adult AD (OR 1.40, 95%CI [1.24, 1.58] and 1.67, 95%CI [1.26, 2.21]). Exposures to PM2.5 and nitrogen dioxide are associated with incident AD, with ORs of 2.30 (95%CI: 1.25, 4.25) and 1.30 (95%CI: 1.04, 1.61) per 10 μg/m³ increment. In terms of short term effects (within days), exposure to particulate matter < 10 μm in diameter (PM10) and sulfur dioxide (SO₂) are associated with exacerbations of AD at lag day 0 based on those time-series studies, with an excessive risk of 2.9%, in particular, per 10 μg/m³ increment in SO₂ exposure. In addition, both short-term and long-term exposures to these air pollutants are associated with AD symptoms (eczema, pruritus, and sleep disturbance). CONCLUSIONS: Outdoor air pollutants exert both short-term and long-term adverse effects on adult AD, contributing to its development, severity and exacerbation of symptoms. The influence of air pollution should be considered in the management of adult AD.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.12932/ap-060922-1448

Cites

6 of 6 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Sulfur dioxide is a known respiratory and mucocutaneous irritant and may trigger eczema-like eruptions and contact dermatitis, particularly in individuals with sensitive skin or existing dermatoses.

    “It is a known respiratory and mucocutaneous irritant and may trigger eczema-like eruptions and contact dermatitis, particularly in individuals with sensitive skin or existing dermatoses [23,24].”

    From The Environmental Determinants of Skin Health: Linking Climate Change, Air Pollution, and the Dermatologic Disease Burden (2025) · cites this paper as [24]

    The Short-term effects section reports an association between sulfur dioxide exposure and exacerbations of adult atopic dermatitis, an eczematous condition. It does not establish that sulfur dioxide is a respiratory or mucocutaneous irritant, triggers contact dermatitis, or particularly affects people with sensitive skin or other existing dermatoses. Page numbers were not available in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 35

  1. Huls A, Abramson MJ, Sugiri D, Fuks K, Kramer U, Krutmann J, et al. Nonatopic eczema in elderly women: Effect of air pollution and genes. J Allergy Clin Immunol. 2019;143:378-85 e9.
  2. Lopez DJ, Lodge CJ, Bui DS, Waidyatillake NT, Su JC, Perret JL, et al. Association between ambient air pollution and development and persistence of atopic and non-atopic eczema in a cohort of adults. Allergy. 2021;76:2524-34.
  3. Nakhjirgan P, Mahmoodi M, Kashani H, Firooz A, Nabizadeh R, Kermani M, et al. Air pollution and exacerbation of skin itching and sleep disturbance in Iranian atopic dermatitis patients. J Environ Health Sci Eng. 2019;17:811-6.
  4. Wang XW, Tian YH, Cao YY, Song J, Li M, Wu Y, et al. Association between Fine Particulate Air Pollution and Outpatient Visits for Eczema in Beijing, China: A Time-series Analysis. Biomed Environ Sci. 2019;32:624-7.
  5. Guo Q, Xiong X, Liang F, Tian L, Liu W, Wang Z, et al. The interactive effects between air pollution and meteorological factors on the hospital outpatient visits for atopic dermatitis in Beijing, China: a time-series analysis. J Eur Acad Dermatol Venereol. 2019;33:2362-70.
  6. Karagun E, Yildiz P, Cangur S. Effects of climate and air pollution factors on outpatient visits for eczema: a time series analysis. Arch Dermatol Res. 2021;313:49-55.
  7. Wang HL, Sun J, Qian ZM, Gong YQ, Zhong JB, Yang RD, et al. Association between air pollution and atopic dermatitis in Guangzhou, China: modification by age and season. Br J Dermatol. 2021;184:1068-76.
  8. Zhang L, Jing D, Lu Q, Shen S. NO2 exposure increases eczema outpatient visits in Guangzhou, China: an indication for hospital management. BMC Public Health. 2021;21:506.
  9. Park S, Ha KH, Kim TG, Kim HC, Kim C, Oh SH. Air pollution and risk of hospital outpatient visits for eczematous skin disorders in metropolitan cities of South Korea. Br J Dermatol. 2021;185:641-4.
  10. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177-88.
  11. Lu Y, Zeger SL. On the equivalence of case-crossover and time series methods in environmental epidemiology. Biostatistics. 2007;8:337-44.
  12. Huet F, Severino-Freire M, Cheret J, Gouin O, Praneuf J, Pierre O, et al. Reconstructed human epidermis for in vitro studies on atopic dermatitis: A review. J Dermatol Sci. 2018;89:213-8.
  13. Hieda DS, Anastacio da Costa Carvalho L, Vaz de Mello B, Oliveira EA, Romano de Assis S, Wu J, et al. Air Particulate Matter Induces Skin Barrier Dysfunction and Water Transport Alteration on a Reconstructed Human Epidermis Model. J Invest Dermatol. 2020;140:2343-52 e3.
  14. Dijkhoff IM, Drasler B, Karakocak BB, Petri-Fink A, Valacchi G, Eeman M, et al. Impact of airborne particulate matter on skin: a systematic review from epidemiology to in vitro studies. Part Fibre Toxicol. 2020;17:35. References
  15. Ring J, Zink A, Arents BWM, Seitz IA, Mensing U, Schielein MC, et al. Atopic eczema: burden of disease and individual suffering -results from a large EU study in adults. J Eur Acad Dermatol Venereol. 2019;33: 1331-40.
  16. Stefanovic N, Flohr C, Irvine AD. The exposome in atopic dermatitis. Allergy. 2020;75:63-74.
  17. Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. The Lancet. 2020;396:345-60.
  18. Bowatte G, Lodge C, Lowe AJ, Erbas B, Perret J, Abramson MJ, et al. The influence of childhood traffic-related air pollution exposure on asthma, allergy and sensitization: a systematic review and a meta-analysis of birth cohort studies. Allergy. 2015;70:245-56.
  19. Khreis H, Kelly C, Tate J, Parslow R, Lucas K, Nieuwenhuijsen M. Exposure to traffic-related air pollution and risk of development of childhood asthma: A systematic review and meta-analysis. Environ Int. 2017;100:1-31.
  20. Fuertes E, Sunyer J, Gehring U, Porta D, Forastiere F, Cesaroni G, et al. Associations between air pollution and pediatric eczema, rhinoconjunctivitis and asthma: A meta-analysis of European birth cohorts. Environ Int. 2020;136:105474.
  21. Ronmark EP, Ekerljung L, Lotvall J, Wennergren G, Ronmark E, Toren K, et al. Eczema among adults: prevalence, risk factors and relation to airway diseases. Results from a large-scale population survey in Sweden. Br J Dermatol. 2012;166:1301-8.
  22. Bieber T, D'Erme AM, Akdis CA, Traidl-Hoffmann C, Lauener R, Schappi G, et al. Clinical phenotypes and endophenotypes of atopic dermatitis: Where are we, and where should we go? J Allergy Clin Immunol. 2017;139:S58-S64.
  23. Mortz CG, Andersen KE, Dellgren C, Barington T, Bindslev-Jensen C. Atopic dermatitis from adolescence to adulthood in the TOACS cohort: prevalence, persistence and comorbidities. Allergy. 2015;70:836-45.
  24. Montnemery P, Nihlen U, Goran Lofdahl C, Nyberg P, Svensson A. Prevalence of self-reported eczema in relation to living environment, socio-economic status and respiratory symptoms assessed in a questionnaire study. BMC Dermatol. 2003;3:4.
  25. Seo S, Kim D, Min S, Paul C, Yoo Y, Choung JT. GIS-based Association Between PM10 and Allergic Diseases in Seoul: Implications for Health and Environmental Policy. Allergy Asthma Immunol Res. 2016;8:32-40.
  26. Tang KT, Ku KC, Chen DY, Lin CH, Tsuang BJ, Chen YH. Adult atopic dermatitis and exposure to air pollutants-a nationwide population-based study. Ann Allergy Asthma Immunol. 2017;118:351-5.
  27. Prunicki M, Kelsey R, Lee J, Zhou X, Smith E, Haddad F, et al. The impact of prescribed fire versus wildfire on the immune and cardiovascular systems of children. Allergy. 2019;74:1989-91.
  28. Sadakane K, Ichinose T, Takano H, Yanagisawa R, Inoue K, Kawazato H, et al. Organic chemicals in diesel exhaust particles enhance picryl chloride-induced atopic dermatitis in NC/Nga mice. Int Arch Allergy Immunol. 2013;162:7-15.
  29. Celebi Sozener Z, Cevhertas L, Nadeau K, Akdis M, Akdis CA. Environmental factors in epithelial barrier dysfunction. J Allergy Clin Immunol. 2020;145:1517-28.
  30. Darlenski R, Kozyrskyj AL, Fluhr JW, Caraballo L. Association between barrier impairment and skin microbiota in atopic dermatitis from a global perspective: Unmet needs and open questions. J Allergy Clin Immunol. 2021;148:1387-93.
  31. Zou QY, Shen Y, Ke X, Hong SL, Kang HY. Exposure to air pollution and risk of prevalence of childhood allergic rhinitis: A meta-analysis. Int J Pediatr Otorhinolaryngol. 2018;112:82-90.
  32. Huls A, Klumper C, MacIntyre EA, Brauer M, Melen E, Bauer M, et al. Atopic dermatitis: Interaction between genetic variants of GSTP1, TNF, TLR2, and TLR4 and air pollution in early life. Pediatr Allergy Immunol. 2018;29:596-605.
  33. Simoni M, Baldacci S, Maio S, Cerrai S, Sarno G, Viegi G. Adverse effects of outdoor pollution in the elderly. J Thorac Dis. 2015;7:34-45.
  34. Clougherty JE. A growing role for gender analysis in air pollution epidemiology. Environ Health Perspect. 2010;118:167-76.
  35. Kantor R, Kim A, Thyssen JP, Silverberg JI. Association of atopic dermatitis with smoking: A systematic review and meta-analysis. J Am Acad Dermatol. 2016;75:1119-25 e1.

Cited by

Sorted by citations

Authors
Hsiao, Y.-Y., Chen, Y., Hung, W., & Tang, K.
Affiliations
  • Taichung Veterans General Hospital (TW)
  • National Yang Ming Chiao Tung University (TW)
ORCID
Venue
Asian Pacific Journal of Allergy and Immunology
Publisher
Allergy, Asthma, and Immunology Association of Thailand
Published
2022-12
Volume
40
Issue
4
Pages
295-307
ISSN
  • 0125-877X (ISSN-L)
  • 2228-8694
DOI
10.12932/ap-060922-1448
OpenAlex
W4317698872
Cited by
12
References
6
Citations by year
2026: 2 · 2025: 2 · 2024: 4 · 2023: 4
FWCI
0.24
Type
journal article
Language
en
Open access
Locations
  • Asian Pacific Journal of Allergy and Immunology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Health Research Institutes
  • 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
atopic dermatitis, adult atopic dermatitis, outdoor air pollution, traffic-related air pollution, particulate matter, PM2.5, PM10, nitrogen dioxide, sulfur dioxide, pruritus, sleep disorders, environmental risk factors
MeSH terms
Adult, Air Pollutants, Air Pollution, Dermatitis, Atopic, Environmental Exposure, Humans, Nitrogen Dioxide, Particulate Matter

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review