CoChat
Sign Up
Cited by 23Air Quality and Health ImpactsDermatology and Skin DiseasesIndoor Air Quality and Microbial Exposure

Effects of Exposure to Indoor Fine Particulate Matter on Atopic Dermatitis in Children

Open access
Kim, Young-Min, Kim, Jihyun, Ha, Seoung-Chul, Ahn, Kangmo·2021·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph182111509PMC PMC8583533
Open this paper in CoChat — free accountOpen PDF

Abstract

This study aimed to investigate the short-term effect of exposure to indoor fine particulate matter (PM2.5) on atopic dermatitis (AD) symptoms in children. Sixty-four children (40 boys and 24 girls) with moderate-to-severe AD, aged under 18 years were enrolled in the study. They were followed up from February 2019 through November 2020. Exposure to indoor PM2.5 in each household of the enrolled children and their AD symptoms were measured daily. The generalized linear mixed model was utilized for statistical analysis. Subdivision analysis was performed by stratifying the patients by age, sex, season, severity, the presence of family allergic diseases, sensitization, and indoor environment conditions including temperature and relative humidity. A total of 9,321 person-days of AD symptom data were collected. The average PM2.5 concentration was 28.7 ± 24.3 µg/m3, with the highest value in winter (47.1 ± 29.6 µg/m3). The overall effect of PM2.5 on AD symptoms was not statistically significant. However, an increase of 10 µg/m3 in indoor PM2.5 concentration increased AD symptom scores by 16.5% (95% CI: 6.5, 27.5) in spring and12.6% (95% CI: 4.3, 21.5) in winter, 6.7% (95% CI: 2.3, 11.3) at indoor temperatures of <25.5 °C, and by 15.0% (95% CI: 3.5, 27.7) with no use of an air purifier. The harmful effect of PM2.5 in boys, in children aged ≥6 years, and in children with inhalant allergen sensitization was significant, showing an increase in AD symptoms of 4.9% (95% CI: 1.4, 8.6), 12.0% (95% CI: 5.3, 19.1), and 7.0% (95% CI: 1.9, 12.3) per 10 µg/m3 of PM2.5, respectively. Furthermore, children with inhalant allergen sensitization plus severe symptoms (SCORing Atopic Dermatitis, SCORAD ≥ 30.7, median value) showed more harmful effects from exposure to PM2.5 (15.7% (95% CI: 4.5, 28.1) increase in AD symptom scores per 10 µg/m3 of PM2.5 increase). Indoor exposure to PM2.5 exacerbated AD symptoms in children in spring, winter, and at indoor temperatures of < 25.5 °C. In particular, this harmful effect was prominent in children with inhalant allergen sensitization and severe symptoms. Minimizing exposure to indoor PM2.5 is needed for the proper management of 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 · 10.3390/ijerph182111509

Cites

9 of 9 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?

  • 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 [61]

    The Discussion (section 4) reports that boys with AD were more vulnerable than girls to indoor PM2.5 exposure, with greater increases in symptom scores. The study enrolled children who already had AD and measured symptom worsening, not their risk of developing AD. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • A season-specific analysis showed a higher risk of atopic dermatitis during the cold season.

    “A season-specific analysis showed a higher risk during the cold season [48, 51, 61].”

    From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [61]

    The Discussion reports that increases in indoor PM2.5 were associated with significantly higher atopic dermatitis symptom scores in winter and spring. This supports a winter-specific association, but the study measured symptom worsening in children who already had atopic dermatitis, not a higher risk of developing it during the cold season. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Studies based on similar populations, but with different periods, study designs and/or statistical analysis, obtained contrasting results.

    “Accordingly, studies based on similar populations, but with different periods, study designs and/or statistical analysis, obtained contrasting results [41, 44, 47, 53, 55, 61, 90, 91, 94, 95].”

    From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [61]

    The Introduction (no page given) describes earlier studies of particulate matter and atopic dermatitis that used different exposure settings and periods. The Results, §3.3 (no page given), report positive associations in spring and winter but a negative association in fall. These passages show variation in methods and findings, but do not establish that this study’s result contrasts with those of the other studies cited in the sentence. (LLM, conf=0.78)

    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: 25

  1. [1]Cohen A.J. Brauer M. Burnett R. Anderson H.R. Frostad J. Estep K. Balakrishnan K. Brunekreef B. Dandona L. Dandona R. Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: An analysis of data from the Global Burden of Diseases Study 2015 Lancet 2017 389 1907 1918 10.1016/S0140-6736(17)30505-6 28408086 PMC5439030 · DOI · Paper page
  2. [2]Brook R.D. Rajagopalan S. Pope C.A. 3rd Brook J.R. Bhatnagar A. Diez-Roux A.V. Holguin F. Hong Y. Luepker R.V. Mittleman M.A. Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association Circulation 2010 121 2331 2378 10.1161/CIR.0b013e3181dbece1 20458016 · DOI · Paper page
  3. [4]Kim Y.M. Kim J. Han Y. Lee B.J. Choi D.C. Cheong H.K. Jeon B.H. Oh I. Bae G.N. Lee J.Y. Comparison of diverse estimation methods for personal exposure to air pollutants and associations with allergic symptoms: The Allergy & Gene-Environment Link (ANGEL) study Sci. Total Environ. 2017 579 1127 1136 27914645
  4. [5]Mirabelli M.C. Vaidyanathan A. Flanders W.D. Qin X. Garbe P. Outdoor PM2.5, Ambient Air Temperature, and Asthma Symptoms in the Past 14 Days among Adults with Active Asthma Environ. Health Perspect. 2016 124 1882 1890 10.1289/EHP92 27385358 PMC5132644 · DOI
  5. [6]Chen F. Lin Z. Chen R. Norback D. Liu C. Kan H. Deng Q. Huang C. Hu Y. Zou Z. The effects of PM2.5 on asthmatic and allergic diseases or symptoms in preschool children of six Chinese cities, based on China, Children, Homes and Health (CCHH) project Environ. Pollut. 2018 232 329 337 10.1016/j.envpol.2017.08.072 28970023 · DOI
  6. [7]Tham E.H. Leung D.Y. Mechanisms by Which Atopic Dermatitis Predisposes to Food Allergy and the Atopic March Allergy Asthma Immunol. Res. 2019 11 4 15 10.4168/aair.2019.11.1.4 30479073 PMC6267189 · DOI
  7. [8]Lee J.Y. Yang H.K. Kim M. Kim J. Ahn K. Is the prevalence of atopic dermatitis in Korean children decreasing?: National Database 2009-2014 Asian Pac. J. Allergy Immunol. 2017 35 144 149 27996291
  8. [9]Ahn K. The role of air pollutants in atopic dermatitis J. Allergy Clin. Immunol. 2014 134 993 999 10.1016/j.jaci.2014.09.023 25439225 · DOI · Paper page
  9. [10]Kim J. Kim B.E. Ahn K. Leung D.Y.M. Interactions Between Atopic Dermatitis and Staphylococcus aureus Infection: Clinical Implications Allergy Asthma Immunol. Res. 2019 11 593 603 10.4168/aair.2019.11.5.593 31332972 PMC6658404 · DOI
  10. [11]Penard-Morand C. Raherison C. Charpin D. Kopferschmitt C. Lavaud F. Caillaud D. Annesi-Maesano I. Long-term exposure to close-proximity air pollution and asthma and allergies in urban children Eur. Respir. J. 2010 36 33 40 10.1183/09031936.00116109 20075054 · DOI
  11. [14]Song S. Lee K. Lee Y.M. Lee J.H. Lee S.I. Yu S.D. Paek D. Acute health effects of urban fine and ultrafine particles on children with atopic dermatitis Environ. Res. 2011 111 394 399 10.1016/j.envres.2010.10.010 21367405 · DOI · Paper page
  12. [17]Habre R. Moshier E. Castro W. Nath A. Grunin A. Rohr A. Godbold J. Schachter N. Kattan M. Coull B. The effects of PM2.5 and its components from indoor and outdoor sources on cough and wheeze symptoms in asthmatic children J. Expo. Sci. Environ. Epidemiol. 2014 24 380 387 10.1038/jes.2014.21 24714073 · DOI
  13. [19]Stalder J.F. Taïeb A. Atherton D.J. Bieber P. Bonifazi E. Broberg A. Calza A. Coleman R. De Prost Y. Gelmetti C. Severity scoring of atopic dermatitis: The SCORAD index: Consensus Report of the European Task Force on Atopic Dermatitis Dermatology 1993 186 23 31 8435513
  14. [20]Lee J.Y. Kim M. Yang H.K. Kim H.M. Cho J. Kim Y.M. Lim I.S. Cheong H.K. Kim H.S. Sohn I. Reliability and validity of the Atopic Dermatitis Symptom Score (ADSS) Pediatr. Allergy Immunol. 2018 29 290 295 10.1111/pai.12865 29350788 · DOI
  15. [21]Kim Y.M. Kim J. Ha S.C. Ahn K. Harmful Effect of Indoor Formaldehyde on Atopic Dermatitis in Children: A Longitudinal Study Allergy Asthma Immunol. Res. 2021 13 468 478 10.4168/aair.2021.13.3.468 33733640 PMC7984948 · DOI
  16. [22]Langan S.M. Bourke J.F. Silcocks P. Williams H.C. An exploratory prospective observational study of environmental factors exacerbating atopic eczema in children Br. J. Dermatol. 2006 154 979 980 10.1111/j.1365-2133.2006.07153.x 16634905 · DOI
  17. [23]Kim J.B. Lee G. Ryu S.H. Lee J.Y. Woo S.-H. Lee S.-B. Kim K.H. Yun S.-T. Bae G.-N. Indoor air pollution of a high-rise apartment caused by combustion sources in winter Par. Aerosol. Res. 2014 10 119 130 10.11629/jpaar.2014.10.3.119 · DOI
  18. [24]Song P. Wang L. Hui Y. Li R. PM2.5 Concentrations indoors and outdoors in heavy air pollution days in Winter Procedia Eng. 2015 121 1902 1906 10.1016/j.proeng.2015.09.173 · DOI
  19. [25]Uekert S.J. Akan G. Evans M.D. Li Z. Roberg K. Tisler C. Dasilva D. Anderson E. Gangnon R. Allen D.B. Sex-related differences in immune development and the expression of atopy in early childhood J. Allergy Clin. Immunol. 2006 118 1375 1381 10.1016/j.jaci.2006.09.008 17157669 · DOI
  20. [26]Stone M.R. Faulkner G.E. Outdoor play in children: Associations with objectively-measured physical activity, sedentary behavior and weight status Prev. Med. 2014 65 122 127 10.1016/j.ypmed.2014.05.008 24836417 · DOI · Paper page
  21. [27]Fish E.N. The X-files in immunity: Sex-based differences predispose immune responses Nat. Rev. Immunol. 2008 8 737 744 10.1038/nri2394 18728636 PMC7097214 · DOI
  22. [29]Ngoc L.T.N. Park D. Lee Y. Lee Y.C. Systematic Review and Meta-Analysis of Human Skin Diseases Due to Particulate Matter Int. J. Environ. Res. Public Health 2017 14 1458 10.3390/ijerph14121458 PMC5750877 29186837 · DOI · Paper page
  23. [30]Niwa Y. Sumi H. Kawahira K. Terashima T. Nakamura T. Akamatsu H. Protein oxidative damage in the stratum corneum: Evidence for a link between environmental oxidants and the changing prevalence and nature of atopic dermatitis in Japan Br. J. Dermatol. 2003 149 248 254 10.1046/j.1365-2133.2003.05417.x 12932228 · DOI · Paper page
  24. [32]Jin S.P. Li Z. Choi E.K. Lee S. Kim Y.K. Seo E.Y. Chung J.H. Cho S. Urban particulate matter in air pollution penetrates into the barrier-disrupted skin and produces ROS-dependent cutaneous inflammatory response in vivo J. Dermatol. Sci. 2018 91 175 183 10.1016/j.jdermsci.2018.04.015 29731195 · DOI · Paper page
  25. [34]Hidaka T. Ogawa E. Kobayashi E.H. Suzuki T. Funayama R. Nagashima T. Fujimura T. Aiba S. Nakayama K. Okuyama R. The aryl hydrocarbon receptor AhR links atopic dermatitis and air pollution via induction of the neurotrophic factor artemin Nat. Immunol. 2017 18 64 73 10.1038/ni.3614 27869817 · DOI · Paper page

Cited by

Sorted by citations

Authors
Kim, Y.-M., Kim, J., Ha, S.-C., & Ahn, K.
Affiliations
  • Samsung Medical Center (KR)
  • SENKO Co., Ltd., Osan 18111, Korea
Corresponding author
Ahn, Kangmo
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2021-11-01
Volume
18
Issue
21
Pages
11509
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph182111509
PMC
PMC8583533
OpenAlex
W3208816787
Cited by
23
References
9
Citations by year
2026: 2 · 2025: 4 · 2024: 7 · 2023: 7 · 2022: 3
FWCI
1.69
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Ministry of Environment (2018001860002)
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
Keywords
PM2.5, atopic dermatitis, children, air pollution exposure, inhalant allergen sensitization, indoor temperature, seasonal variation, SCORAD, household air pollution, allergy risk factors, sex differences, age differences, relative humidity, airway inflammation biomarkers, airway hyperresponsiveness
MeSH terms
Adolescent, Air Pollutants, Child, Dermatitis, Atopic, Eczema, Female, Humans, Male, Seasons, Air Pollution, Indoor, 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