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Cited by 6Air Quality and Health ImpactsIndoor Air Quality and Microbial ExposureClimate Change and Health Impacts

Short-Term Ambient Air Pollution and Urticaria in Guangzhou, China: Estimating the Association and Population Attributable Fraction

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Wang, Huanli, Matusik, Morgan, Wunderlich, Robert, Hanson, Sarah E., Babich, Kelly, Samad, Lilianne, Qian, Aaron M., McMillin, Stephen Edward +8 more·2023·Toxics
DOI 10.3390/toxics11120949PMC PMC10747676
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Abstract

Limited evidence is available regarding the association between acute exposure to ambient air pollutants and the risk of urticaria, even though the skin is an organ with direct contact with the external environment. This study utilized generalized additive models to investigate the association between particulate matter with an aerodynamic diameter smaller than 10 μm (PM10) and 2.5 μm (PM2.5), nitrogen dioxide (NO2) and sulfur dioxide (SO2), and daily outpatient visits for urticaria in Guangzhou, China from 2013 to 2017. We also estimated the attributable fraction of urticaria outpatient visits due to air pollution. A total of 216,648 outpatient visits due to urticaria occurred during the study period. All air pollutants were significantly associated with an increased excess risk of urticaria. Each 10 μg/m3 increase in PM2.5, PM10, NO2, and SO2 was associated with an increase of 1.23% (95% CI: 0.42%, 2.06%), 0.88% (95% CI: 0.28%, 1.49%), 3.09% (95% CI: 2.16%, 4.03%), and 2.82% (95% CI: 0.93%, 4.74%) in hospital visits for urticaria at lag05, respectively. It was estimated that 3.77% (95% CI: 1.26%, 6.38%), 1.91% (95% CI: 0.60%, 3.26%), 6.36% (95% CI: 4.38%, 8.41%), and 0.08% (95% CI: 0.03%, 0.14%) of urticaria outpatient visits were attributable to PM2.5, PM10, NO2, and SO2 using the World Health Organization’s air quality guideline as the reference. Relatively stronger associations were observed during the cold season. This study indicates that short-term air pollution may play a significant role in outpatient visits for urticaria, and that such relationships could be modified by season.

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  • Studies have reported a higher risk of urticaria in younger and older age groups, in female individuals and in the cold season.

    “However, studies have reported a higher risk in younger and older age groups, in female individuals and in the cold season [73, 74, 77, 78].”

    From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [74]

    The Results and Discussion report a stronger association between air pollution and urticaria outpatient visits in the cold season than in the warm season. The cited passages do not establish higher urticaria risk in younger or older age groups or in female individuals, and the seasonal finding concerns pollution-associated visits rather than overall urticaria risk. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Most studies analyzed the lag effect between 0 and 7 days for urticaria, with the highest association observed at lag 2-5.

    “Most studies analyzed the lag effect between 0 and 7 days, with the highest association observed at lag 2–5 [72–74, 78, 79].”

    From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [74]

    The Methods (section 2.3; page unavailable) analyze lags 0–5, and the Results (section 3; page unavailable) report the strongest association for the cumulative lag0–5 measure. This does not establish what most studies analyzed, extend this study’s analysis to day 7, or show that the strongest association occurred specifically at lags 2–5. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • The short-term association between air pollution and hospital visits for urticaria was higher for gaseous pollutants such as NO2 and SO2.

    “the short-term association between AP and hospital visits for urticaria was higher for gaseous pollutants such as NO2 and SO2 [72–74]”

    From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [74]

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Authors
Wang, H., Matusik, M., Wunderlich, R., Hanson, S. E., Babich, K., Samad, L., Qian, A. M., McMillin, S. E., Ye, X., Zhang, S., Liu, Y., Chen, X., Li, Z., Lin, H., Zhu, H., & Wang, X.
Affiliations
  • Guangzhou Institute of Dermatology (CN)
  • University of New Mexico Hospital (US)
  • Mercy Health (US)
  • Missouri Department of Health and Senior Services (US)
  • Connecticut Department of Public Health (US)
  • Saint Louis University (US)
  • Sun Yat-sen University (CN)
Corresponding author
  • Zhu, Huilan
  • Wang, Xiaojie
ORCID
Venue
Toxics
Publisher
MDPI AG
Published
2023-11-21
Volume
11
Issue
12
Pages
949
ISSN
2305-6304 (ISSN-L)
DOI
10.3390/toxics11120949
PMC
PMC10747676
OpenAlex
W4388857324
Cited by
6
References
0
Citations by year
2026: 5 · 2024: 1
FWCI
0.69
Type
journal article
Language
en
Open access
Licence
Locations
  • Toxics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
the Bill & Melinda Gates Foundation (Grant Number: INV-016826)
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
Keywords
urticaria, ambient air pollution, particulate matter, PM2.5, PM10, nitrogen dioxide, sulfur dioxide, outpatient visits, population attributable fraction, seasonal variation, cold season, skin health, Guangzhou

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