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Exposure to air pollution and incidence of atopic dermatitis in the general population: A national population-based retrospective cohort study

      Background

      To date, little evidence is available to determine whether atopic dermatitis (AD) can be caused by exposure to air pollutants, including gases and particulate matter.

      Objective

      We aimed to evaluate the relationship between air pollutants and incidence of AD using the National Health Insurance Service-National Sample Cohort database.

      Methods

      We included 209,168 subjects from the general population previously not diagnosed with AD between 2008 and 2013. Long-term average concentration of air pollutants before diagnosis was calculated for each subject.

      Results

      For 1,030,324 person-years, incident cases of AD were observed in 3203 subjects. There was a significant positive association between incidence of AD and long-term average concentration of particulate matter smaller than 2.5 μm in diameter (hazard ratio [HR], 1.420; 95% CI, 1.392-1.448; for 1 μg/m3), particulate matter smaller than 10 μm in diameter (HR, 1.333, 95% CI, 1.325-1.341; for 1 μg/m3), sulfur dioxide (HR, 1.626; 95% CI, 1.559-1.695; for 1 parts per billion), nitrogen dioxide (HR, 1.200; 95% CI, 1.187-1.212; for 1 parts per billion), and carbon monoxide (HR, 1.005; 95% CI, 1.004-1.005; for 1 parts per billion) after adjusting for age, sex, income, comorbid diseases, and meteorologic variables.

      Limitations

      The National Health Insurance Service database lacks detailed information on individual subjects.

      Conclusions

      This study demonstrated that long-term exposure to air pollutants, including gases and particulate matter, is an independent risk factor for developing AD.

      Key words

      Abbreviations used:

      AD (atopic dermatitis), aOR (adjusted odds ratio), HR (hazard ratio), ICD-10 (International Classification of Diseases, tenth revision), NHIS-NSC (National Health Insurance Service-National Sample Cohort), PM (particulate matter), PM2.5 (particulate matter smaller than 2.5 μm in diameter), PM10 (particulate matter smaller than 10 μm in diameter), ppb (parts per billion), ppm (parts per million)
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