Table 1.
Epidemiology studies showing positive associations between air pollution exposure and atopic dermatitis.
| Title | Authors (Year) | Country | Patient Profile | Study Size | Air Pollutants | Exposure Assessment | Outcome Measurement |
|---|---|---|---|---|---|---|---|
| Environmental Factors, Parental Atopy and Atopic Eczema in Primary-School Children: A Cross-Sectional Study in Taiwan | Lee et al. (2007) [61] | Taiwan | Children (6–12) | 10,951 boy and 10,340 girl students whose parents filled out surveys | SO2, NOx, O3, CO, and PM10 | Air monitoring station data; perceived pollution exposure asked about in surveys | Questionnaire modified from ISAAC asking about patient-reported eczema symptoms |
| Atopic Diseases, Allergic Sensitization, and Exposure to Traffic-related Air Pollution in Children | Morgenstern et al. (2008) [56] | Germany | Children | 2860 children at the age of 4 years and 3061 at the age of 6 years from two prospective birth cohort studies (GINI and LISA) |
Traffic-related PM2.5 and NO2 | Exposure modeling (linear models) | Questionnaire asking about doctor-diagnosed eczema and patient-reported eczema symptoms in previous 12 months |
| Traffic-Related Air Pollution, Climate, and Prevalence of Eczema in Taiwanese School Children |
Lee et al. (2008) [62] | Taiwan | Children (mostly 12–14) | 158,732 boy and 159,194 girl students whose parents filled out surveys | SO2, NOx, O3, CO, and PM10 | Air monitoring station data; principal component factor analysis with varimax motion for source-specific exposures | Questionnaire modified from ISAAC asking about patient-reported eczema symptoms |
| Epidemiology of Eczema among Lebanese Adolescents | Al-Sahab et al. (2008) [68] | Lebanon | Children aged 13–14 years | 3153 children | Living near a busy area | ISAAC environmental questionnaire | ISAAC questionnaires |
| Self-Reported Truck Traffic on the Street of Residence and Symptoms of Asthma and Allergic Disease: A Global Relationship in ISAAC Phase 3 | Brunekreff et al. (2009) [54] | Multi-center study around the world (ISAAC Phrase 3) | Children | 315,572 children 13–14 years of age from 110 centers in 46 countries and 197,515 children 6–7 years of age from 70 centers in 29 countries | Traffic-related air pollution (TRAP) | Self-reported description of truck traffic on street of residence via surveys | Questionnaires about patient-reported symptoms of eczema within the past 12 months and occurrence of appearing and disappearing rash |
| Eczema, Respiratory Allergies, and Traffic-Related Air Pollution in Birth Cohorts from Small-Town Areas | Krämer et al. (2009) [55] | Germany | Children | 3390 newborns and kids | Traffic-related soot and NO2 | Land-use regression models | Annual self-reported questionnaires |
| Acute Health Effects of Urban Fine and Ultrafine Particles on Children with Atopic Dermatitis | Song et al. (2011) [63] | South Korea | Children (8–12) | 41 students with AD | PM10, PM2.5, PM1, NO2, SO3, and O3 | Air monitoring station data and rooftop spectrometer measurements | Patient diaries, including self-reported eczema severity scores ranging from 0–10 |
| Eczema among Adults: Prevalence, Risk Factors and Relation to Airway Diseases. Results from a Large-Scale Population Survey in Sweden | Rönmark et al. (2012) [59] | Sweden | Adults | 18,087 survey respondents | Gas, dust, or fumes exposure at work | Self-reported questionnaire | GA2LEN questionnaire asking about patient-reported eczema symptoms and diagnosis |
| Symptoms of Atopic Dermatitis Are Influenced by Outdoor Air Pollution | Kim et al. (2013) [64] | South Korea | Children (16–85 months) | 17 boys and 5 girls with AD | PM10, PM2.5, NO, NO2, NOx, and VOCs | Air monitoring station data | Patient diaries, including eczema severity scores ranging from 0–10 |
| Improvement of Atopic Dermatitis Severity after Reducing Indoor Air Pollutants | Kim et al. (2013) [66] | South Korea | Children (1–5 years) | 210 male and 215 female children | PM10, CO, CO2, and formaldehyde | Air quality monitors | Diagnosis determined by dermatologist examination; surveys: Eczema Area and Severity Index (EASI) and investigator’s global assessment (IGA) measurement |
| Association between Environmental Factors and Current Asthma, Rhinoconjunctivitis and Eczema Symptoms in School-Aged Children from Oropeza Province—Bolivia: A Cross-Sectional Study | Solis-Soto, Patińo, Nowak, and Radon (2013) [69] | Bolivia | Children aged 9–15 years | 2340 children | Intensity of truck traffic near residence | ISAAC environmental questionnaire: frequency of truck traffic | ISAAC questionnaires |
| Prenatal Air Pollutant Exposure and Occurrence of Atopic Dermatitis | Huang et al. (2015) [57] | 21 counties across Taiwan | Children | 16,686 mother—infant pairs | NO2, SO2, CO, O3, and PM10 | Spatial interpolation, GIS, and cross-validation for exposure modeling | Questionnaire filled out by parents about physician-diagnosed AD |
| Indoor Air Pollution Aggravates Symptoms of Atopic Dermatitis in Children | Kim et al. (2015) [65] | South Korea | Children | 30 children with AD | NO, NO2, NOx, PM10, PM2.5, PM1, and VOCs | Air quality monitors | Teacher recorded pruritus symptoms in diaries for children (0–10) |
| Association of Pollution and Climate with Atopic Eczema in US Children | Kathuria and Silverberg (2016) [77] | United States | Children | 91,642 children | CO, NO3, NO2, OC, SO3, SO2, PM2.5, PM10, and O3 | Monitoring systems | National Survey of Children’s Health questionnaire |
| Adult Atopic Dermatitis and Exposure to Air Pollutants—A Nationwide Population-Based Study | Tang et al. (2017) [58] | Taiwan | Adults | 1023 patients with AD and 4092 controls | PM2.5 and the Pollutant Standards Index (PSI) | Data from ground-level monitoring stations | Physician-diagnosed AD |
| Association between Exposure to Traffic-Related Air Pollution and Prevalence of Allergic Diseases in Children, Seoul, Korea | Yi et al. (2017) [75] | South Korea | Children | 14,756 children | Traffic-related air pollution (TRAP) | Road network data on proximity to and density of major roads | Questionnaire modified from ISAAC |
| Traffic-Related Air Pollution and Eczema in the Elderly: Findings from the SALIA Cohort | Schnass et al. (2018) [60] | West Germany | Adult women aged 55+ | 834 women from the SALIA cohort | Traffic-related air pollution (NO2 and NOx), PM2.5, PMcoarse, and PM10 | Monitoring data, back-extrapolation algorithm, and land-use regressions | Questionnaire modified from ISAAC asking about patient-reported eczema symptoms and physician-diagnosed eczema |
| Preventive Effect of Residential Green Space on Infantile Atopic Dermatitis Associated with Prenatal Air Pollution Exposure | Lee et al. (2018) [70] | South Korea | Pregnant women and their babies at age 6 months | 659 mothers and their babies | Exposure to traffic-related air pollution: PM10, and NO2 | Land use regression models with data from air monitoring stations | ISAAC questionnaires |
| Association between Particulate Matter Concentration and Symptoms of Atopic Dermatitis in Children Living in an Industrial Urban Area of South Korea | Oh et al. (2018) [71] | South Korea | Children aged 1–5 years | 21 children with AD | PM10 and PM2.5 | Air quality monitoring stations | Physician-confirmed diagnosis and parent-recorded symptom diary |
| Nonatopic Eczema in Elderly Women: Effect of Air Pollution and Genes | Hüls et al. (2019) [67] | Germany | Adult women aged 55+ | 834 women from the SALIA cohort | NO2, NOx, PM2.5, and PM10 | Monitoring data, back-extrapolation algorithm, and land-use regressions | Questionnaire modified from ISAAC asking about patient-reported eczema symptoms and physician-diagnosed eczema |
| Ambient Air Pollution and the Hospital Outpatient Visits for Eczema and Dermatitis in Beijing: A Timestratified Case-Crossover Analysis |
Guo et al. (2019) [93] | China | Children and adults | 157,595 visits | PM2.5, PM10, NO2, and SO2 | Air quality monitoring stations | Clinic and hospital visits based on International Classification of Diseases (ICD) codes |
| Association between Exposure to Traffic-Related Air Pollution and Pediatric Allergic Diseases Based on Modeled Air Pollution Concentrations and Traffic Measures in Seoul, Korea: A Comparative Analysis | Min et al. (2020) [73] | South Korea | Children aged 1–12 years | 14,614 children | PM2.5, PM10, and NO2 | Air quality monitoring sites and prediction models for NO2, PM10 and land use regressions for PM2.5 | ISAAC questionnaires |
| Relative Impact of Meteorological Factors and Air Pollutants on Childhood Allergic Diseases in Shanghai, China | Hu et al. (2020) [94] | China | Children | 787,646 cases | PM2.5, PM10, NO2, O3, and SO2 | Air quality monitoring stations | Clinic and hospital visits based on ICD codes |
| Association between Air Pollution and Atopic Dermatitis in Guangzhou, China: Modification by Age and Season | Wang et al. (2020) [95] | China | Children and adults | 29,972 visits | PM2.5, PM10, NO2, O3, and SO2 | Air quality monitoring stations | Clinic visits based on ICD codes |
| Association between Ambient Air Pollution and Development and Persistence of Atopic and Non-Atopic Eczema in a Cohort of Adults | Lopez et al. (2021) [76] | Australia | Adults | 2369 adults | PM2.5 and NO2 | Satellite-based land-use regression model | Self-administered postal survey (questionnaire and skin prick test results) |
| Exposure to Air Pollution and Incidence of Atopic Dermatitis in the General Population: A National Population-Based Retrospective Cohort Study | Park, Kim, and Seo (2021) [72] | South Korea | Children and adults | 209,168 people without AD at start of study; 3203 developed AD | PM10, PM2.5, SO2, NO2, O3, and CO | Air quality monitoring stations | ICD-10 code from insurance database |
| Effects of Exposure to Indoor Fine Particulate Matter on Atopic Dermatitis in Children | Kim et al. (2021) [96] | South Korea | Children | 64 children | PM2.5 | Indoor laser-based air quality sensor | Physician-confirmed diagnosis and Atopic Dermatitis Symptom Score (ADSS) |
| Onset and Remission of Eczema at Pre-School Age in Relation to Prenatal and Postnatal Air Pollution and Home Environment across China | Lu et al. (2021) [74] | China | Children | 39,782 children | PM2.5, PM10, and NO2 | Monitoring station data and inverse distance weighted air pollution models | ISAAC questionnaires |
| Effects of Climate and Air Pollution Factors on Outpatient Visits for Eczema: A Time Series Analysis | Karagün, Yildiz, and Cangür (2021) [97] | Turkey | Children and adults | 27,549 patients | PM10 and SO2 | Air quality monitoring stations | Clinic visits based on ICD codes |
| NO2 Exposure Increases Eczema Outpatient Visits in Guangzhou, China: An Indication for Hospital Management | Zhang et al. (2021) [98] | China | Children and adults | 293,000 patients | PM2.5, PM10, NO2, O3, and SO2 | Air quality monitoring stations | Clinic visits based on ICD codes |
| Associations between Ambient Air Pollution and Medical Care Visits for Atopic Dermatitis | Baek, Cho, and Roh (2021) [99] | South Korea | Children and adults | 513,870 visits | PM2.5, PM10, NO2, O3, CO, and SO2 | Air quality monitoring stations | Clinic, hospital, and emergency department visits based on ICD codes |
| Association of Wildfire Air Pollution and Health Care Use for Atopic Dermatitis and Itch | Fadadu et al. (2021) [3] | United States | Children and adults | 8049 visits; 4174 patients | PM2.5 and wildfire smoke | Air quality monitoring stations and satellite imagery | Clinic visits based on ICD codes |
| Air Pollution and Weather Conditions Are Associated with Daily Outpatient Visits of Atopic Dermatitis in Shanghai, China | Ye at al. (2022) [78] | China | Children and adults | 34,633 patients | PM2.5, PM10, NO2, O3, and SO2 | Air quality monitoring stations | Clinic visits based on ICD codes |
| Relationship between Air Pollution and Childhood Atopic Dermatitis in Chongqing, China: A Time-Series Analysis | Luo et al. (2022) [79] | China | Children | 214,747 patients | PM2.5, PM10, SO2, NO2, O3, and CO | Air quality monitoring stations | Clinic visits based on ICD codes |
| Association of Exposure to Wildfire Air Pollution With Exacerbations of Atopic Dermatitis and Itch Among Older Adults | Fadadu et al. (2022) [80] | United States | Children and adults | 5529 visits; 3448 patients | PM2.5 and wildfire smoke | Air quality monitoring stations and satellite imagery | Clinic visits based on ICD codes |
Abbreviations: AD, atopic dermatitis; PM2.5, particulate matter less than 2.5 microns in diameter; PM10, particulate matter less than 10 microns in diameter; PM1, particulate matter less than 1 micron in diameter; O3, ozone; CO, carbon monoxide; OC: organic carbon; SO2, sulfur dioxide; NO3: nitrate; NO2, nitrogen dioxide; NO, nitric oxide; ISAAC, International Study of Asthma and Allergies in Childhood; VOC, volatile organic compounds; ICD: International Classification of Diseases.