NO2 exposure increases eczema outpatient visits in Guangzhou, China: an indication for hospital management

Abstract

Background Ambient nitrogen dioxide (NO2) is a common air pollutant in developing countries and causes skin conditions, but its effect on eczema in subtropical areas is not clear in China. Object To measure the effect of short-term exposure of NO2 on the incidence of eczema and the change of outpatient visits. Methods Data of daily temperature, air pollutants, and outpatient visits from 2013 to 2018 were collected in a row. The generalized additive model (GAM) and Poisson distribution were used to assess the association between short-term exposure of NO2 and the outpatient visits of patients with eczema. The cumulative exposure effect of lag 0–3 days and the displacement effect of NO2 and other pollutants were considered as well. A single pollutant model was used to examine the independent association, and a two-pollutant model was adopted to control the confounding effect. Results The daily outpatient visits of eczema increased from 75.26 to 190.85 from 2013 to 2018 (P < 0.001). The combined influence of NO2 and the related pollutant exerted a stronger influence on the incidence of eczema. The maximum effect of NO2 appeared on the exposed day. (lag 0) and disappeared on day 4 (lag 3). The children and seniors were more vulnerable to NO2 exposure. Conclusion Exposure to NO2 is tightly associated with eczema incidence and outpatient visits. The hospitals should react to the visit fluctuations and adjust physician duty shifts to improve outpatient service efficiency.

Short-term exposure of PM2.5 and PM10 increases the number of outpatients with eczema in Guangzhou: A time-series study

“…To date, no more research has revealed the effects of different combinations of pollutants on eczema. The effects of single pollutants on eczema still have different results in different regions, such as previous studies have revealed that O 3 and NO 2 were not associated with increased patient visits for AD but our team has revealed that NO 2 exposure increases eczema outpatient (10,27). The effect of pollutants on eczema is still inconclusive, thus, the effect of combined pollutants has not been concluded.…”

“…In addition, SO 2 can enhance the production of active oxygen and further reduce the content of antioxidants in the skin (62). Moreover, our previous study revealed that outpatient visits for patients with eczema were positively associated with short-term exposure to ambient NO 2 (10). NO 2 will damage the skin integrity which conducts a higher risk of exposure to allergic substances (63).…”

“…Air pollution, including particulate matter (PM), nitrogen dioxide (NO 2 ), and sulfur dioxide (SO 2 ), is one of the environmental stimuli ( 9 ). Recently, our team has revealed the tight association between exposure to NO 2 with eczema incidence and outpatient visits ( 10 ). In addition to NO 2 , accumulating scientific evidence has reported the associations of PM with the development of eczema and dermatitis ( 11 , 12 ).…”

Air pollution and global healthcare use for atopic dermatitis: A systematic review

“…Almost all studies (17/18) were determined to have low risk for bias (Table 2). We used the five GRADE domains (study limitations, consistency of effect, precision, directness and publication bias) 49 to evaluate the overall body of evidence on the association between air pollution and healthcare use for AD and determined a moderate grade of certainty (Appendix S1). This was primarily due to consistent results across studies for most air pollutants, precision of the results of analyses conducted with large sample sizes, and the directness of measuring physician‐diagnosed AD with health services data.…”

Effects of Ambient Exposure to Nitrogen Dioxide on Outpatient Visits for Psoriasis in Rapidly Urbanizing Areas

“…Being the largest organ of the human body, the skin can be exposed to air pollutants from the external environment under different weather conditions. When the amount of air pollution exposure exceeds the resilience threshold for self protection, it may result in skin diseases (Szyszkowicz et al, 2010;Xu et al, 2011;Li et al, 2016;Liu et al, 2018;Ren et al, 2019;Chao et al, 2021;Zhang et al, 2021). Thus, the effects of NO2 exposure on skin diseases have received increasing attention.…”