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Effects of Exposure to Indoor Fine Particulate Matter on Atopic Dermatitis in Children
Young-Min Kim1,2, Jihyun Kim1,2, Seoung-Chul Ha3
1Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul 06351, Korea.
Insights
Indoor fine particulate matter (PM2.5) exposure worsens atopic dermatitis (AD) symptoms in children, particularly during spring and winter. Minimizing indoor PM2.5 is crucial for managing AD, especially in sensitized children with severe symptoms.
Area of Science:
- Environmental Health
- Pediatric Dermatology
- Allergology
Background:
- Atopic dermatitis (AD) is a chronic inflammatory skin condition affecting children worldwide.
- Indoor air quality, specifically fine particulate matter (PM2.5), is increasingly recognized as a potential environmental trigger for AD exacerbations.
- Understanding the specific impact of indoor PM2.5 on AD symptoms is crucial for developing effective management strategies.
Purpose of the Study:
- To investigate the short-term effects of indoor fine particulate matter (PM2.5) exposure on the severity of atopic dermatitis (AD) symptoms in children.
- To identify specific subgroups of children with AD who are more vulnerable to the effects of indoor PM2.5.
- To provide evidence-based recommendations for minimizing indoor PM2.5 exposure in pediatric AD management.
Main Methods:
- A longitudinal study involving 64 children with moderate-to-severe AD, monitored daily for symptoms and indoor PM2.5 levels over 21 months.
- Statistical analysis using generalized linear mixed models to assess the relationship between PM2.5 exposure and AD symptom scores.
- Subgroup analyses were conducted based on age, sex, season, disease severity, allergic sensitization, and indoor environmental factors.
Main Results:
- Overall, indoor PM2.5 exposure did not show a statistically significant effect on AD symptoms.
- However, a 10 µg/m³ increase in indoor PM2.5 was associated with a significant increase in AD symptom scores during spring (16.5%) and winter (12.6%).
- Harmful effects were more pronounced in boys, children aged ≥6 years, those with inhalant allergen sensitization, and particularly in those with severe AD (SCORAD ≥ 30.7).
- Increased AD symptoms were also observed at indoor temperatures below 25.5 °C and without air purifier use.
Conclusions:
- Indoor PM2.5 exposure can exacerbate atopic dermatitis symptoms in children, especially during colder seasons and at lower indoor temperatures.
- Children with inhalant allergen sensitization and severe AD are particularly susceptible to the adverse effects of indoor PM2.5.
- Reducing indoor PM2.5 levels is a necessary component of comprehensive management strategies for pediatric atopic dermatitis.
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.
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