Air Pollution Linked to Worse Atopic Dermatitis – AJMC

Report on the Impact of Environmental Pollutants on Atopic Dermatitis and Sustainable Development Goals

Introduction

Recent data reveal a stronger potential connection between atopic dermatitis (AD), a chronic inflammatory and immune-mediated skin condition, and increased levels of environmental pollutants. This association highlights a significant and potentially growing population burden. The findings emphasize the critical need for improved measures to mitigate pollution and climate change to enhance patient outcomes, aligning with the Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 13 (Climate Action).

Study Overview

A meta-analysis published in JAMA Dermatology investigated correlations between AD outcomes and environmental factors such as ambient air pollution, weather, and climate. The study utilized MEDLINE, EMBASE, and Cochrane databases, including 42 studies from 14 countries spanning 1985 to 2024. The research focused on adult patients aged 18 years and older, with evidence certainty assessed via the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.

Key Findings on Environmental Pollutants and AD

The analysis identified an increase in AD outpatient clinical visits associated with rises in ambient environmental pollutants, measured per 10-μg/m³ increments:

• Particulate matter 10 μm or smaller (PM10): Risk Ratio (RR) 1.008; 95% Confidence Interval (CI), 1.003–1.012; high-certainty evidence
• Particulate matter 2.5 μm or smaller (PM2.5): RR 1.013; 95% CI, 0.999–1.027; moderate-certainty evidence
• Sulfur dioxide (SO₂): RR 1.029; 95% CI, 1.020–1.039; high-certainty evidence
• Nitrogen dioxide (NO₂): RR 1.014; 95% CI, 0.999–1.030; moderate-certainty evidence

Emergency Department Visits and Air Pollution

Increases in particulate matter were also linked to higher emergency department (ED) visits for AD:

• For every 10-μg/m³ increase in PM10, a 1% increase in ED or clinical visits was observed (RR 1.008; 95% CI, 1.003–1.012; high-certainty evidence).
• For every 10-μg/m³ increase in PM2.5, there was a probable increase in ED or clinical visits (RR 1.013; 95% CI, 0.999–1.027; moderate-certainty evidence).

Temperature, Weather, and AD Outcomes

1. Higher temperatures in hot climates or seasons correlated with increased AD-related ED or clinical visits, particularly among female patients for outpatient visits.
2. Lower temperatures in cold climates or seasons were associated with more daily AD-related ED or clinical visits.
3. Precipitation and sunlight showed potential connections to greater AD severity, although evidence certainty was low.

Additional Environmental Factors

• Probable associations exist between greater AD prevalence and exposure to environmental tobacco smoke, traffic-related air pollution, secondhand smoke, and proximity to traffic and industrial plants.
• No significant association was found between nitric oxide or nitrogen dioxide exposure and AD in adulthood.

Public Health and Sustainable Development Implications

The study’s findings demonstrate harmful correlations between population-level AD activity and various ambient air pollutants, reinforcing the urgent need for public health interventions. These results support the advancement of SDG 3 (Good Health and Well-being) by aiming to reduce disease burden, and SDG 13 (Climate Action) by emphasizing pollution reduction and climate change mitigation.

Addressing these environmental determinants aligns with SDG 11 (Sustainable Cities and Communities) through improved air quality and SDG 12 (Responsible Consumption and Production) by promoting sustainable industrial practices.

Conclusion

The comprehensive synthesis of evidence highlights the significant impact of environmental pollution and climate factors on atopic dermatitis outcomes. The findings underscore the necessity for global efforts to decrease pollution and mitigate climate change, thereby improving health outcomes and advancing multiple Sustainable Development Goals.

References

1. Park M, Mohsen ST, Katz T, et al. Climate conditions, weather changes, and air pollutants and atopic dermatitis: a meta-analysis. JAMA Dermatol. Published online June 25, 2025. doi:10.1001/jamadermatol.2025.1790
2. Schnass W, Hüls A, Vierkötter A, Krüger U, Krutmann J, Schikowski T. Traffic-related air pollution and eczema in the elderly: findings from the SALIA cohort. Int J Hyg Environ Health. 2018;221(6):861-867. doi:10.1016/j.ijheh.2018.06.002
3. Tang KT, Ku KC, Chen DY, Lin CH, Tsuang BJ, Chen YH. Adult atopic dermatitis and exposure to air pollutants—a nationwide population-based study. Ann Allergy Asthma Immunol. 2017;118(3):351-355. doi:10.1016/j.anai.2016.12.005
4. Park SK, Kim JS, Seo HM. Exposure to air pollution and incidence of atopic dermatitis in the general population: a national population-based retrospective cohort study. J Am Acad Dermatol. 2022;87(6):1321-1327. doi:10.1016/j.jaad.2021.05.061
5. Sargen MR, Hoffstad O, Margolis DJ. Warm, humid, and high sun exposure climates are associated with poorly controlled eczema: PEER (Pediatric Eczema Elective Registry) cohort, 2004-2012. J Invest Dermatol. 2014;134(1):51-57. doi:10.1038/jid.2013.27416
6. Vocks E, Busch R, Fröhlich C, Borelli S, Mayer H, Ring J. Influence of weather and climate on subjective symptom intensity in atopic eczema. Int J Biometeorol. 2001;45(1):27-33. doi:10.1007/s004840000077

1. Sustainable Development Goals (SDGs) Addressed or Connected

1. SDG 3: Good Health and Well-being
   • The article discusses the population burden of atopic dermatitis (AD), a chronic inflammatory skin condition, and its connection to environmental pollutants, which directly relates to ensuring healthy lives and promoting well-being for all ages.
2. SDG 13: Climate Action
   • The article highlights the impact of climate change and pollution on AD outcomes, emphasizing the need to mitigate pollution and climate change worldwide.
3. SDG 11: Sustainable Cities and Communities
   • References to traffic-related air pollution and industrial plant exposure connect to making cities and human settlements inclusive, safe, resilient, and sustainable.
4. SDG 12: Responsible Consumption and Production
   • Indirectly connected through the emphasis on reducing pollution and managing environmental pollutants.

2. Specific Targets Under Those SDGs Identified

1. SDG 3: Good Health and Well-being
   • Target 3.9: By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination.
2. SDG 13: Climate Action
   • Target 13.2: Integrate climate change measures into national policies, strategies, and planning.
   • Target 13.3: Improve education, awareness-raising and human and institutional capacity on climate change mitigation, adaptation, impact reduction, and early warning.
3. SDG 11: Sustainable Cities and Communities
   • Target 11.6: By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to air quality and municipal and other waste management.
4. SDG 12: Responsible Consumption and Production
   • Target 12.4: By 2020, achieve the environmentally sound management of chemicals and all wastes throughout their life cycle.

3. Indicators Mentioned or Implied to Measure Progress

1. Health-related Indicators (SDG 3)
   • Incidence and prevalence rates of atopic dermatitis (AD) outpatient clinical visits and emergency department visits linked to environmental pollutants.
   • Risk ratios (RR) measuring increase in AD clinical visits per 10-μg/m³ increase in particulate matter and other pollutants.
2. Environmental Quality Indicators (SDG 11 and 12)
   • Levels of ambient air pollutants such as particulate matter (PM10 and PM2.5), sulfur dioxide, nitrogen dioxide.
   • Measurements of environmental tobacco smoke, traffic-related air pollution, and exposure to industrial plants.
3. Climate Indicators (SDG 13)
   • Temperature variations and their correlation with AD-related clinical visits.
   • Precipitation and humidity levels associated with AD severity.

4. Table: SDGs, Targets and Indicators

Source: ajmc.com