Synergistic Effects between Ambient Air Pollution and Second-Hand Smoke on Inflammatory Skin Diseases in Chinese Adolescents

Int J Environ Res Public Health. 2022 Aug 13;19(16):10011. doi: 10.3390/ijerph191610011.

Abstract

Atopic dermatitis (AD), chronic hand eczema (CHE), and urticaria are common inflammatory skin diseases among adolescents and associated with air quality. However, the synergistic effects of ambient air pollution and second-hand smoke (SHS) have been unclear. We conducted a cross-sectional study including 20,138 Chinese college students where dermatological examinations and a questionnaire survey were carried out. A generalized linear mixed model was applied for the association between individualized exposure of O3, CO, NO2, SO2, PM2.5, and PM10 and the prevalence of inflammatory skin diseases. Interactions between air pollutants and SHS were analyzed. As a result, CO, NO2, SO2, PM2.5, and PM10 were positively correlated with the prevalence of AD, CHE, and urticaria. Higher frequency of SHS exposure contributed to increased probabilities of AD (p = 0.042), CHE (p < 0.001), and urticaria (p = 0.002). Of note, CO (OR: 2.57 (1.16−5.69) in third quartile) and NO2 (OR: 2.38 (1.07−5.27) in third quartile) had positive interactions with SHS for AD, and PM2.5 synergized with SHS for CHE (OR: 2.25 (1.22−4.15) for second quartile). Subgroup analyses agreed with the synergistic results. In conclusion, SHS and ambient air pollution are both associated with inflammatory skin diseases, and they have a synergistic effect on the prevalence of AD and CHE.

Keywords: adolescents; air pollution; atopic dermatitis; eczema; second-hand smoke; synergistic effect; urticaria.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Air Pollutants* / analysis
  • Air Pollution* / adverse effects
  • Air Pollution* / analysis
  • China / epidemiology
  • Cross-Sectional Studies
  • Dermatitis, Atopic* / epidemiology
  • Dermatitis, Atopic* / etiology
  • Environmental Exposure / analysis
  • Humans
  • Nitrogen Dioxide / analysis
  • Particulate Matter / analysis
  • Tobacco Smoke Pollution* / adverse effects
  • Urticaria*

Substances

  • Air Pollutants
  • Particulate Matter
  • Tobacco Smoke Pollution
  • Nitrogen Dioxide

Grants and funding

This work was supported by the Project of Intelligent Management Software for Multimodal Medical Big Data for New Generation Information Technology, Ministry of Industry and Information Technology of People’s Republic of China (TC210804V), the National Key Research and Development Project of China “Precision Medicine Initiative” (#2016YFC0900802), the Program of Introducing Talents of Discipline to Universities (111 Project, #B20017), the Natural Science Foundation of Hunan Province (No.2021JJ41004), the China Postdoctoral Science Foundation (2020M682595), and the Medical and Health Research Project of China Aerospace Science and Industry Corporation (2020-LCYL-025). The funders did not participate in this study.