The prenatal and postnatal effects of air pollution on asthma in children with atopic dermatitis.

OBJECTIVES

Air pollution is strongly associated with asthma, but has not been determined to induce new-onset asthma development in children with atopic dermatitis (AD).

WORKING HYPOTHESIS: To assess whether prenatal/postnatal exposure to air pollutants triggers new-onset asthma development in children with AD.

STUDY

DESIGN

Retrospective cohort study.

PATIENT-SUBJECT SELECTION: Data of patients <age 18 years diagnosed with eczema or AD between 2009 and 2019 were extracted from the multicenter Kaohsiung Medical University Hospital Research Database. Patients diagnosed with new-onset asthma were in the asthma group and patients without asthma history were in the non-asthma group.

METHODOLOGY: The monthly average concentration of air pollutants for 1, 3, and 5 years before the index date, and 3, 6, and 9 months prenatally were analyzed and further stratified by age, immunoglobulin (Ig) E, and the percentage of eosinophil and eosinophil cationic protein (ECP).

RESULTS

Postnatal exposure to airborne particulate matter (PM2.5 , PM10 ), sulfur dioxide (SO2 ), ozone (O3 ), carbon monoxide (CO), nitric oxide (NO), nitric dioxide (NO2 ), and NOx , and prenatal exposure to PM2.5 , PM10 , SO2 , NO, and NOx were significantly higher in the asthma group than in the non-asthma group. Patients having IgE above 100 IU/ml and ECP less than 24 ng/ml were significantly influenced by postnatal exposure to PM2.5 and PM10 , especially CO, to develop asthma, and those having an eosinophil count >3% were significantly influenced by prenatal exposure to PM2.5 , especially SO2 , NO, and NO2 .

CONCLUSIONS

Prenatal and postnatal exposure to air pollution have an association with asthma development in AD patients.