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Air pollutants, climate change factors may drive atopic dermatitis disease activity

6 Min Read

Regina Schaffer , 2025-06-25 15:34:00

Key takeaways:

  • Adults exposed to environmental factors associated with climate change were more likely to have atopic dermatitis.
  • Ambient air pollution and temperature extremes played the largest role.

Ambient air pollution, hot and cold temperature extremes and other factors associated with climate change are likely associated with population-level atopic dermatitis activity, including an increase in ED and clinic visits, data show.

In a systematic review and meta-analysis, researchers found that a 10-g/m3 increase in particulate matter (PM)10 pollution, PM2.5 pollution, nitrogen dioxide (NO) and sulfate was associated with a 1% to 3% increased risk for AD-related ED and outpatient visits, which can have a “substantial effect” on cities and regions, depending on the population size. The findings were published in JAMA Dermatology.


Ambient air pollution, hot and cold temperature extremes and other factors associated with climate change are likely associated with population-level atopic dermatitis activity. Image: Adobe Stock.

“In this systematic review and meta-analysis, higher concentrations of various ambient air pollutants, as well as climactic factors including extreme temperatures, precipitation, humidity and sunlight exposure, were associated with increased atopic dermatitis disease activity, as were exposures to second-hand smoking and industrial pollutants,” Samiha Mohsen, MD, MSc, an incoming dermatology resident at the University of Calgary, Megan Park, BSc, a medical student at University of Toronto, told Healio. “Climate change may be exacerbating these problems.”

Samiha Mohsen

Megan Park

Researchers analyzed 42 observational studies from 14 countries published between 1985 and 2024, sourced from national health insurance data. Data showed a 1% increase in AD outpatient ED or clinic visits for every 10-g/m3 increase in PM10 levels, for a risk ratio of 1.008 (95% CI, 1.003-1.012; high certainty). Researchers noted a similar association for PM 2.5 m in diameter or less (RR = 1.013; 95% CI, 0.999-1.027; moderate certainty), sulfur dioxide (RR = 1.029; 95% CI, 1.020-1.039; high certainty), and NO (RR = 1.014; 95% CI, 0.999-1.030; moderate certainty).

Looking at climate factors, the researchers suggested with moderate to high certainty that extreme hot and cold environmental temperatures were associated with increased AD-related clinical visits. However, the evidence showed low certainty that higher precipitation, including rain, may be associated with increased AD severity, although there was moderate certainty that higher levels of humidity are associated with increased AD severity.

The literature suggested an uncertain association between increased sunlight exposure and AD severity, with very low certainty, according to the researchers. There was moderate certainty that exposure to secondhand smoke, traffic and industrial plants were associated with increased AD prevalence.

“In 2021, WHO updated its air quality guidelines to lower acceptable levels for PM2.5, PM10, and NO,” Park and Mohsen told Healio. “However, implementation remains inconsistent globally, especially in low- and middle-income countries with high pollution levels, such as those in East and South Asia. Disparities also persist within high-income countries like the United States, where racial and ethnic minority groups experience disproportionately higher exposure to PM2.5. Public health measures to protect vulnerable populations are warranted.”

Mohsen and Park said more research is needed on biological mechanisms that might explain how air pollution, weather variability and climate change influence the pathogenesis and activity of AD, particularly in low- and middle-income countries.

“It is also essential to examine the influence of socioeconomic factors, urbanization and disparities in pollution exposure, and to see whether public health policy changes can mitigate some of these adverse effects,” Mohsen and Park told Healio.

For more information:

Samiha Mohsen, MD, MSc, can be reached at dermatology@healio.com. Megan Park, BSc, can be reached at megan.park@mail.utoronto.ca.

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