{"doi":"10.1016/j.jdin.2023.04.017","title":"Association between yearlong air pollution and moderate-severe atopic dermatitis: A United States cross-sectional claims analysis","abstract":"To the Editor: Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease affecting over 7% of US adults, with 40% having moderate-severe disease.1Fuxench Z.C.C. Block J.K. Boguniewicz M. et al.Atopic dermatitis in America study: a cross-sectional study examining the prevalence and disease burden of atopic dermatitis in the US adult population.J Invest Dermatol. 2019; 139: 583-590https://doi.org/10.1016/j.jid.2018.08.028Abstract Full Text Full Text PDF PubMed Scopus (215) Google Scholar Air pollution, specifically particulate matter ≤2.5 μm (PM2.5), has been associated with AD development among healthy individuals.2Park S.K. Kim J.S. Seo H.M. Exposure to air pollution and incidence of atopic dermatitis in the general population: a national population-based retrospective cohort study.J Am Acad Dermatol. 2021; 87: 1321-1327https://doi.org/10.1016/j.jaad.2021.05.061Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar In regional studies, short-term air pollution greatly exceeding Environmental Protection Agency (EPA) standards were associated with flaring of AD symptoms.3Fadadu R.P. Grimes B. Jewell N.P. et al.Association of wildfire air pollution and health care use for atopic dermatitis and itch.JAMA Dermatology. 2021; 157: 658-666https://doi.org/10.1001/jamadermatol.2021.0179Crossref PubMed Scopus (40) Google Scholar However, most US individuals chronically live at PM2.5 levels within EPA standards,4United States Environmental Protection AgencyNational air quality: status and trends of key air pollutants.https://www.epa.gov/air-trendsDate: 2014Date accessed: April 20, 2022Google Scholar and it is unclear how yearlong pollution at these regulated levels affects AD severity nationwide. To investigate the association between yearlong PM2.5 pollution and AD severity among AD patients, we performed a cross-sectional study of AD patients between October 19, 2017 and October 19, 2018, using the Clinformatics Data Mart Database, a de-identified national insurance claims dataset. Patients at least 12 years old with at least 6 months of continuous enrollment, an AD ICD-10 code, and either an asthma or allergic rhinitis code were included (Supplementary Table I, available via Mendeley at https://doi.org/10.17632/zsyrpbmx6j.1).5Fulton R.L. Mitra N. Chiesa-Fuxench Z. Sockler P.G. Margolis D.J. Untapping the potential of utilizing electronic medical records to identify patients with atopic dermatitis: an algorithm using ICD-10 codes.Arch Dermatol Res. 2021; 314: 439-444https://doi.org/10.1007/s00403-021-02251-wCrossref PubMed Scopus (2) Google Scholar The primary outcome of having moderate-severe AD was identified by receipt of dupilumab, phototherapy, or a systemic immunosuppressant. Yearlong average PM2.5 levels were collected from EPA stations nearest to each patient’s zip code. Categorical and continuous variables were compared using Chi-squared and Student’s t-tests, respectively. Adjusting for age, sex, insurance, and urbanization, multivariate logistic regression calculated odds ratios for associations between yearlong average PM2.5 levels and moderate-severe AD. P-values < .05 were considered statistically significant. Our study included 31,405 AD patients with a mean (SD) age of 46 (22) years and 64% female (Table I). Moderate-severe AD patients were more likely to be older (48 vs 46) and live in nonmetropolitan areas (90% vs 92%). Annual average PM2.5 ranged from 1.56 to 21.82 μg/m3. Mean yearlong average PM2.5 (8.35 vs 8.39 μg/m3) was comparable between moderate-severe and mild AD patients. No statistically significant associations existed between yearlong PM2.5 (OR = 1.001; 95% CI, 0.987-1.015, P = .905) concentrations and AD severity (Table II).Table IDemographic characteristics of patient cohortTotalMild ADModerate-severe ADP-valueN = 31,405N = 22,317N = 9088Sex, % female (No.)64% (20,062)64% (14,191)65% (5871).090Age, mean (SD), y46 (22)46 (23)48 (21)<.001Age group, % (No.), y<.001 12-1715% (4863)17","journal":"JAAD International","year":2023,"id":377183,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.947,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1140610,"name":"Johan Anker Chrom Allerup","orcid":"0000-0002-1517-2505","position":1,"is_corresponding":false},{"id":369648,"name":"Shufeng Li","orcid":"0000-0003-0584-3325","position":2,"is_corresponding":false},{"id":558961,"name":"Justin Ko","orcid":"0000-0003-4232-5906","position":3,"is_corresponding":false},{"id":110483,"name":"Jennifer Chen","orcid":"0000-0002-7808-2670","position":4,"is_corresponding":false},{"id":449586,"name":"Eleni Linos","orcid":"0000-0002-5856-6301","position":5,"is_corresponding":false},{"id":759529,"name":"Albert S. Chiou","orcid":"0000-0002-8436-0008","position":6,"is_corresponding":false},{"id":492106,"name":"Pavin Trinh","orcid":"0000-0002-3747-6278","position":0,"is_corresponding":true}],"reference_count":4,"raw_metadata":null,"created_at":"2026-07-19T01:16:36.370283Z","pmid":"37592975","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}