The Burden of Air Pollution on Skin Health: a Brief Report and Call to Action.
Air pollution
Atopic dermatitis
Carbon monoxide
Climate change
Eczema
Public health
Skin health
Vulnerable populations
Wildfires
Journal
Dermatology and therapy
ISSN: 2193-8210
Titre abrégé: Dermatol Ther (Heidelb)
Pays: Switzerland
ID NLM: 101590450
Informations de publication
Date de publication:
16 Dec 2023
16 Dec 2023
Historique:
received:
17
11
2023
accepted:
28
11
2023
medline:
16
12
2023
pubmed:
16
12
2023
entrez:
16
12
2023
Statut:
aheadofprint
Résumé
Air pollution in North America has intensified due to wildfires in recent years. In 2023, the wildfires in the Canadian province of Quebec caused a southward spread of pollutants, negatively affecting air quality and thereby aggravating certain health conditions in northeastern USA. This study examines the impact of air pollution on atopic dermatitis (AD) and skin health and how wildfires can exacerbate the burden of disease. Carbon monoxide levels measured by the U.S. Environmental Protection Agency (EPA) in the Boston region during the months following the Canadian wildfires of 2023 were collected from the U.S. EPA Outdoor Air Quality webpage. Patient records on dermatology clinic visits for dermatitis and eczema at the Mass General Brigham (MGB) hospital system, 300 miles from the wildfires, were examined, and the data compared with data from the corresponding months in 2019-2022 for historical control. No individual patient data were collected. A notable rise and atypical summer peak in carbon monoxide (CO) levels in the Boston region during 2023 correlated with a spike in AD, dermatitis, and eczema-related dermatology clinic visits within the MGB hospital system, as compared with the prior 4 years. The synchronized atypical peaks of CO levels and AD-related visits during the summer of 2023 highlight the potential impact of acute air pollution events such as wildfires on air quality and the consequences for skin health. Air pollution, exacerbated by wildfires, can damage the skin through the smoke and chemicals utilized for extinguishing fires, which contain multiple potential allergens and irritants to the skin, such as CO, particulate matter (PM2.5), and ammonium phosphates, triggering airway and skin inflammation and flares of AD. This issue disproportionately affects vulnerable populations, including low-income communities and the geriatric and pediatric populations. Healthcare professionals and government agencies must work together to improve air quality and purification policies and initiatives to lower the burden of skin disease, especially for vulnerable communities.
Identifiants
pubmed: 38103119
doi: 10.1007/s13555-023-01080-1
pii: 10.1007/s13555-023-01080-1
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
© 2023. The Author(s).
Références
Bhatia A, Katz J, Sanger-Katz M (2023, June 8). Just how bad was the pollution in New York? New York Times. https://www.nytimes.com/interactive/2023/06/08/upshot/new-york-city-smoke.html .
Hassan A, Betts A (2023, September 29). Maui wildfires latest: Lahaina reopens to residents. New York Times. https://www.nytimes.com/article/maui-wildfires-hawaii.html .
Wilkins ET. Air pollution and the London fog of December, 1952. J R Sanit Inst. 1954;74(1):1–15.
doi: 10.1177/146642405407400101
pubmed: 13118590
Bell ML, Davis DL. Reassessment of the lethal London fog of 1952: novel indicators of acute and chronic consequences of acute exposure to air pollution. Environ Health Perspect. 2001;109(Suppl 3):389–94.
doi: 10.1289/ehp.01109s3389
pubmed: 11427388
pmcid: 1240556
World Health Organization. Air pollution. 2023. https://www.who.int/china/health-topics/air-pollution . Accessed 15 Sept 2023.
Zhang D, Liu J, Li B. Tackling air pollution in china—what do we learn from the great smog of 1950s in LONDON. Sustainability. 2014;6(8):5322–38.
doi: 10.3390/su6085322
National Eczema Association. Knowledge is power. 2023. https://nationaleczema.org . Accessed 17 Aug 2023.
World Health Organization. Ambient (outdoor) air pollution. 2022. https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health . Accessed 15 Aug 2023.
United States Environmental Protection Agency. Particulate Matter (PM) Pollution: National Ambient Air Quality Standards (NAAQS) for PM. 2023. https://www.epa.gov/pm-pollution/national-ambient-air-quality-standards-naaqs-pm . Accessed 15 Sept 2023.
IQAir. World Air Quality Report. Interactive global map of 2022 PM2.5 concentrations by city. 2023. https://www.iqair.com/us/world-air-quality-report . Accessed 15 Aug 2023.
Zhang B, Weuve J, Langa KM, et al. Comparison of Particulate air pollution from different emission sources and incident dementia in the US. JAMA Intern Med. 2023;183(10):1080–9.
doi: 10.1001/jamainternmed.2023.3300
pubmed: 37578757
U.S. Department of Agriculture. Nationwide aerial application of fire retardant on national forest system lands: Supplemental environmental impact statement. 2022. https://www.fs.usda.gov/sites/default/files/2022-02/2022-Aerial-Fire-Retardant-DraftSEIS.pdf . Accessed 15 Nov 2023.
United Nations Environment Programme, World Health Organization, Food and Agriculture Organization of the United Nations. Chapter 9/12: Environmental and health effects of fertilizer use. 2022. https://wedocs.unep.org/20.500.11822/40363 . Accessed 11 Nov 2023.
Schachtel A, Dyer JA, Boos MD. Climate change and pediatric skin health. Int J Womens Dermatol. 2021;7(1):85–90.
doi: 10.1016/j.ijwd.2020.07.006
pubmed: 33537397
Arnedo-Pena A, Garcia-Marcos L, Carvajal Uruena I, et al. Air pollution and recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years. Arch Bronconeumol. 2009;45(5):224–9.
doi: 10.1016/j.arbres.2008.10.004
pubmed: 19371994
Buchholz RR, Park M, Worden HM, et al. New seasonal pattern of pollution emerges from changing North American wildfires. Nat Commun. 2022;13(1):2043.
doi: 10.1038/s41467-022-29623-8
pubmed: 35440561
pmcid: 9018720
Lee Y-L, Su H-J, Sheu H-M, Yu H-S, Guo YL. Traffic-related air pollution, climate, and prevalence of eczema in Taiwanese school children. J Investig Dermatol. 2008;128(10):2412–20.
doi: 10.1038/jid.2008.110
pubmed: 18449213
Environment Canada Environmental Protection Service. Environmental and technical information for problem spills manuals: ammonium phosphates. Ottawa: Technical Services Branch; 1984.
Kim BE, Leung DYM. Significance of skin barrier dysfunction in atopic dermatitis. Allergy Asthma Immunol Res. 2018;10(3):207–15.
doi: 10.4168/aair.2018.10.3.207
pubmed: 29676067
pmcid: 5911439
Araviiskaia E, Berardesca E, Bieber T, et al. The impact of airborne pollution on skin. J Eur Acad Dermatol Venereol. 2019;33(8):1496–505.
doi: 10.1111/jdv.15583
pubmed: 30897234
pmcid: 6766865
Hidaka T, Ogawa E, Kobayashi EH, et al. The aryl hydrocarbon receptor AhR links atopic dermatitis and air pollution via induction of the neurotrophic factor artemin. Nat Immunol. 2017;18(1):64–73.
doi: 10.1038/ni.3614
pubmed: 27869817
Krutmann J, Liu W, Li L, et al. Pollution and skin: from epidemiological and mechanistic studies to clinical implications. J Dermatol Sci. 2014;76(3):163–8.
doi: 10.1016/j.jdermsci.2014.08.008
pubmed: 25278222
Elentner A, Schmuth M, Yannoutsos N, et al. Epidermal overexpression of xenobiotic receptor PXR impairs the epidermal barrier and triggers Th2 immune response. J Invest Dermatol. 2018;138(1):109–20.
doi: 10.1016/j.jid.2017.07.846
pubmed: 28927887
Oetjen LK, Trier AM, Kim BS. PXR: a new player in atopic dermatitis. J Invest Dermatol. 2018;138(1):8–10.
doi: 10.1016/j.jid.2017.08.002
pubmed: 29273149
Sugaya M. The role of Th17-related cytokines in atopic dermatitis. Int J Mol Sci. 2020;21(4):1314.
doi: 10.3390/ijms21041314
pubmed: 32075269
pmcid: 7072946
Fadadu RP, Grimes B, Jewell NP, et al. Association of wildfire air pollution and health care use for atopic dermatitis and itch. JAMA Dermatol. 2021;157(6):658–66.
doi: 10.1001/jamadermatol.2021.0179
pubmed: 33881450
Fadadu RP, Green M, Jewell NP, Grimes B, Vargo J, Wei ML. Association of exposure to wildfire air pollution with exacerbations of atopic dermatitis and itch among older adults. JAMA Netw Open. 2022;5(10): e2238594.
doi: 10.1001/jamanetworkopen.2022.38594
pubmed: 36287569
pmcid: 9606843
NASA Earth Observations. Carbon Monoxide. 2022. https://neo.gsfc.nasa.gov/view.php?datasetId=MOP_CO_M . Accessed 11 Nov 2023.
Hui-Beckman JW, Goleva E, Leung DYM, Kim BE. The impact of temperature on the skin barrier and atopic dermatitis. Ann Allergy Asthma Immunol. 2023;31(6):713-9.
United States Environmental Protection Agency. Outdoor air quality data. 2023. https://www.epa.gov/outdoor-air-quality-data/download-daily-data . Accessed 30 Aug 2023.
Krutmann J, Schikowski T, Morita A, Berneburg M. Environmentally-induced (extrinsic) skin aging: exposomal factors and underlying mechanisms. J Invest Dermatol. 2021;141(4S):1096–103.
doi: 10.1016/j.jid.2020.12.011
pubmed: 33541724
Huls A, Vierkotter A, Gao W, et al. Traffic-related air pollution contributes to development of facial lentigines: further epidemiological evidence from caucasians and Asians. J Invest Dermatol. 2016;136(5):1053–6.
doi: 10.1016/j.jid.2015.12.045
pubmed: 26868871
Huang CH, Chen SC, Wang YC, Wang CF, Hung CH, Lee SS. Detrimental correlation between air pollution with skin aging in Taiwan population. Medicine (Baltimore). 2022;101(31):e29380.
doi: 10.1097/MD.0000000000029380
pubmed: 35945750
Noah TL, Worden CP, Rebuli ME, Jaspers I. The effects of wildfire smoke on asthma and allergy. Curr Allergy Asthma Rep. 2023;23(7):375–87.
doi: 10.1007/s11882-023-01090-1
pubmed: 37171670
Lorion RP. Preventive goals and indirect/consultation strategies: focusing on beginnings reduces the incidence and severity of the ends. In: Reference module in neuroscience and biobehavioral psychology. New York: Elsevier; 2017. https://doi.org/10.1016/B978-0-12-809324-5.05102-6 .
Jelousi S, Sharma D, Alexis A, Murase JE. The impact of global health disparities on atopic dermatitis in displaced populations: narrowing the health equity gap for patients with skin of color. Dermatol Ther (Heidelberg). 2022;12(12):2679–89.
doi: 10.1007/s13555-022-00823-w
Shrestha PM, Humphrey JL, Carlton EJ, et al. Impact of Outdoor air pollution on indoor air quality in low-income homes during wildfire seasons. Int J Environ Res Public Health. 2019;16(19):3535.
doi: 10.3390/ijerph16193535
pubmed: 31546585
pmcid: 6801919
GreenRoots Inc. COVID-19 in Chelsea: a glance into one of the hardest hit cities and the role of intersecting social determinants of health. 2021. https://static1.squarespace.com/static/57ac44ebb3db2b4ff1e21ced/t/61bb43cee87b3c39cf1d712c/1639662549281/Final+PDF_DEC+15_JW+Corrections.pdf . Accessed 16 Sept 2023.
Hajat A, Hsia C, O’Neill MS. Socioeconomic disparities and air pollution exposure: a global review. Curr Environ Health Rep. 2015;2(4):440–50.
doi: 10.1007/s40572-015-0069-5
pubmed: 26381684
pmcid: 4626327
Seth D, Fadadu R, Jewell N, Wei M. 246 Environmental injustice and risk for wildfire-associated skin flares. J Investig Dermatol. 2022;142(8):S42.
doi: 10.1016/j.jid.2022.05.253
Burki TK. The innovations cleaning our air. Lancet Respir Med. 2019;7(2):111–2.
doi: 10.1016/S2213-2600(19)30002-5
pubmed: 30638907
Greenbaum DS. The clean air act: substantial success and the challenges ahead. Ann Am Thorac Soc. 2018;15(3):296–7.
doi: 10.1513/AnnalsATS.201710-763PS
pubmed: 29262262
AirNow. Wildfire smoke: a guide for public health officials. 2021. https://www.airnow.gov/publications/wildfire-smoke-guide/wildfire-smoke-a-guide-for-public-health-officials/ . Accessed 25 Oct 2023.
Park HC, Kim YH, Kim JE, et al. Effect of air purifier on indoor air quality and atopic dermatitis. Allergy Asthma Respir Dis. 2013;1(3):248–56.
doi: 10.4168/aard.2013.1.3.248
Congress.gov. H.R.4077-Cleaner air spaces act of 2023. 2023. https://www.congress.gov/bill/118th-congress/house-bill/4077/text?s=1&r=5&q=%7B%22search%22%3A%5B%22air+pollution%22%5D%7D . Accessed 12 Sept 2023.
World Health Organization. Wildfires. https://www.who.int/health-topics/wildfires#tab=tab_1 . Accessed 12 Aug 2023.
Mackenbach JP. Politics is nothing but medicine at a larger scale: reflections on public health’s biggest idea. J Epidemiol Community Health. 2009;63(3):181–4.
doi: 10.1136/jech.2008.077032
pubmed: 19052033
Sharma D, Murase LC, Murase JE, Rosenbach M. Combatting climate change: 10 interventions for dermatologists to consider for sustainability. Cutis. 2022;110(2):59–62.
doi: 10.12788/cutis.0577
pubmed: 36219644
United Nations Environment Programme. As climate changes, world grapples with a wildfire crisis. 2022. https://www.unep.org/news-and-stories/story/climate-changes-world-grapples-wildfire . Accessed 12 Nov 2023.