The Impact of Atmospheric Pollutants on the Prevalence of Atopic Eczema in 6-7-Year-Old Schoolchildren in Spain; ISAAC Phase III

Atopic Eczema (AE) is a chronic inflammatory skin disease that affects children and adults, and alters quality of life with a high morbidity rate and severe economic burden. The objective of the present work was to analyse specific atmospheric pollutants (O3, NO, PM10 and SO2) affecting the prevalence of diagnosed AE and its symptoms among 6-7-year-old schoolchildren.
The participants included 21311 schoolchildren aged 6-7 years from 8 Spanish regions, whose parents completed the ISAAC Phase III questionnaire to ascertain AE diagnosis and symptoms. The mean levels (µg/m3) of O3, NO, PM10 (particles 10 micrometers or less in diameter) and SO2 were determined in each geographical area participating in this study.
According to these mean levels, three levels of exposure to each pollutant were considered: level 1 (percentiles 0-25); level 2 (percentiles 26-74); level 3 (percentiles 75-100). Exposure to O3 was associated with increased prevalence of rashes (exposure level 2, Odds Ratio (OR): 1.22, 95% Confidence Interval (95%CI): 1.02-1.45; level 3 OR: 1.33, 95%CI:1.10-1.61) and diagnosed AE (level 2, OR: 1.27, 95%CI: 1.17-1.39; level 3 OR: 1.27, 95%CI:1.15-1.41). An association was found between the level of NO and a drop in the prevalence of diagnosed AE (exposure level 2, OR: 0.88, 95%CI: 0.81-0.95; level 3 OR: 0.85, 95%CI:0.74-0.97). There was also an association between the highest exposure level to PM10 and a reduced prevalence of rashes (level 3 OR: 0.42, 95%CI: 0.22-0.81) and diagnosed AE (level 3OR: 0.53, 95%CI: 0.38-0.75).
Future studies into exposure to O3 and its relationship with allergic diseases may be conducted in order to prevent this association.

1. Giner A, Tabar AI, Vives R. [Atopic dermatitis in paediatric practice]. An Sist Sanit Navar 2002; 25 Suppl 2:45-61.
2. Williams HC. Atopic eczema. BMJ 1995;311(7015):1241-2.
3. Asher MI, Montefort S, Björkstén B, Lai KW, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases one and three repeat multicountry cross-sectional surveys. Lancet 2006; 368(9537):733-43.
4. Barnetson R St C, Rogers M. Childhood atopic eczema.BMJ 2002; 324(7350):1376–9.
5. Boquete M, Almuniña C. Dermatitis atópica: nuevas consideraciones. Bol Pediatr 2007; 47(199):4-14.
6. Kusunoki T, Asai K, Harazaki M, Korematsu S, Hosoi S.
Month of birth and prevalence of atopic dermatitis in schoolchildren: dry skin in early infancy as a possible etiologic factor. J Allergy Clin Immunol 1999;103(6):1148-52.
7. Peden DB. Development of Atopy and Asthma: Candidate environmental influences and important periods of exposure. Environ Health Perspect 2000;108(suppl 3):475-82.
8. Ballester F. Contaminación atmosférica, cambio climático y salud. Rev Esp Salud Pública 2005; 79(2):159-75.
9. Lee Y-L, Su H-J, Sheu H-M, Yu H-S, Guo Y-L. Traffic- related air pollution, climate, and prevalence of eczema in taiwanese schoolchildren. J Invest Dermatol 2008;128(10):2412-20.
10. Stewart AW, Asher MI, Clayton TO, Crane J, D´Souza W, Ellwood PE, et al. The effect of season-of- response to ISAAC questions about asthma, rhinitis and eczema in children. Int J Epidemiol 1997; 26(1):126-36.
11. Weiland SK, Hüsing A, Strachan DP, Rzehak P, Pearce N. Climate and the prevalence of symptoms of asthma, allergic rhinitis, and atopic eczema in children. Occup Environ med Med 2004; 61(7):609-15.
12. Arnedo-Pena A, García-Marcos L, Carvajal Urueña I, Busquets Monge R, Morales Suárez-Varela M, Miner Canflanca 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.
13. Morales MM, García- Marcos L, Kogan MD, Llopis A, Martínez A, Aguinaga I, et al. Climate and prevalence of atopic eczema in 6 to 7year old school children in Spain. ISAAC PhASE III. Int J Biometeorol 2008; 52(8):833-40.
14. Van de Ven M, Van den Eijnden R, Engels R. Atopic diseases and related risk factors among Dutch adolescents. Eur J Public Health 2006; 16(5):549-58.
15. Williams H, Stewart A, von Mutius E, Cookson W, Ross Anderson H. Is eczema really on the increase worldwide? J Allergy Clin Immunol 2008; 121(4):947-54.
16. Williams H, Robertson C, Stewart A, Aït-Khaled N, Anabwani G, Anderson R, et al. Worldwide variations in the prevalence of symptoms of atopic eczema in the international study of asthma and allergies in childhood. J Allergy Clin Immunol 1999(1 pt 1); 103:125-38.
17. Hanifin, Rajka. Diagnostic features of atopic dermatitis.Acta Derm Venereol (Stockh) 1980; 92:44-7.
18. Calidad del aire de fondo regional en España para protección de la salud: Contaminación por ozono (O3) y partículas (PM10). In: Banco público de indicadores ambientales del Ministerio de Medio Ambiente. Ministerio de Medio Ambiente, 2007.
19. PRTR-España Registro estatal de emisiones y fuentes contaminantes In: www.prtr-es.es.
20. Datos históricos de calidad del aire en España. In:www.troposfera.org.
21. El estado del medio ambiente y evolución. In: Memoria “Medio ambiente en España”. Ministerio de Medio Ambiente, 2003.
22. Estado y evolución del medio ambiente. In: Memoria “Medio ambiente en España”. Ministerio de Medio Ambiente, 2003.
23. Estrategia española de calidad del aire. In: Secretaría general para la prevención de la contaminación y del cambio climático. Dirección general de calidad y evaluación ambiental. Ministerio de Medio Ambiente,2005.
24. Inventario de gases de efecto invernadero de España.Serie 1990-2006. Ministerio de Medio Ambiente. Secretaría general para la prevención de la contaminación y del cambio climático. Dirección general de calidad y evaluación ambiental. Subdirección general de calidad del aire y prevención de riesgos. Ministerio de Medio Ambiente, 2008.
25. INE-Instituto Nacional de Estadística (2004a) Temperaturas medias, humedad media mensual en porcentaje, precipitación total en mm, número de horas de sol. Climatología. Entorno físico y medio ambiente. In: Anuario Estadístico de España 2005. Madrid: Ministerio de Medio Ambiente, 2005:21-4.
26. INE-Instituto Nacional de Estadística (2004b) Temperaturas máximas y mínimas por regiones. Climatología. Entorno físico y medio ambiente. In: Anuario Estadístico de España 2005. Madrid: Ministerio de Medio Ambiente, 2005:25.
27. INE-Instituto Nacional de Estadística (2005a)Temperaturas medias, humedad media mensual en porcentaje, precipitación total en mm, número de horas de sol. Climatología. Entorno físico y medio ambiente. In: Anuario Estadístico de España 2005. Madrid: Ministerio de Medio Ambiente, 2005:21-4.
28. INE-Instituto Nacional de Estadística (2005b)Temperaturas máximas y mínimas por regiones. Climatología. Entorno físico y medio ambiente. In: Anuario Estadístico de España 2005. Madrid: Ministerio de Medio Ambiente, 2005:25.
29. Pénard-Morand C, Charpin D, Raherison C, Caillaud D, Lavaud F, Annesi-Maesano I. Long-term exposure to background air pollution related to respiratory and allergic health in schoolchildren. Clin Exp Allergy 2005;35(10):1279-87.
30. Strickland MJ, Gass KM, Goldman GT, Mulholland JA.Effects of ambient air pollution measurement error on health effect estimates in time-series studies: a simulation-based analysis. J Expo Sci Environ Epidemiol 2013 .
31. Díaz-Sánchez D. Pollution and the immune response: atopic diseases--are we too dirty or too clean? Immunology 2000; 101(1):11-8.
32. Melén E, Nyberg F, Lindgren CM, Berglind N, Zucchelli M, NordlingE, et al. Interaction between glutathione s- transferase P1, tumor necrosis factor and traffic-related air pollution for development of childhood allergic disease. Environ Health Perspect 2008; 116(8):1077–84.
33. Schwartz J. Air Pollution and Children’s Health.Pediatrics 2004; 113 (4 Suppl):1037-43.
34. Guo YL, Lin YC, Sung FC, Huang SL, Ko YC, Lai JS, et al. Climate, traffic-related air pollutants and asthma prevalence in middle-school children in Taiwan. Environ Health Perspect 1999; 107(12):1001-6.
35. Heinrich J, Wichmann HE. Traffic related pollutants in Europe and their effect on allergic disease. Curr Opin Allergy Clin Immunol 2004; 4(5):341-8.
36. Magalhães JL, Laerte J, Couto C, Tavares A.Atmospheric pollution and the prevalence of asthma: study among schoolchildren of 2 areas in Rio de Janeiro, Brazil. Ann Allergy Asthma Immunol 2004; 92(6):629-34.
37. Martín D, Martín JM, García-Marcos L. Prevalencia de la dermatitis atópica en escolares de Cartagena y su relación con el sexo y la contaminación. An Pediatr (Barc) 2004;60:555-60.
38. De Marco R, Poli A, Ferrari M, Accordini S, Giammanco G, Bugiani M, et al. The impact of climate and traffic- related NO2 on the prevalence of asthma and allergic rhinitis in Italy. Clin Exp Allergy 2002; 32(10):1405-12.
39. Suárez-Varela MM, García-Marcos Alvarez L, Kogan MD, González AL, Gimeno AM, Aguinaga Ontoso I, et al. Climate and prevalence of atopic eczema in 6- to 7- year-old school children in Spain. ISAAC phase III. Int J Biometeorol 2008; 52(8):833-40.
40. Byremo G, Rød G, Carlsen KH. Effect of climatic change in children with atopic eczema. Allergy 2006;61(12):1403-10.

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Issue	Vol 12, No 3 (2013)
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Keywords
Atmospheric Pollutants Atopic Eczema Phase III ISAAC Study

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Suárez-Varela MM, Gallardo-Juan A, García-Marcos L, Gimeno-Clemente N, Silvarrey-Varela AL, Miner-Canflanca I, Batlles-Garrido J, Blanco-Quiros A, Busquets-Monge RM, Domínguez-Aurrecoechea B, Arnedo-Pena A, González-Díaz C, Aguinaga-Ontoso I, Martínez-Gimeno A, Llopis-González A. The Impact of Atmospheric Pollutants on the Prevalence of Atopic Eczema in 6-7-Year-Old Schoolchildren in Spain; ISAAC Phase III. Iran J Allergy Asthma Immunol. 1;12(3):220-227.

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