Spectrum of susceptibility to air quality and weather in individual children with atopic dermatitis

Background: Exposure to air pollution aggravates symptoms of atopic dermatitis (AD) in children in the population studies. Variability in individual patient's response from individual susceptibility is needed to be explored. Objective: This study aimed to investigate spectrum of individual variability in the associations between AD symptoms and air quality. Methods: We enrolled 89 children aged 0-6 years with AD (22 890 person-days). Daily manifestation of symptoms was recorded for an average of 257 days (range 100-499). Both an individual analysis using logistic regression models and an overall analysis using a generalized estimating equation were performed. Results: The odds ratios of an individual ranged 0.24-8.11 for particulate matter <10 μm in diameter (PM ₁₀ ), 0.09-101.92 for nitrogen oxide (NO ₂ ), 0.03-44.00 for ozone (O ₃ ), 0.11-58.30 for sulfur dioxide (SO ₂ ), 0.00-15.83 for carbon monoxide (CO), 0.00-39 446.94 for temperature, and 0.03-5.18 for relative humidity, demonstrating a wide individual variability. In the overall analysis, PM ₁₀ , NO ₂ , SO ₂ , and CO had a significantly positive association, whereas temperature and relative humidity were negatively associated with AD symptoms. Air pollution was responsible for aggravation of symptoms from 24.7% (O ₃ ) to 39.3% (SO ₂ ) of AD children. Overall, 71.9% of the AD children responded to at least one or more air pollution and weather variable. Conclusion: Responses of AD children to air pollution and weather variable were considerably variable among individuals. An individualized model would be useful to forecast and manage AD symptoms in patients.