Atopic eczema is a common and complex disease. Missing genetic hereditability and increasing prevalence in industrialising nations point towards an environmental driver. We investigated the temporal association of weather and pollution parameters with eczema severity. This cross-sectional clinical study was performed between May 2018 and March 2020 and is part of the Tower Hamlets Eczema Assessment. All participants had a diagnosis of eczema, lived in East London, were of Bangladeshi ethnicity and were less than 31 years of age. The primary outcome was the probability of having an EASI score > 10 after prior ambient exposure to commonly studied meteorological variables and pollutants. There were 430 participants in EASI ≤ 10 and 149 in EASI >10 groups. By using logistic generalized additive models and a model selection process, we found that tropospheric ozone (O3) averaged over the preceding 270 days was strongly associated with eczema severity alongside the exposure to fine particles with diameters of 2.5 μm or less (PM2.5) averaged over the preceding 120 days. In our models and analyses PM2.5 appeared to largely act in a supporting role to O3. We demonstrate that long-term exposure to ground-level ozone at high levels has the strongest association with eczema severity.

B.R. Thomas

Papers

Modelling of temporal exposure to the ambient environment and eczema severity