Association between short-term air pollutants and psoriasis outpatient visits: a time series study in Nanchang, China
摘要
It is well known that psoriasis is caused by a combination of genetic and environmental factors. Among the many environmental factors, emerging evidence suggests air pollution plays a crucial role in the exacerbation of psoriasis symptoms, and the association of air pollutants with psoriasis remains elusive. To address that, daily outpatient visit data for psoriasis from 1 January 2017 to 31 December 2022 was obtained from the Dermatology Hospital of Jiangxi Province (Nanchang, Jiangxi, China). Daily meteorological factors (temperature and relative humidity) and 24-h mean concentrations of four common air pollutants, including particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), O3 8-h maximum values (O38h) and carbon monoxide (CO), were consecutively recorded. Quasi-Poisson generalized additive model (GAM), in conjunction with a distributed lag nonlinear model (DLNM) was used to examine the associations between air pollutants and hospital outpatient visits for psoriasis. Stratified analyses by gender, age and season were further conducted. Specifically, for every 10 µg/m3 increase (1 mg/m3 in CO) of PM2.5 (lag 07), PM10 (lag 07), SO2 (lag 03), NO2 (lag 07), O38h (lag 02), and CO (lag 07), the relative risk (RR) values were 1.051 (95%CI: 1.038,1.063), 1.030 (95%CI: 1.023, 1.037), 1.141 (95%CI: 1.100, 1.184), 1.093 (95%CI: 1.077, 1.110) 1.011 (95%CI: 1.006, 1.016) and 1.289 (95%CI: 1.161, 1.432), respectively. Stratified analyses suggested that the associations were stronger in females, aged ≥ 65 years old. There was a seasonal variation in the strength of association with air pollution. The exposure-response curves for all pollutants showed an almost linear trend with no discernible thresholds. Our study demonstrated that exposure to ambient air pollution is associated with an increase in psoriasis outpatient visits in Nanchang, China. Our finding is crucial for understanding the environmental triggers of the disease between psoriasis and air pollution, which can lead to improved prevention and management strategies.