To synthesize epidemiologic evidence linking air pollution exposure to various skin diseases, including atopic dermatitis, psoriasis, urticaria, acne, melanoma, and skin aging.
Key Findings:
Atopic dermatitis was the most studied condition, with short- and long-term exposure linked to increased risk, rated very low certainty due to bias.
Psoriasis showed stronger short-term associations with gaseous pollutants and moderate certainty for long-term studies, but overall evidence was limited.
Urticaria had generally positive associations with air pollution, particularly for particulate matter, but certainty was low due to bias.
Acne evidence was limited and showed very low certainty due to high bias and few studies.
Melanoma studies yielded heterogeneous results with very low certainty, primarily due to confounding.
Skin aging markers were linked to air pollution but with low certainty due to bias and limited data.
Interpretation:
Despite positive associations between air pollution and skin diseases, the overall quality of evidence is low due to high risk of bias and methodological limitations, which may impact public health recommendations.
Limitations:
High risk of bias due to confounding and selection issues, including incomplete adjustment for confounders like socioeconomic status and health behaviors.
Limited data from low- and middle-income countries, which may not represent global trends.
Few studies assessed disease severity or vulnerable subgroups, limiting understanding of the full impact.
Conclusion:
More longitudinal studies are needed to establish causality and improve exposure assessments, particularly in underrepresented regions and populations, to better inform public health strategies.
