High tree pollen levels and low temperatures increased the utilization of atopic dermatitis-related medical services in children residing in a tropical urban area (San Juan, Puerto Rico)

Abstract

Atopic dermatitis (AD) is a highly prevalent and multifactorial condition influenced by environmental factors such as the concentration of airborne allergens and meteorological variables. However, there is a lack of consensus on the role of these factors in triggering AD, particularly in tropical areas, where high values of these variables are common and studies are scarce. Therefore, this ecological study aimed to assess the association between concentrations of outdoor fungal spores and tree pollen, temperature, and water vapor pressure with AD-related medical services utilization in children 12 years or younger residing in a tropical urban area (San Juan, Puerto Rico), from 2017 to 2020. The study analyzed medical records of two dermatology clinics and local data on outdoor aeroallergens and meteorological variables to determine the number of AD-related medical claims during the study period, based on their medical diagnostic code. The multivariate regression analysis showed that high tree pollen concentrations (IRR = 1.2670, p = 0.032) and low average temperatures (IRR = 1.3114, p = 0.009) increased the probability of AD-related medical claims. In contrast, this probability was reduced with high average temperatures (IRR = 0.6782, p = 0.001) and low water vapor pressure values (IRR = 0.7802, p = 0.022). No associations were found with outdoor fungal spores. In conclusion, this study found that high tree pollen concentrations and low temperatures increased the utilization of AD-related medical services. Educating individuals about reducing exposure to unfavorable environmental conditions could be a useful intervention in preventing the exacerbation of AD.