Effects of ambient air pollution on outpatient visits for psoriasis in Wuhan, China: a time-series analysis

Higher concentrations of ambient air pollutants are associated with increased outpatient visits for psoriasis in Wuhan, China. Among the well-known air pollutants (PM2 center dot 5, PM10, NO2, SO2, CO and O-3), NO2 had a notable significant and stable effect on these increased visits. Background Psoriasis can be provoked by both external and internal factors. The effects of environmental factors on psoriasis remain unclear. Objectives To investigate the effects of air pollution on outpatient visits for psoriasis. Methods A distributed lag nonlinear model following quasi-Poisson regression was used to evaluate the lag effects of air pollutants on psoriasis outpatient visits, adjusting for potential confounders. Stratified analyses were performed to identify potential effect modifications by sex, age and season. Results In total, 13 536 outpatient visits for psoriasis were recorded in Wuhan, China from 1 January 2015 to 31 December 2019. In the single-pollutant model, exposures to particulate matter (PM) smaller than 2.5 mu m (PM2.5), PM smaller than 10 mu m (PM10), NO2 and SO2 were found to be significantly associated with increased daily psoriasis outpatient visits. For the largest effects, a 10-mu g m(-3) increase in concentrations of PM2.5 (lag1), PM10 (lag1), NO2 (lag0) and SO2 (lag3) corresponded to 0.32% [95% confidence interval (CI) 0.01-0.63], 0.26% (95% CI 0.05-0.48), 0.98% (95% CI 0.01-1.96) and 2.73% (95% CI 1.01-4.47) increases in psoriasis outpatient visits, respectively. In the two-pollutant model, only NO2 showed significant and stable effects on the outpatient visits for psoriasis. Conclusions Ambient air pollution, especially NO2, appears to be significantly associated with an increased risk of outpatient visits for psoriasis in Wuhan, China. Air pollution control and exposure prevention could be effective measures to relieve the symptoms of psoriasis among these patients.