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      Therapeutics and Clinical Risk Management (submit here)

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      Is Open Access

      Association of uremic pruritus in hemodialysis patients with the number of days of high mean 24-hour particulate matter with a diameter of <2.5 μm


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          Uremic pruritus (UP) is a common and incapacitating symptom in patients undergoing hemodialysis (HD). The pathogenesis of UP is multifactorial and complex. Particulate matter (PM), a major air pollutant, is a mixture of particles with various chemical compositions. PM is associated with several allergic diseases, including dermatitis. To assess the role of PM (PM with a diameter of <10 μm [PM 10] and PM with a diameter of <2.5 μm [PM 2.5]) and other clinical variables in UP in patients on HD, we recruited 866 patients on maintenance HD (MHD). We analyzed the number of days of mean 24-hour PM 10 ≥125 μg/m 3/12 months (NDPM 10) or the number of days of mean 24-hour PM 2.5 ≥35 μg/m 3/12 months (NDPM 2.5) exceeding the standard level in the past 12 months respectively to determine the association with UP. In a multivariate logistic regression, HD duration, serum ferritin levels, low-density lipoprotein (LDL) levels, and NDPM 2.5 ≥116 days/12 months were positively associated with UP. This cross-sectional study showed that the number of days on which the environmental PM 2.5 exceeds the standard level might be associated with UP in patients on MHD.

          Most cited references37

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          The role of air pollutants in atopic dermatitis.

          Kangmo Ahn (2014)
          Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease and a growing health concern, especially in children, because of its high prevalence and associated low quality of life. Genetic predisposition, environmental triggers, or interactions between them contribute to the pathophysiology of AD. Therefore, it is very important to identify and control risk factors from the environment in susceptible subjects for successful treatment and prevention. Both indoor and outdoor air pollution, which are of increasing concern with urbanization, are well-known environmental risk factors for asthma, whereas there is relatively little evidence in AD. This review highlights epidemiologic and experimental data on the role of air pollution in patients with AD. Recent evidence suggests that a variety of air pollutants, such as environmental tobacco smoke, volatile organic compounds, formaldehyde, toluene, nitrogen dioxide, and particulate matter, act as risk factors for the development or aggravation of AD. These air pollutants probably induce oxidative stress in the skin, leading to skin barrier dysfunction or immune dysregulation. However, these results are still controversial because of the low number of studies, limitations in study design, inaccurate assessment of exposure and absorption, and many other issues. Further research about the adverse effects of air pollution on AD will help to expand our understanding and to establish a better strategy for the prevention and management of AD.
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            Long-term exposure to close-proximity air pollution and asthma and allergies in urban children.

            The aim of this study was to evaluate the impact of urban air pollution, assessed through reliable indicators of exposure, on asthma and allergies in schoolchildren. A validated dispersion model combining data on traffic conditions, topography, meteorology and background pollution was used to relate 3-yrs averaged concentrations of major urban pollutants at the sites of schools to skin prick tests, exercise-induced asthma and reported asthma and allergies in 6,683 children (9-11 yrs) attending 108 schools randomly selected in six French communities. For the 4,907 children who had resided at their current address for the past 3 yrs, asthma (exercise induced, past year and lifetime) was significantly positively associated with benzene, SO(2), particles with a 50% cut-off aerodynamic diameter of 10 microm (PM(10)), nitrogen oxides (NO(x)) and CO. In the same children, eczema (lifetime and past year) was significantly positively associated with benzene, PM(10), NO(2), NO(x) and CO, lifetime allergic rhinitis with PM(10) and sensitisation to pollens with benzene and PM(10). Among the 2,213 children residing at their current address since birth, the associations persisted for lifetime asthma with benzene (adjusted OR per interquartile range (95% CI) 1.3 (1.0-1.9)) and PM(10 )(1.4 (1.0-2.0)), and for sensitisation to pollens with volatile organic compounds (1.3 (1.0-1.9)) and PM(10) (1.2 (1.0-1.9)). Accurately modelled urban air pollution was associated with some measures of childhood asthma and allergies.
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              Symptoms of atopic dermatitis are influenced by outdoor air pollution.


                Author and article information

                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                23 February 2017
                : 13
                : 255-262
                [1 ]Department of Pediatric Dentistry
                [2 ]Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Linkou Medical Center
                [3 ]Chang Gung University College of Medicine, Taoyuan, Taiwan, Republic of China
                Author notes
                Correspondence: Wen-Hung Huang, Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Shing Street, Gueishan, Taoyuan 333, Taiwan, Republic of China, Email williammedia@ 123456gmail.com

                These authors contributed equally to this work

                © 2017 Liu et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Original Research

                air pollution,uremic pruritus,environmental particulate matter,pm2.5
                air pollution, uremic pruritus, environmental particulate matter, pm2.5


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