Hui-Wen Tseng,1,2,3,4 Ling-Ying Lu,3,5

Affiliations:
1 Department of Dermatology, Ministry of Health and Welfare Pingtung Hospital, Pingtung, Taiwan
2 Institute of Biomedical Sciences, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan
3 School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan
4 Department of Nursing, Meiho University, Neipu, Pingtung, Taiwan
5 Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

Abstract

Background: Air volatile organic compounds (VOCs) cause allergic reaction mainly via the respiratory tract or skin.
Objectives: This study aimed to investigate the association between daily visits by patients with urticaria and short-term changes in exposure to ambient air VOCs.
Methods: The dependent variable was information from patients with urticaria at a medical center in Kaohsiung, Taiwan, from 2014/01/01 to 2018/07/31. The multivariable model included one-day average 75th percentile values of air VOCs and meteorologic data retrieved from Taiwan Air Quality Monitoring Network database, and was analyzed using a case-crossover study design and conditional logistic regression.
Results: Total daily clinic visits for urticaria were significantly positively associated with higher levels of 4 VOCs (ethylbenzene, toluene, m-/p-xylene, and o-xylene (adjusted odds ratio (AOR: 1.03–1.28)) on the visit days, and 10 VOC levels on the fourth lag day (benzene, ethylbenzene, toluene, m-/p-xylene, o-xylene, 1,3,5-trimethylbenzene, n-hexane, methylcyclohexane, cyclohexane, and ethylene (AOR: 1.02–3.02)). Analyses of age and gender subgroups revealed that men showed resistance on the visit day, and women, older, and younger patients were more vulnerable. Men were influenced by higher benzene levels (AOR = 1.24) on the fourth lag day. Higher values of more than 6 VOCs on the fourth lag day significantly affected women, younger and older patients (AOR: 1.04–6.5). The most notable VOCs were methylcyclohexane (women AOR = 3.28, younger AOR = 3.82) and 1,3,5-trimethylbenzene (women AOR = 2.77, older AOR = 6.5) on the fourth lag day, which had the lowest concentrations but highest influence.
Conclusion: the concentration of certain air VOCs significantly affected daily visits for urticaria.
Key words: ambient air volatile organic compounds, case-crossover study, short-term impact, urticaria, Kaohsiung, Taiwan