Environmental exposures and atopic dermatitis: an umbrella review of systematic reviews and meta-analyses
Abstract
Background: Atopic dermatitis (AD) is a common chronic inflammatory skin disorder with a substantial global burden. Although multiple studies have investigated the impact of environmental exposures on AD, a comprehensive review integrating children, adults, and mixed-age populations is lacking. This study aimed to synthesise current evidence on environmental risk factors for AD and examine age-specific susceptibility.
Methods: We systematically searched PubMed, Embase, and Web of Science up to March 2026 for systematic reviews and meta-analyses on environmental exposures and AD risk. Exposures were categorised as: microbe- and immune-related factors (antibiotics and helminth infections), environmental pollution and chemicals (air pollution, per- and polyfluoroalkyl substances (PFAS), heavy metals, pesticides), and lifestyle or residential factors (active and passive smoking, pet exposure, urban environment, light at night, indoor fuel use). Eligible studies reported pooled effect estimates including odds ratios (ORs), relative risks (RRs), or hazard ratios (HRs) with 95% confidence intervals (CIs), or clear directional associations. Data extraction prioritised fully adjusted estimates, dose-response relationships, and age-stratified findings. Methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). Evidence synthesis focused on effect direction, statistical significance, heterogeneity (I2), and overlap of primary studies,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Tryptophan Metabolism and Gut-Brain Homeostasis
- Rationale for a Multi-Factorial Approach for the Reversal of Cognitive Decline in Alzheimer’s Disease and MCI: A Review
- Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit
- Relationship between sleep disorders and gut dysbiosis: what affects what?
- The role of CLOCK gene in psychiatric disorders: Evidence from human and animal research
- Genetic, Transcriptome, Proteomic, and Epidemiological Evidence for Blood-Brain Barrier Disruption and Polymicrobial Brain Invasion as Determinant Factors in Alzheimer’s Disease
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.