Agua dura... Mayor prevalencia de Dermatitis Atopica...

Estudio observacional, encuentra que en zonas donde hay agua dura, los niños presentan más dermatitis atópica. No es un estudio de causa y efecto, es observacional y requiere otros estudios, pero sí es interesante, comentan los autores.

Association between domestic water hardness, chlorine, and atopic dermatitis risk in early life: A population-based cross-sectional study

Michael R. Perkin

, PhD

, 

Joanna Craven

, MPH

, 

Kirsty Logan

, PhD

, 

David Strachan

, MD

, 

Tom Marrs

, BM BS

, 

Suzana Radulovic

, MD

, 

Linda E. Campbell

, BSc

, 

Stephanie F. MacCallum

, MSc

, 

W.H. Irwin McLean

, DSc

, 

Gideon Lack

, MD

, 

Carsten Flohr

, PhD

on behalf of the Enquiring About Tolerance Study Team

Published Online: April 28, 2016

DOI: http://dx.doi.org/10.1016/j.jaci.2016.03.031

Publication stage: In Press Corrected Proof

Article Infoclick to expand contents 

Background

Domestic water hardness and chlorine have been suggested as important risk factors for atopic dermatitis (AD).

Objective

We sought to examine the link between domestic water calcium carbonate (CaCO₃) and chlorine concentrations, skin barrier dysfunction (increased transepidermal water loss), and AD in infancy.

Methods

We recruited 1303 three-month-old infants from the general population and gathered data on domestic water CaCO₃ (in milligrams per liter) and chlorine (Cl₂; in milligrams per liter) concentrations from local water suppliers. At enrollment, infants were examined for AD and screened for filaggrin (FLG) skin barrier gene mutation status. Transepidermal water loss was measured on unaffected forearm skin.

Results

CaCO₃ and chlorine levels were strongly correlated. A hybrid variable of greater than and less than median levels of CaCO₃ and total chlorine was constructed: a baseline group of low CaCO₃/low total chlorine (CaL/ClL), high CaCO₃/low total chlorine (CaH/ClL), low CaCO₃/high total chlorine (CaL/ClH) and high CaCO₃/high total chlorine (CaH/ClH). Visible AD was more common in all 3 groups versus the baseline group: adjusted odds ratio (AOR) of 1.87 (95% CI, 1.25-2.80; P = .002) for the CaH/ClL group, AOR of 1.46 (95% CI, 0.97-2.21; P = .07) for the CaL/ClH, and AOR of 1.61 (95% CI, 1.09-2.38; P = .02) for the CaH/ClH group. The effect estimates were greater in children carrying FLG mutations, but formal interaction testing between water quality groups and filaggrin status was not statistically significant.

Conclusions

High domestic water CaCO₃ levels are associated with an increased risk of AD in infancy. The influence of increased total chlorine levels remains uncertain. An intervention trial is required to see whether installation of a domestic device to decrease CaCO₃levels around the time of birth can reduce this risk.

Benjamin Hidalgo-Matlock

Skin Care Physicians of Costa Rica

4000-1054

2208-8206

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