Environmental pollution has emerged as one of the major public health challenges worldwide, affecting multiple organ systems including the skin and upper respiratory tract. Rapid industrialization, urbanization, vehicular emissions, and increased exposure to airborne pollutants have contributed significantly to the rising prevalence of dermatological and ENT disorders [1]. Air pollutants such as particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, and sulfur dioxide have been associated with inflammatory and allergic diseases affecting the skin and respiratory mucosa [2].

The skin, being the outermost protective barrier of the body, is directly exposed to environmental pollutants. Chronic exposure to pollutants accelerates oxidative stress, inflammation, premature aging, and exacerbation of inflammatory skin conditions such as acne, eczema, atopic dermatitis, and psoriasis [3]. Environmental pollutants may impair skin barrier function and activate inflammatory pathways contributing to dermatological disorders [4].

Air pollution has also been implicated in worsening dermatological conditions through increased production of reactive oxygen species and inflammatory mediators [5]. Exposure to ultrafine particles can penetrate tissues and induce systemic inflammatory responses, further aggravating skin diseases [6].

ENT disorders, particularly allergic rhinitis, sinusitis, and upper airway inflammation, are closely associated with environmental pollution. Outdoor pollutants and ozone exposure may increase the risk of allergic airway diseases and respiratory inflammation [7]. Epidemiological studies have shown a strong association between air pollution and respiratory allergic conditions [8].

The prevalence of allergic rhinitis has increased substantially in urban populations exposed to polluted environments [9]. Moreover, environmental pollution may contribute to inflammatory skin disorders such as acne vulgaris through immune activation and oxidative stress mechanisms [10]. Despite growing evidence globally, limited regional data exist regarding the combined impact of environmental pollution on skin and ENT disorders in developing countries. Therefore, this study aims to investigate the relationship between environmental pollution exposure and the prevalence of dermatological and ENT disorders from a public health perspective

Study Design A cross-sectional observational study was conducted to evaluate the association between environmental pollution exposure and the prevalence of skin and ENT (Ear, Nose, and Throat) disorders. Study Setting and Population The study was carried out among individuals residing in urban and semi-urban areas with varying levels of environmental pollution exposure. Participants included children, young adults, and adults attending outpatient clinics and community settings. Sample Size and Sampling Technique A total sample of 300 participants was selected using a convenient sampling technique. Individuals were grouped based on their level of exposure to environmental pollution (high exposure vs low exposure areas) Inclusion Criteria • Individuals aged 10–50 years • Residents of the selected study areas for at least 2 years • Willingness to participate in the study Exclusion Criteria • Patients with known chronic systemic diseases unrelated to environmental exposure • Individuals with congenital skin or ENT disorders • Patients on long-term immunosuppressive therapy Data Collection Data were collected using a structured questionnaire and clinical assessment. The questionnaire included demographic details, duration of residence, exposure to traffic/industrial pollution, biomass fuel exposure, and use of protective measures. Clinical evaluation was performed to identify ENT and dermatological conditions including: • Allergic rhinitis • Sinusitis • Otitis media • Acne vulgaris • Eczema and other inflammatory skin diseases Exposure Assessment Environmental pollution exposure was categorized based on: • Residential location (high traffic/industrial vs low pollution areas) • Duration of exposure • Occupational exposure history Statistical Analysis Data were analyzed using descriptive statistics. Chi-square test was applied to determine the association between pollution exposure and disease prevalence. A p-value < 0.05 was considered statistically significant SPSS 21

A total of 300 participants were included in the study and were categorized into high and low environmental pollution exposure groups. As shown in Table 1, out of 300 participants, 160 (53.3%) belonged to the high pollution exposure group, while 140 (46.7%) were in the low exposure group. This relatively balanced distribution allowed meaningful comparison between both groups. According to Table 2, ENT disorders were significantly more common among individuals with high pollution exposure.

• Allergic rhinitis was the most frequently observed condition, affecting 48.8% of participants in the high exposure group compared to 22.9% in the low exposure group.
• Sinusitis was also notably higher in the high exposure group (38.8% vs 20.0%).
• Throat irritation showed a similar pattern, being more prevalent among exposed individuals (25.0% vs 12.9%).

Overall, all ENT conditions showed a statistically significant association with environmental pollution exposure (p < 0.05), indicating a clear relationship between air pollution and upper respiratory tract morbidity. Findings in Table 3 demonstrate a strong association between pollution exposure and dermatological conditions.

• Acne vulgaris was the most common skin disorder, affecting 53.1% of highly exposed participants compared to 25.0% in the low exposure group.
• Eczema was also significantly higher in the high exposure group (37.5% vs 15.7%).
• Other inflammatory dermatoses followed the same trend, showing increased prevalence in polluted environments.

These findings suggest that prolonged exposure to environmental pollutants contributes to skin inflammation and barrier dysfunction

Table 1: Distribution of Participants by Exposure Level

Table 2: ENT Disorders by Exposure

Table 3: Skin Disorders by Exposure

Table 4: Overall Disease Burden

The present study demonstrated a significant association between environmental pollution exposure and increased prevalence of skin and ENT disorders. Participants exposed to polluted environments showed higher frequencies of allergic rhinitis, sinusitis, acne, eczema, and other inflammatory conditions compared to individuals with lower exposure levels. These findings are supported by previous international studies [11].

Exposure to airborne pollutants contributes to respiratory inflammation, mucosal irritation, and allergic sensitization, thereby increasing susceptibility to ENT disorders [12]. Traffic-related pollution and biomass smoke exposure are major contributors to respiratory allergic diseases, particularly in urban populations [13].

Oxidative stress appears to play a major role in pollution-induced tissue damage. Ozone exposure induces oxidative injury and inflammatory changes in skin tissues, supporting the mechanism observed in the current study [14]. According to the World Health Organization, ambient air pollution is a major global health threat associated with increased morbidity from respiratory and dermatological diseases [15].

Children and young adults living in highly polluted regions are particularly vulnerable to allergic and inflammatory disorders [16]. Outdoor air pollution exposure has also been associated with worsening symptoms of atopic dermatitis and other inflammatory skin diseases [17].

Environmental pollutants and climate-related changes may intensify respiratory allergies and inflammatory conditions affecting both skin and ENT systems [18]. Furthermore, outdoor air pollution significantly contributes to premature mortality and chronic disease burden worldwide [19].

Pollution-induced oxidative stress may also accelerate skin aging and inflammatory skin damage. Protective strategies, including antioxidant use and reduction of pollutant exposure, may help minimize environmental skin injury [20].

From a public health perspective, the findings of this study highlight the importance of pollution control policies, environmental awareness programs, and preventive healthcare strategies to reduce the burden of ENT and dermatological disorders in affected populations.

From a public health perspective, the findings of this study highlight the importance of pollution control policies, environmental awareness programs, and preventive healthcare strategies to reduce the burden of ENT and dermatological disorders in affected populations

1. Environmental Health Krutmann J, Liu W, Li L, et al. Pollution and skin: From epidemiological and mechanistic studies to clinical implications. J Dermatol Sci. 2014;76(3):163–168.
2. Dermatology Vierkötter A, Krutmann J. Environmental influences on skin aging and ethnic-specific manifestations. 2012;4(3):227–231.
3. Kim KE, Cho D, Park HJ. Air pollution and skin diseases: Adverse effects of airborne particulate matter on various skin diseases. Life Sci. 2016;152:126–134.
4. Schraufnagel DE. The health effects of ultrafine particles. Exp Mol Med. 2020;52(3):311–317.
5. Otolaryngology Hwang SH, Choi YH, Paik SY, et al. Potential importance of ozone in the association between outdoor air pollution and allergic diseases. Allergy Asthma Immunol Res. 2018;10(1):5–15.
6. Guarnieri M, Balmes JR. Outdoor air pollution and asthma. 2014;383(9928):1581–1592.
7. Zhang Y, Zhang L. Increasing prevalence of allergic rhinitis in China. Allergy Asthma Immunol Res. 2019;11(2):156–169.
8. Bowe WP, Logan AC. Acne vulgaris, probiotics and the gut-brain-skin axis. Gut Pathog. 2011;3:1.
9. Liu W, Pan X, Vierkötter A, et al. A time-series study of ambient air pollution and outpatient visits for acne vulgaris in Beijing. Skin Pharmacol Physiol. 2018;31(2):107–113.
10. Hehua Z, Qing C, Shanyan G, Qijun W, Yuhong Z. The impact of PM2.5 on skin diseases: A review. Environ Sci Pollut Res. 2017;24(8):6898–6908.
11. Bernstein JA, Alexis N, Barnes C, et al. Health effects of air pollution. J Allergy Clin Immunol. 2004;114(5):1116–1123.
12. Laumbach RJ, Kipen HM. Respiratory health effects of air pollution: Update on biomass smoke and traffic pollution. J Allergy Clin Immunol. 2012;129(1):3–11.
13. Oxidative Stress Valacchi G, Muresan XM, Sticozzi C, et al. Ozone-induced damage in 3D skin model. Free Radic Biol Med. 2012;53(5):1063–1071.
14. Ambient air pollution: A global assessment of exposure and burden of disease. World Health Organization
15. World Health Organization WHO. Air pollution and child health: Prescribing clean air. WHO Air Pollution Report
16. Pénard-Morand C, Raherison C, Charpin D, et al. Long-term exposure to close-proximity air pollution and asthma and allergies in urban children. Eur Respir J. 2010;36(1):33–40.
17. Kim J, Kim EH, Oh I, et al. Symptoms of atopic dermatitis are influenced by outdoor air pollution. J Allergy Clin Immunol. 2013;132(2):495–498.
18. Allergic Rhinitis D’Amato G, Cecchi L. Effects of climate change on environmental factors in respiratory allergic diseases. Clin Exp Allergy. 2008;38(8):1264–1274.
19. Lelieveld J, Evans JS, Fnais M, et al. The contribution of outdoor air pollution sources to premature mortality on a global scale. 2015;525:367–371.
20. Burke KE. Mechanisms of aging and development—A new understanding of environmental damage to the skin and prevention with topical antioxidants. Mech Ageing Dev. 2018;172:123–130.