Abstract

We sought to examine the relationship globally between UV dose exposure and current eczema prevalences. ISAAC Phase Three provided data on eczema prevalence for 13-14 year-olds in 214 centres in 87 countries and for 6-7 year-olds in 132 centres in 57 countries. Linear and non-linear associations between (natural log transformed) eczema prevalence and the mean, maximum, minimum, standard deviation and range of monthly UV dose exposures were assessed using linear mixed-effects regression models. For the 13-14 year olds, the country-level eczema prevalence was positively and linearly associated with country-level monthly mean (prevalence ratio: 1.31, 95% confidence interval: [1.05, 1.63] per kJ/m2) and minimum (1.25 [1.06, 1.47] per kJ/m2) UV dose exposure. Linear and non-linear associations were also observed for other metrics of UV. Results were similar in trend, but non-significant, for the fewer centres with 6-7 year-olds (e.g. 1.24 [0.96, 1.59] per kJ/m2 for country-level monthly mean UV). No consistent within-country associations were observed (e.g. 1.05 [0.89, 1.23] and 0.92 [0.71, 1.18] per kJ/m2 for center-level monthly mean UV, for the 13-14 and 6-7 year-olds, respectively). These ecological results support a role for UV exposure in explaining some of the variation in global childhood eczema prevalence.