title: The effect of environmentally friendly wallpaper and flooring material on indoor air quality and atopic dermatitis: a pilot study.
abstract: BACKGROUND
  Formaldehyde (FA) and other volatile organic compounds (VOCs) are considered among the main causes of atopic aggravation. Their main sources include wallpapers, paints, adhesives, and flooring materials.
  
  
  OBJECTIVE
  To assess the effects of environmentally friendly wallpaper and flooring material on indoor air quality and atopic dermatitis severity.
  
  
  METHODS
  Thirty patients with atopic dermatitis were enrolled in this study. To improve air quality, the wallpaper and flooring in the homes of the subjects were replaced with plant- or silica-based materials. The indoor air concentration of FA and the total VOCs (TVOCs) were measured before remodeling and 2, 6, and 10 weeks thereafter. Pruritus and the severity of atopic eczema were evaluated by using a questionnaire and the eczema area and severity index (EASI) score before and at 4, 8, and 12 weeks after remodeling. The subjects were instructed to continue their therapy for atopic dermatitis.
  
  
  RESULTS
  The houses of 24 subjects were remodeled; all subjects completed the study. The concentration of FA in ambient air significantly decreased within 2 weeks after remodeling. The TVOC level showed a decrease at week 2 but increased again at weeks 6 and 10. The reduction of pruritus and EASI score was statistically significant in patients whose baseline EASI score was >3.
  
  
  CONCLUSIONS
  Replacing the wallpaper and flooring of houses with environmentally friendly material reduced FA in ambient air and improved pruritus and the severity of atopic eczema. The improvement of pruritus and eczema was statistically significant in patients whose baseline EASI score was >3.
authors.affiliation: Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jung Im
authors.initials: JI
authors.lastname: Na
authors.affiliation: Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sang Young
authors.initials: SY
authors.lastname: Byun
authors.affiliation: Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Mi Young
authors.initials: MY
authors.lastname: Jeong
authors.affiliation: Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kyoung Chan
authors.initials: KC
authors.lastname: Park
authors.affiliation: Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chang Hun
authors.initials: CH
authors.lastname: Huh
keywords: Atopic dermatitis; Formaldehyde; Housing; Indoor air quality; Volatile organic compounds