Clinical Implications of Post-Earthquake Environmental Exposures in Children with Allergic Diseases

Background/Objectives: Environmental changes following large-scale natural disasters may influence the clinical course of chronic diseases. However, the impact of post-earthquake environmental exposures on pediatric allergic diseases remains insufficiently studied. To evaluate the association between post-earthquake environmental exposures and disease control in children with allergic diseases. Methods: This retrospective longitudinal cohort study included 528 children with previously diagnosed asthma, allergic rhinitis, or atopic dermatitis who were followed in a tertiary pediatric allergy center in Malatya, Türkiye. Clinical assessments performed before the 6 February 2023 Kahramanmaraş earthquakes (T0) were compared with follow-up evaluations conducted 6–12 months after the earthquake (T1). Environmental exposures assessed during the post-earthquake period included prolonged residence in temporary housing, demolition-related dust exposure, and elevated ambient particulate matter levels. Clinical deterioration was defined using disease-specific indicators (decline in ACT/cACT score or treatment step escalation for asthma, increase in TNSS for allergic rhinitis, and increase in SCORAD for atopic dermatitis). Multivariable logistic and linear regression models were used to evaluate associations between environmental exposures and clinical outcomes. Results: Clinical deterioration was observed in 219 children (41.5%). Prolonged residence in temporary housing for ≥6 months (aOR 2.1, 95% CI 1.2–3.9, p = 0.01) and exposure to demolition-related dust (aOR 1.9, 95% CI 1.1–3.5, p = 0.02) were independently associated with clinical deterioration. Among children with asthma, both prolonged temporary housing (adjusted β −1.84, p = 0.002) and demolition-related dust exposure (adjusted β −1.39, p = 0.018) were associated with worsening asthma control. Conclusions: Post-earthquake environmental exposures, particularly prolonged residence in temporary housing and demolition-related dust exposure, were associated with worsening control of pediatric allergic diseases. These findings highlight the importance of environmental health considerations in disaster response and long-term management of children with chronic allergic conditions.