Air pollution significantly associated with severe ocular allergic inflammatory diseases.
Miyazaki Dai,Fukagawa Kazumi,Fukushima Atsuki,Fujishima Hiroshi,Uchio Eiichi,Ebihara Nobuyuki,Shoji Jun,Takamura Etsuko,Namba Kenichi,Ohashi Yuichi,Okamoto Shigeki,Satake Yoshiyuki,Ohtsu Hiroshi,Shimizu Yumiko,Inoue Yoshitsugu
Ambient air pollution is a well-recognized risk for various diseases including asthma and heart diseases. However, it remains unclear whether air pollution may also be a risk of ocular allergic diseases. Using a web-based, nation-wide, cross-sectional study design, we examined whether the level of ambient air pollution is significantly associated with the prevalence of ocular allergic diseases. A web-based questionnaire was posted to invite the participants who are members of the Japan Ophthalmologist Association and their family members. The answers from 3004 respondents were used to determine whether there were significant associations between the level of the pollutants and the prevalence of ocular allergic diseases. The study period was between March to May 2017. The data of the air pollutants during 2012 to 2016 were obtained from the National Institute for Environmental Studies. The prevalence of allergic diseases was calculated by post stratification and examined for significant associations with the level of pollutants using multiple logistic regression analyses. The prevalence of seasonal allergic conjunctivitis, perennial allergic conjunctivitis, atopic keratoconjunctivitis (AKC), and vernal keratoconjunctivitis (VKC) in Japan was 45.4%, 14.0%, 5.3%, and 1.2%, respectively. The high prevalence of the severe forms of allergic conjunctivitis, including AKC and VKC, were significantly associated with the levels of the air pollutants. The prevalence of AKC was significantly associated with the levels of NO with an odds ratio (OR) of 1.23 (per quintile). The prevalence of VKC was significantly associated with the levels of NO and PM with ORs of 1.72 and 1.54 respectively. The significant associations between the prevalence of AKC and VKC and the levels of air pollutants indicate that clinicians need to be aware that air pollutants may pose serious risks of vision threatening severe ocular allergy.
Ambient air pollution, weather changes, and outpatient visits for allergic conjunctivitis: A retrospective registry study.
Hong Jiaxu,Zhong Taoling,Li Huili,Xu Jianming,Ye Xiaofang,Mu Zhe,Lu Yi,Mashaghi Alireza,Zhou Ying,Tan Mengxi,Li Qiyuan,Sun Xinghuai,Liu Zuguo,Xu Jianjiang
Allergic conjunctivitis is a common problem that significantly impairs patients' quality of life. Whether air pollution serves as a risk factor for the development of allergic conjunctivitis remains elusive. In this paper, we assess the relationship between air pollutants and weather conditions with outpatient visits for allergic conjunctivitis. By using a time-series analysis based on the largest dataset ever assembled to date, we found that the number of outpatient visits for allergic conjunctivitis was significantly correlated with the levels of NO2, O3, and temperature, while its association with humidity was statistically marginal. No associations between PM10, PM2.5, SO2, or wind velocity and outpatient visits were seen. Subgroup analyses showed that sex seemed to modify the effects of humidity on outpatient visits for allergic conjunctivitis, but not for NO2, O3, or temperature. People younger than 40 were found to be susceptible to changes of all four parameters, while those older than 40 were only consistently affected by NO2 levels. Our findings revealed that higher levels of ambient NO2, O3, and temperature increase the chances of outpatient visits for allergic conjunctivitis. Ambient air pollution and weather changes may contribute to the worsening of allergic conjunctivitis.
Airborne particulate matter (PM2.5) and the prevalence of allergic conjunctivitis in Japan.
Mimura Tatsuya,Ichinose Takamichi,Yamagami Satoru,Fujishima Hiroshi,Kamei Yuko,Goto Mari,Takada Sachiko,Matsubara Masao
The Science of the total environment
OBJECTIVE:Exposure to particulate matter less than 2.5 μm in diameter (PM2.5) is associated with asthma and respiratory symptoms, but little is known about the influence of PM2.5 on allergic conjunctivitis. The purpose of this study was to examine the association of PM2.5 with outpatient attendance for allergic conjunctivitis. METHODS:We conducted a time-series analysis of the association between outpatient attendance for allergic conjunctivitis and PM2.5 levels from May to July (non-pollen season) and from August to October (the autumnal pollen season) in 2012. Air pollution data (including the levels of PM2.5, oxidants, nitric oxide, nitrogen dioxide, nitrogen oxide, carbon monoxide, methane, non-methane hydrocarbons, and total hydrocarbons) and data on the daily weather conditions (temperature, wind speed, and humidity) were collected at a centrally located monitoring station in Tokyo. We calculated weekly average values for the daily number of outpatient visits, as well as the air pollution and weather data, and used the weekly average values for analysis. RESULTS:There was a significant association between the number of outpatient visits for allergic conjunctivitis and the PM2.5 level (r=0.62, p=0.0177) from May to July, while no correlation was found between the number of outpatient visits and any variable assessed from August to November. Multivariate analysis also showed that PM2.5 was a significant predictor of the number of outpatient visits from May to July (odds ratio=9.05, p=0.0463), while there were no significant predictors of the number of outpatient visits from August to October. From May to July, PM2.5 showed a negative correlation with humidity (r=-0.53, p=0.0499). CONCLUSIONS:These findings suggest a possible role of PM2.5 in the development of allergic conjunctivitis during the non-pollen season. This association between PM2.5 and allergic conjunctivitis may have broad public health implications in relation to allergic diseases.
Airborne Fine Particulate Matter Induces Oxidative Stress and Inflammation in Human Nasal Epithelial Cells.
Hong Zhicong,Guo Zhiqiang,Zhang Ruxin,Xu Jian,Dong Weiyang,Zhuang Guoshun,Deng Congrui
The Tohoku journal of experimental medicine
Airborne fine particulate matter with an aerodynamic diameter equal to or smaller than 2.5 μm is abbreviated as PM2.5, which is one of the main components in air pollution. Exposure to PM2.5 is associated with increased risk of many human diseases, including chronic and allergic rhinitis, but the underlying molecular mechanism for its toxicity has not been fully elucidated. We have hypothesized that PM2.5 may cause oxidative stress and enhance inflammatory responses in nasal epithelial cells. Accordingly, we used human RPMI 2650 cells, derived from squamous cell carcinoma of the nasal septum, as a model of nasal epithelial cells, and exposed them to PM2.5 that was collected at Fudan University (31.3°N, 121.5°E) in Shanghai, China. PM2.5 exposure decreased the viability of RPMI 2650 cells, suggesting that PM2.5 may impair the barrier function of nasal epithelial cells. Moreover, PM2.5 increased the levels of intracellular reactive oxygen species (ROS) and the nuclear translocation of NF-E2-related factor-2 (Nrf2). Importantly, PM2.5 also decreased the activities of superoxide dismutase, catalase and glutathione peroxidase. Pretreatment with N-Acetyl-L-cysteine (an anti-oxidant) reduced the degree of the PM2.5-induced oxidative stress in RPMI 2650 cells. In addition, PM2.5 increased the production of granulocyte-macrophage colony-stimulating factor, tumor necrosis factor-α, interleukin-13 and eotaxin (C-C motif chemokine ligand 11), each of which initiates and/or augments local inflammation. These results suggest that PM2.5 may induce oxidative stress and inflammatory responses in human nasal epithelial cells, thereby leading to nasal inflammatory diseases. The present study provides insights into cellular injury induced by PM2.5.
Diesel Exhaust Particles Upregulate Interleukins IL-6 and IL-8 in Nasal Fibroblasts.
Kim Jin Ah,Cho Jae Hoon,Park Il-Ho,Shin Jae-Min,Lee Seoung-Ae,Lee Heung-Man
BACKGROUND:Diesel exhaust particles (DEP) are a major source of air pollution. Nasal fibroblasts are known to produce various cytokines and chemokines. The aim of this study was to evaluate DEP-induced cytokines and chemokines in nasal fibroblasts and to identify the signaling pathway involved. METHODS:A cytokine and chemokine array performed after stimulation of nasal fibroblasts with DEP revealed that levels of IL-6 and IL-8 were increased most significantly among various cytokines and chemokines. RT-PCR and ELISA were used to determine the mRNA and protein expression levels of IL-6 and IL-8. Signaling pathways of p-38, Akt, and NF-κB were analyzed by western blotting, luciferase assay, and ELISA. Organ cultures of nasal interior turbinate were also developed to demonstrate the ex vivo effect of DEP on the expression of IL-6 and IL-8 and the associated signaling pathway. RESULTS:DEP increased the expressions of IL-6 and IL-8 in nasal fibroblasts at mRNA and protein levels. DEP induced phosphorylation of p38, Akt, and NF-κB, whereas inhibitors of p38, Akt, and NF-κB blocked these phophorylations and the expressions of IL-6 and IL-8. These findings were also observed in ex vivo organ culture of nasal inferior turbinate. CONCLUSIONS:DEP induces expression of IL-6 and IL-8 via p38, Akt, and NF-κB signaling pathways in nasal fibroblasts. This finding suggests that air pollution might induce or aggravate allergic rhinitis or chronic rhinosinusitis.
Childhood exposure to ambient polycyclic aromatic hydrocarbons is linked to epigenetic modifications and impaired systemic immunity in T cells.
Hew K M,Walker A I,Kohli A,Garcia M,Syed A,McDonald-Hyman C,Noth E M,Mann J K,Pratt B,Balmes J,Hammond S Katharine,Eisen E A,Nadeau K C
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
BACKGROUND:Evidence suggests that exposure to polycyclic aromatic hydrocarbons (PAHs) increases atopy; it is unclear how PAH exposure is linked to increased severity of atopic diseases. OBJECTIVE:We hypothesized that ambient PAH exposure is linked to impairment of immunity in atopic children (defined as children with asthma and/or allergic rhinitis) from Fresno, California, an area with elevated ambient PAHs. METHODS:We recruited 256 subjects from Fresno, CA. Ambient PAH concentrations (ng/m(3) ) were measured using a spatial-temporal regression model over multiple time periods. Asthma diagnosis was determined by current NHLBI criteria. Phenotyping and functional immune measurements were performed from isolated cells. For epigenetic measurements, DNA was isolated and pyrosequenced. RESULTS:We show that higher average PAH exposure was significantly associated with impaired Treg function and increased methylation in the forkhead box protein 3 (FOXP3) locus (P < 0.05), conditional on atopic status. These epigenetic modifications were significantly linked to differential protein expression of FOXP3 (P < 0.001). Methylation was associated with cellular functional changes, specifically Treg dysfunction, and an increase in total plasma IgE levels. Protein expression of IL-10 decreased and IFN-γ increased as the extent of PAH exposure increased. The strength of the associations generally increased as the time window for average PAH exposure increased from 24 hr to 1 year, suggesting more of a chronic response. Significant associations with chronic PAH exposure and immune outcomes were also observed in subjects with allergic rhinitis. CONCLUSIONS AND CLINICAL RELEVANCE:Collectively, these results demonstrate that increased ambient PAH exposure is associated with impaired systemic immunity and epigenetic modifications in a key locus involved in atopy: FOXP3, with a higher impact on atopic children. The results suggest that increased atopic clinical symptoms in children could be linked to increased PAH exposure in air pollution.
Effect modification of immunoglobulin E-mediated atopy and rhinitis by glutathione S-transferase genotypes in passive smokers.
Gerbase M W,Keidel D,Imboden M,Gemperli A,Bircher A,Schmid-Grendelmeier P,Bridevaux P-O,Berger W,Schindler C,Rochat T,Probst-Hensch N
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
BACKGROUND:Experimental studies suggest that glutathione S-transferase (GST) genotypes modify nasal allergen responses induced by secondhand smoke (SHS) exposure. OBJECTIVE:We aimed to investigate whether GSTs affected systemic IgE and allergic rhinitis (AR) in SHS-exposed individuals from a population-based cohort. METHODS:Analyses comprised 2309 never-smokers from the Swiss study on air pollution and health in adults cohort, reporting SHS status at baseline and 11 years later. Outcomes were defined by total serum IgE≥100 kU/L, specific serum IgE determined by Phadiatop® ≥0.35 kU/L and self-reported AR. GSTP1 Ile105Val, GSTM1 and GSTT1 gene deletion genotypes were identified at the follow-up survey. RESULTS:After adjustment for relevant covariates, the homozygous GSTP1 105-Val genotype was negatively associated with high total IgE and high-specific IgE by Phadiatop®, notably in subjects persistently exposed to SHS (OR: 0.20, 95% CI 0.05-0.75; P=0.02, for high total IgE and OR: 0.29, 95% CI 0.10-0.89; P=0.03, for high specific IgE by Phadiatop®). Carrying at least one copy of the GSTM1 gene (non-null) showed a similar association for high specific IgE by Phadiatop® (OR: 0.41, 95% CI 0.22-0.76; P=0.004). No significant associations were found between GSTs and rhinitis. CONCLUSION AND CLINICAL RELEVANCE:In this large cohort, homozygosity for GSTP1 105-Val or carrying the GSTM1 non-null genotype decreased the risk of high total IgE or high specific IgE using Phadiatop® by nearly half in subjects exposed to SHS, as compared with subjects carrying opposite alleles. These findings underline the value of genetic susceptibility when evaluating the effects of environmental exposure on allergic illness. The potential long-term effects of persistent SHS exposure in genetically vulnerable individuals may be of public health relevance.
Long-term exposure to close-proximity air pollution and asthma and allergies in urban children.
Pénard-Morand C,Raherison C,Charpin D,Kopferschmitt C,Lavaud F,Caillaud D,Annesi-Maesano I
The European respiratory journal
The aim of this study was to evaluate the impact of urban air pollution, assessed through reliable indicators of exposure, on asthma and allergies in schoolchildren. A validated dispersion model combining data on traffic conditions, topography, meteorology and background pollution was used to relate 3-yrs averaged concentrations of major urban pollutants at the sites of schools to skin prick tests, exercise-induced asthma and reported asthma and allergies in 6,683 children (9-11 yrs) attending 108 schools randomly selected in six French communities. For the 4,907 children who had resided at their current address for the past 3 yrs, asthma (exercise induced, past year and lifetime) was significantly positively associated with benzene, SO(2), particles with a 50% cut-off aerodynamic diameter of 10 microm (PM(10)), nitrogen oxides (NO(x)) and CO. In the same children, eczema (lifetime and past year) was significantly positively associated with benzene, PM(10), NO(2), NO(x) and CO, lifetime allergic rhinitis with PM(10) and sensitisation to pollens with benzene and PM(10). Among the 2,213 children residing at their current address since birth, the associations persisted for lifetime asthma with benzene (adjusted OR per interquartile range (95% CI) 1.3 (1.0-1.9)) and PM(10 )(1.4 (1.0-2.0)), and for sensitisation to pollens with volatile organic compounds (1.3 (1.0-1.9)) and PM(10) (1.2 (1.0-1.9)). Accurately modelled urban air pollution was associated with some measures of childhood asthma and allergies.
Traffic-related air pollution and the development of asthma and allergies during the first 8 years of life.
Gehring Ulrike,Wijga Alet H,Brauer Michael,Fischer Paul,de Jongste Johan C,Kerkhof Marjan,Oldenwening Marieke,Smit Henriette A,Brunekreef Bert
American journal of respiratory and critical care medicine
RATIONALE:The role of air pollution exposure in the development of asthma, allergies, and related symptoms remains unclear, due in part to the limited number of prospective cohort studies with sufficiently long follow-ups addressing this problem. OBJECTIVES:We studied the association between traffic-related air pollution and the development of asthma, allergy, and related symptoms in a prospective birth cohort study with a unique 8-year follow-up. METHODS:Annual questionnaire reports of asthma, hay fever, and related symptoms during the first 8 years of life were analyzed for 3,863 children. At age 8, measurements of allergic sensitization and bronchial hyperresponsiveness were performed for subpopulations (n = 1,700 and 936, respectively). Individual exposures to nitrogen dioxide (NO(2)), particulate matter (PM(2.5)), and soot at the birth address were estimated by land-use regression models. Associations between exposure to traffic-related air pollution and repeated measures of health outcomes were assessed by repeated-measures logistic regression analysis. Effects are presented for an interquartile range increase in exposure after adjusting for covariates. MEASUREMENTS AND MAIN RESULTS:Annual prevalence was 3 to 6% for asthma and 12 to 23% for asthma symptoms. Annual incidence of asthma was 6% at age 1, and 1 to 2% at later ages. PM(2.5) levels were associated with a significant increase in incidence of asthma (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.10-1.49), prevalence of asthma (OR, 1.26; 95% CI, 1.04-1.51), and prevalence of asthma symptoms (OR, 1.15; 95% CI, 1.02-1.28). Findings were similar for NO(2) and soot. Associations were stronger for children who had not moved since birth. Positive associations with hay fever were found in nonmovers only. No associations were found with atopic eczema, allergic sensitization, and bronchial hyperresponsiveness. CONCLUSIONS:Exposure to traffic-related air pollution may cause asthma in children.
Relation of lung function and current inhalant allergen-specific immunoglobulin E concentrations in adolescents (GINIplus cohort).
Luzak Agnes,Flexeder Claudia,von Berg Andrea,Berdel Dietrich,Klümper Claudia,Koletzko Sibylle,Bauer Carl-Peter,Heinrich Joachim,Nowak Dennis,Schulz Holger
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
BACKGROUND:The prevalence of allergen sensitization reaches up to 46.6% in 14- to 17-year-old German adolescents. Polysensitization is strongly associated with a higher risk of allergic rhinitis or asthma. Whether or how sensitization also is related to lung function remains uncertain. OBJECTIVE:To assess whether sensitization to common inhalant allergens is associated with lung function in adolescents after stratification by allergic respiratory disease. METHODS:In total, 1,719 15-year-old participants of the German Infant Study on the Influence of Nutrition Intervention plus Air Pollution and Genetics on Allergy Development (GINIplus) birth cohort provided valid spirometric indices, including forced expiratory volume in 1 second, forced vital capacity (FVC), forced expiratory flow rate at 25% to 75% of the FVC, and specific immunoglobulin E (IgE) screening test to 8 inhalant allergens (ImmunoCAP). Complete information on allergic rhinitis and asthma status was available for 1,128 subjects. Associations between lung function parameters and sensitization, classified into 4 groups (no sensitization to polysensitization) were analyzed using adjusted linear regression models. RESULTS:Among participants, 21.1% (n = 347) had allergic rhinitis, 10.1% (n = 119) had asthma, and 46.4% (n = 798) had a positive screening test to inhalant allergens. Prevalences were consistently higher in boys. The percentage of subjects with rhinitis or asthma increased from 5.8% in non-sensitized subjects (n = 620) to 69.4% in polysensitized subjects (n = 144). Sensitization was not associated with any spirometric parameter considered in subjects with allergic rhinitis, asthma, or neither disease. CONCLUSION:Although allergen-specific IgE concentrations can contribute to the identification of subjects at higher risk for allergic rhinitis and asthma, sensitization to inhalant allergens is not related to impaired spirometric lung parameters within the different allergic respiratory disease subgroups.
Using high-resolution residential greenspace measures in an urban environment to assess risks of allergy outcomes in children.
Gernes Rebecca,Brokamp Cole,Rice Glenn E,Wright J Michael,Kondo Michelle C,Michael Yvonne L,Donovan Geoffrey H,Gatziolis Demetrios,Bernstein David,LeMasters Grace K,Lockey James E,Khurana Hershey Gurjit K,Ryan Patrick H
The Science of the total environment
Despite reported health benefits of urban greenspace (gs), the epidemiological evidence is less clear for allergic disease. To address a limitation of previous research, we examined the associations of medium- and high-resolution residential gs measures and tree and/or grass canopies with allergic outcomes for children enrolled in the longitudinal cincinnati childhood allergy and air pollution study (ccaaps). We estimated residential gs based on 400 m radial buffers around participant addresses (n = 478) using the normalized differential vegetation index (ndvi) and land cover-derived urban greenspace (ugs) (tree and grass coverage, combined and separate) at 30 m and 1.5-2.5 m resolution, respectively. Associations between outdoor aeroallergen sensitization and allergic rhinitis at age 7 and residential gs measures at different exposure windows were examined using multivariable logistic regression models. A 10% increase in ugs-derived grass coverage was associated with an increased risk of sensitization to grass pollens (adjusted odds ratio [aor]: 1.27; 95% confidence interval = 1.02-1.58). For each 10% increase in ugs-derived tree canopy coverage, nonstatistically significant decreased odds were found for grass pollen sensitization, tree pollen sensitization, and sensitization to either (aor range = 0.87-0.94). Results similar in magnitude to ugs-tree canopy coverage were detected for ndvi and allergic sensitizations. High-resolution (down to 1.5 m) gs measures of grass- and tree-covered areas showed associations in opposite directions for different allergy outcomes. These data suggest that measures strongly correlated with tree canopy (e.g., ndvi) may be insufficient to detect health effects associated with proximity to different types of vegetation or help elucidate mechanisms related to specific gs exposure pathways.
Do Variants in GSTs Modify the Association between Traffic Air Pollution and Asthma in Adolescence?
Bowatte Gayan,Lodge Caroline J,Lowe Adrian J,Erbas Bircan,Dennekamp Martine,Marks Guy B,Perret Jennifer,Hui Jennie,Wjst Matthias,Gurrin Lyle C,Allen Katrina J,Abramson Michael J,Matheson Melanie C,Dharmage Shyamali C
International journal of molecular sciences
Polymorphisms in genes involved in the oxidative stress response may partially explain the documented heterogeneous associations between traffic-related air pollution (TRAP) exposure and asthma and allergies in children. We investigated whether the GSTT1, GSTM1 and GSTP1 gene polymorphisms modified the associations between TRAP exposure during the first year of life and asthma, wheeze and hay fever in adolescence. We used a birth cohort of 620 high risk infants from the Melbourne Atopy Cohort Study. TRAP exposure during the first year of life was defined as the cumulative length of major roads within 150 m of each participant's residence during the first year of life. Wheeze, asthma and hay fever were measured at ages 12 (n = 370) and 18 (n = 434) years. The associations and interactions with glutathione S-transferases (GST s) were investigated using regression models. Overall, there was no relationship between TRAP exposure during the first year of life and current asthma, wheeze and hay fever at ages 12 or 18 years. However, in GSTT1 null carriers, every 100 m increase in cumulative lengths of major road exposure during the first year of life was associated with a 2.31-fold increased risk of wheeze and a 2.15-fold increased risk of asthma at 12 years. TRAP is associated with some respiratory outcomes in carriers of genetic polymorphisms in oxidative stress metabolism genes.
Poor air quality in classrooms related to asthma and rhinitis in primary schoolchildren of the French 6 Cities Study.
Annesi-Maesano Isabella,Hulin Marion,Lavaud François,Raherison Chantal,Kopferschmitt Christine,de Blay Frederic,Charpin Denis André,Denis Caillaud
BACKGROUND:Relationships between indoor air quality (IAQ) found in schools and the allergic and respiratory health of schoolchildren have been insufficiently explored. A survey was conducted in a large sample of classrooms of primary schools in France to provide objective assessments of IAQ to which young schoolchildren are exposed in classrooms, and to relate exposure to major air pollutants found in classrooms to asthma and allergies of schoolchildren. METHODS:Concentrations of fine particles with aerodynamic diameter ≤2.5 μm (PM(2.5)), nitrogen dioxide (NO(2)) and three aldehydes were objectively assessed in 401 randomly chosen classrooms in 108 primary schools attended by 6590 children (mean age 10.4 years, SD ±0.7) in the French 6 Cities Study. The survey incorporated a medical visit including skin prick testing (SPT) for common allergens, a test for screening exercise-induced asthma (EIA) and a standardised health questionnaire completed by parents. RESULTS:Children were differently exposed to poor air quality in classrooms, with almost 30% being highly exposed according to available standards. After adjusting for confounders, past year rhinoconjunctivitis was significantly associated with high levels of formaldehyde in classrooms (OR 1.19; 95% CI 1.04 to 1.36). Additionally, an increased prevalence of past year asthma was found in the classrooms with high levels of PM(2.5) (OR 1.21; 95% CI 1.05 to 1.39), acrolein (OR 1.22; 95% CI 1.09 to 1.38) and NO(2) (OR 1.16; 95% CI 0.95 to 1.41) compared with others. The relationship was observed mostly for allergic asthma as defined using SPT. A significant positive correlation was found between EIA and the levels of PM(2.5) and acrolein in the same week. CONCLUSIONS:In this random sample, air quality in classrooms was poor, varied significantly among schools and cities, and was related to an increased prevalence of clinical manifestations of asthma and rhinitis in schoolchildren. Children with a background of allergies seemed at increased risk.
Exposure to tobacco smoke and childhood rhinitis: a population-based study.
Yao Tsung-Chieh,Chang Su-Wei,Chang Wei-Chiao,Tsai Ming-Han,Liao Sui-Ling,Hua Man-Chin,Lai Shen-Hao,Yeh Kuo-Wei,Tseng Yu-Lun,Lin Wan-Chen,Tsai Hui-Ju,Huang Jing-Long
Exposure to tobacco smoke has been associated with harmful effects on child health. The association between tobacco smoke exposure and childhood rhinitis has not been established in developed or developing countries. We investigated the association between serum cotinine levels and rhinitis in a population sample of 1,315 Asian children. Serum cotinine levels were positively associated with rhinitis ever (adjusted odds ratio [AOR] = 2.95; 95% confidence interval [CI]: 1.15-7.60) and current rhinitis (AOR = 2.71; 95% CI: 1.07-6.89), while the association for physician-diagnosed rhinitis approaching borderline significance (AOR = 2.26; 95% CI: 0.88-5.83). Stratified analyses demonstrated significant association of serum cotinine levels with current rhinitis among children without allergic sensitization (AOR = 6.76; 95% CI: 1.21-37.74), but not among those with allergic sensitization. Serum cotinine levels were positively associated with rhinitis ever (AOR = 3.34; 95% CI: 1.05-10.61) and current rhinitis (AOR = 4.23; 95% CI: 1.28-13.97) among adolescents but not in children aged less than 10 years. This population-based study demonstrates supportive evidence for positive association of tobacco smoke exposure with rhinitis, while the effect is mainly confined to non-allergic rhinitis and more pronounced in adolescents than in young children, highlighting the need for raising public health awareness about the detrimental effects of tobacco smoke exposure on children's respiratory health.
Allergic rhinitis and secondhand tobacco smoke: a population-based study.
Lin Sandra Y,Reh Douglas D,Clipp Sandra,Irani Laili,Navas-Acien Ana
American journal of rhinology & allergy
BACKGROUND:Allergic rhinitis (AR) is a common disease that affects approximately one-fifth of the U.S. population. Few studies have evaluated the association between secondhand tobacco smoke (SHS) exposure and the impacts on symptom severity in AR. In this study, we evaluated the association of SHS and AR in a community-based study of adult nonsmokers. METHODS:In Washington County, Maryland, 83 subjects with AR (physician diagnosed or reported skin test positive), and 117 nonallergic subjects from the same community were recruited and interviewed. A validated questionnaire was used to assess past and present SHS exposure as well as disease-specific quality of life. RESULTS:SHS was reported in 34/83 allergic subjects. Compared with AR subjects with no SHS exposure, subjects with AR and SHS were more likely to report a family history of chronic sinusitis (p = 0.04) and use nasal decongestants (p = 0.012). There was also a borderline association with reporting more severe nasal obstruction (p = 0.14) and nasal drainage (p = 0.08). Compared with nonallergic subjects, allergic subjects were more likely to report longer SHS exposure currently (adjusted mean difference = 1.6 hours/week; p = 0.01) and 20 years ago (adjusted mean difference = 2.9 hours/week; p = 0.03). CONCLUSION:Past and current SHS may be a risk factor for AR. Allergic subjects with SHS exposure were more likely to use nasal decongestants and to report more severe nasal symptoms such as nasal obstruction and nasal drainage than nonexposed allergic subjects.
Association of indoor air pollution with rhinitis symptoms, atopy and nitric oxide levels in exhaled air.
Hersoug Lars-Georg,Husemoen Lise Lotte N,Thomsen Simon Francis,Sigsgaard Torben,Thuesen Betina H,Linneberg Allan
International archives of allergy and immunology
BACKGROUND:Exposure to particulate matter (PM) outdoors can induce airway inflammation and exacerbation of asthma in adults. However, there is limited knowledge about the effects of exposure to indoor PM. The aim of this study was to investigate the association of exposure to indoor sources of PM with rhinitis symptoms, atopy and nitric oxide in exhaled air (FeNO) as a measure of airway inflammation. METHODS:We conducted a population-based cross-sectional study of 3,471 persons aged 18-69 years. Exposure to indoor sources of PM and prevalence of rhinitis symptoms were assessed by a self-administered questionnaire. Atopy was defined as at least 1 positive test (≥0.35 kU/l) for serum-specific IgE against grass, birch, cat or Dermatophagoides pteronyssinus. Regression analyses were used to adjust for confounders. RESULTS:Self-reported exposure to the use of woodstoves, candles or gas kitchen cookers was not significantly associated with either increased prevalence of rhinitis symptoms or atopy or increased levels of FeNO. The prevalence of atopy and allergic rhinitis and the levels of FeNO were significantly decreased among current and previous smokers. Exposure to environmental tobacco smoke (ETS) for 0.5-5 h, but not above 5 h, was significantly associated with a slightly increased prevalence of rhinitis symptoms. CONCLUSION:Self-reported exposure to the use of woodstoves, candles or gas cookers was not significantly associated with an increased risk of rhinitis symptoms or atopy, nor increased FeNO. Self-reported exposure to ETS was associated with a slightly higher prevalence of self-reported rhinitis symptoms without any clear dose-response relationship.
The association between high ambient air pollution exposure and respiratory health of young children: A cross sectional study in Jinan, China.
Chen Zhangjian,Cui Liangliang,Cui Xiaoxing,Li Xinwei,Yu Kunkun,Yue Kesan,Dai Zhixiang,Zhou Jingwen,Jia Guang,Zhang Ji
The Science of the total environment
There is growing concern about health effects of high air pollution in less-developed countries. Children represent a population at increased risk for air pollution-related respiratory conditions. This study investigated the relationship between high ambient air pollution exposure and respiratory health of young schoolchildren. From 2014 to 2016 in Jinan, China, 2532 primary school children in grades three to five from two different schools with different levels of air pollution were included in the study. Levels of ambient air pollution exposure including PM, PM, NO, SO, CO and O were measured continuously at the two schools. A questionnaire about children's respiratory health was conducted every year. Among them, about 150 randomly selected children also performed lung function tests two times a year at the beginning of November and middle of December. Annual average exposure levels of PM (66.8-79.1 vs 90.0-107.7 μg/m), PM (129.5-177.3 vs 198.1-218.6 μg/m), NO (45.3-53.2 vs 45.0-56.2 μg/m), SO (29.8-56.5 vs 40.5-80.3 μg/m), CO (1.3-1.5 vs 1.4-1.7 mg/m) and O (84.8-120.2 vs 61.1-128.1 μg/m) in the heavy pollution primary school were significantly higher than the light one. The higher air pollution exposure was related to increased prevalence of respiratory diseases of young children in the last year, especially allergic rhinitis. The increased odds of lung function impairment associated with exposure to higher air pollution, could be up to 171.5% (aOR = 2.715; 95% CI = 1.915-3.849) for PEF < 75% predicted in 2014. However, after short-term exposure for 1.5 month or a week, paired comparison for parameters of the same child showed different results. The association between high ambient air pollution exposure and respiratory health of young children is closely related to exposure time and dose and may be fluctuate and complex.
Influence of exposure to tobacco cigarette smoke on the eosinophil count in the nasal mucosa of young patients with perennial allergic rhinitis.
Montano-Velazquez B B,Garcia Vazquez F J,Navarrete R C,Martinez M D M,Gonzalez L F,Jauregui-Renaud K
BACKGROUND:To assess the influence of exposure to tobacco cigarette smoke on the eosinophil count and the frequency of apoptosis of eosinophils in the nasal mucosa of teenagers with perennial allergic rhinitis. METHODS:Fifty patients were evaluated (aged 10 to 19 years old): 25 patients with and 25 patients with no recent exposure to tobacco cigarette smoke, by means of The Global Youth Tobacco Survey and cotinine/creatinine ratio. After a clinical evaluation, all the patients replied to a validated questionnaire of the severity of nasal symptoms; then, a nasal sample was processed to identify the eosinophil count and the frequency of apoptosis of eosinophils. RESULTS:Patients with active exposure to tobacco cigarette smoke had higher eosinophil counts than patients with no exposure to the smoke. In the two groups, apoptosis of eosinophils in the nasal mucosa was scarce and no significant correlation was observed between the frequency/severity of the nasal symptoms and the eosinophil count. CONCLUSION:Teenagers with perennial allergic rhinitis and active exposure to tobacco cigarette smoke may show increased eosinophil counts in the nasal mucosa, which might not be related to apoptosis of eosinophils or to the frequency/severity of nasal symptoms.
Prevalence of allergic rhinitis in china.
Zhang Yuan,Zhang Luo
Allergy, asthma & immunology research
Allergic rhinitis (AR) is a serious systemic allergic disease, which together with comorbid asthma causes major illness and disability worldwide. Recent epidemiological studies have revealed wide variations in the increasing prevalence of AR and allergies globally, including in China. Despite a markedly higher population than western countries, and a landmass close to Europe in area, little epidemiological data is available on AR in China. Thus, the present study reviewed the prevalence, comorbid allergic diseases, trends and pattern of sensitizing allergens in adults and children suffering from AR in China. Available data indicated that despite variations in the prevalence of AR in different regions of the country, the prevalence of AR has increased in both adults and children over the last 2 decades. Similarly, there has been an increase in a "western"-type lifestyle, industrialization and air pollution over this period, which may have contributed to the increased prevalence of AR observed in China.
The effects of PM on asthmatic and allergic diseases or symptoms in preschool children of six Chinese cities, based on China, Children, Homes and Health (CCHH) project.
Chen Fei'er,Lin Zhijing,Chen Renjie,Norback Dan,Liu Cong,Kan Haidong,Deng Qihong,Huang Chen,Hu Yu,Zou Zhijun,Liu Wei,Wang Juan,Lu Chan,Qian Hua,Yang Xu,Zhang Xin,Qu Fang,Sundell Jan,Zhang Yinping,Li Baizhan,Sun Yuexia,Zhao Zhuohui
Environmental pollution (Barking, Essex : 1987)
The urbanization and industrialization in China is accompanied by bad air quality, and the prevalence of asthma in Chinese children has been increasing in recent years. To investigate the associations between ambient PM levels and asthmatic and allergic diseases or symptoms in preschool children in China, we assigned PM exposure data from the Global Burden of Disease (GBD) project to 205 kindergartens at a spatial resolution of 0.1° × 0.1° in six cities in China (Shanghai, Nanjing, Chongqing, Changsha, Urumqi, and Taiyuan). A hierarchical multiple logistical regression model was applied to analyze the associations between kindergarten-level PM exposure and individual-level outcomes of asthmatic and allergic symptoms. The individual-level variables, including gender, age, family history of asthma and allergic diseases, breastfeeding, parental smoking, indoor dampness, interior decoration pollution, household annual income, and city-level variable-annual temperature were adjusted. A total of 30,759 children (average age 4.6 years, 51.7% boys) were enrolled in this study. Apart from family history, indoor dampness, and decoration as predominant risk factors, we found that an increase of 10 μg/m of the annual PM was positively associated with the prevalence of allergic rhinitis by an odds ratio (OR) of 1.20 (95% confidence interval [CI] 1.11, 1.29) and diagnosed asthma by OR of 1.10 (95% CI 1.03, 1.18). Those who lived in non-urban (vs. urban) areas were exposed to more severe indoor air pollution arising from biomass combustion and had significantly higher ORs between PM and allergic rhinitis and current rhinitis. Our study suggested that long-term exposure to PM might increase the risks of asthmatic and allergic diseases or symptoms in preschool children in China. Compared to those living in urban areas, children living in suburban or rural areas had a higher risk of PM exposure.
The burden associated with ocular symptoms in allergic rhinitis.
Klossek J M,Annesi-Maesano I,Pribil C,Didier A
International archives of allergy and immunology
BACKGROUND:Ocular symptoms remain widely neglected while they concern the majority of subjects with allergic rhinitis (AR) and impair their daily activities. We describe the characteristics of ocular symptoms in subjects suffering from AR in the French INSTANT study and their impact on daily activities. METHODS:This cross-sectional observational survey was carried out in November 2006 using face-to-face interviews. RESULTS:31.7% of the population-based sample (n = 4,019) suffered from AR and 52.0% of AR subjects (n = 663) described ocular symptoms. Men had significantly less ocular symptoms than women (odds ratio 0.71, 95% CI 0.57-0.89). 57.5% of subjects suffered from ocular symptoms for >5 years, 30.2% for >6 months in the past 12 months, and 92.2% during the pollen season. The troublesome ocular symptoms were itching eyes (51.1%), watery eyes (38.6%), red eyes (6.6%) and swollen eyelids (3.6%). The trigger factors were pollens (51.3%), household dust and mites (34.8%), pets (12.2%) and air pollution (3.8%). Ocular symptoms had a negative impact on daily activities (blurred sight 47.8%, reduction in daily activities 38.8%, reduction in efficacy at work 25.8%, sleep disturbances 16.3%, and sick leave 12.9%). They were diagnosed in 38.9% of subjects and followed up in 34.8%. Treatment for ocular symptoms was prescribed to 35.4% of subjects and to 61.9% of subjects with a regular follow-up care. CONCLUSIONS:This survey confirms the impact of ocular symptoms on AR patients' lives and suggests that they are still neglected and undertreated.
Associations of gestational and early life exposures to ambient air pollution with childhood respiratory diseases in Shanghai, China: A retrospective cohort study.
Liu Wei,Huang Chen,Hu Yu,Fu Qingyan,Zou Zhijun,Sun Chanjuan,Shen Li,Wang Xueying,Cai Jiao,Pan Jun,Huang Yanmin,Chang Jing,Sun Yuexia,Sundell Jan
BACKGROUND:Associations of ambient air pollutants with respiratory health are inconsistent. OBJECTIVES:We analyzed the associations of gestational and early life exposures to air pollutants with doctor-diagnosed asthma, allergic rhinitis, and pneumonia in children. METHODS:We selected 3358 preschool children who did not alter residences after birth from a cross-sectional study in 2011-2012 in Shanghai, China. Parents reported children's respiratory health history, home environment, and family lifestyle behaviors. We collected daily concentrations of sulphur dioxide (SO2), nitrogen dioxide (NO2), and particulate matter with an aerodynamic diameter ≤10μm (PM10) during the child's total lifetime (2006-2012) for each district where the children lived. We analyzed the associations using logistic regression models. RESULTS:After adjusting for covariates and the other studied pollutants, we found that exposure to NO2 (increment of 20μg/m(3)) during the first year of life was significantly associated with asthma [odds ratio (OR)=1.77; 95% confidence interval (CI): 1.29-2.43] and allergic rhinitis (OR=1.67; 95% CI: 1.07-2.61). Exposure to NO2 during gestation, the first two and three years, and over total lifetimewas all consistently associated with increased odds of allergic rhinitis. Quartiles of NO2 concentration during different exposure periods showed a slight dose-response relationship with the studied diseases. These diseases had significant associations with pollutant mixtures that included NO2, but had no significant association with exposures to SO2 and PM10 individually or in mixtures. CONCLUSIONS:Gestational and early life exposures to ambient NO2 are risk factors for childhood respiratory diseases.
Effect of Traffic-Related Air Pollution on Allergic Disease: Results of the Children's Health and Environmental Research.
Jung Dal Young,Leem Jong Han,Kim Hwan Cheol,Kim Jeong Hee,Hwang Seung Sik,Lee Ji Young,Kim Byoung Ju,Hong Yun Chul,Hong Soo Jong,Kwon Ho Jang
Allergy, asthma & immunology research
PURPOSE:This study evaluated the relationship of living near to main roads to allergic diseases, airway hyperresponsiveness (AHR), allergic sensitization, and lung function in Korean children. METHODS:A total of 5,443 children aged 6-14 years from 33 elementary schools in 10 cities during 2005-2006 were included in a baseline survey of the Children's Health and Environmental Research. We assessed association of traffic-related air pollution (TAP) exposure with the distance to the nearest main road, total road length of main roads and the proportion of the main road area within the 200-m home area. RESULTS:Positive exposure-response relationships were found between the length of the main road within the 200-m home area and lifetime wheeze (adjusted prevalence ratio [PR] for comparison of the longest to the shortest length categories=1.24; 95% CIs, 1.04-1.47; P for trend=0.022) and diagnosed asthma (PR=1.42; 95% CIs, 1.08-1.86; P for trend=0.011). Living less than 75 m from the main road was significantly associated with lifetime allergic rhinitis (AR), past-year AR symptoms, diagnosed AR, and treated AR. The distance to the main road (P for trend=0.001), the length of the main road (P for trend=0.041), and the proportion of the main road area (P for trend=0.006) had an exposure-response relationship with allergic sensitization. A strong inverse association was observed between residential proximity to the main load and lung function, especially FEV1, FEV1/FVC, and FEF₂₅₋₇₅. The length of the main road and the proportion of the main road area were associated with reduced FEV1 in schoolchildren. CONCLUSIONS:The results of this study suggest that exposure to traffic-related air pollution may be associated with increased risk of asthma, AR, and allergic sensitization, and with reduced lung function in schoolchildren.
The Effects of Air Pollution on the Development of Atopic Disease.
Hassoun Yasmin,James Christine,Bernstein David I
Clinical reviews in allergy & immunology
Air pollution is defined as the presence of noxious substances in the air at levels that impose a health hazard. Thus, there has been long-standing interest in the possible role of indoor and outdoor air pollutants on the development of respiratory disease. In this regard, asthma has been of particular interest but many studies have also been conducted to explore the relationship between air pollution, allergic rhinitis, and atopic dermatitis. Traffic-related air pollutants or TRAP refers to a broad group of pollutants including elemental carbon, black soot, nitrogen dioxide (NO, nitric oxide (NO), sulfur dioxide (SO, particulate matter (PM and PM), carbon monoxide (CO), and carbon dioxide (CO). In this review, we aim to examine the current literature regarding the impact of early childhood exposure to TRAP on the development of asthma, allergic rhinitis, and atopic dermatitis. Although there is growing evidence suggesting significant associations, definitive conclusions cannot be made with regard to the effect of TRAP on these diseases. This conundrum may be due to a variety of factors, including different definitions used to define TRAP, case definitions under consideration, a limited number of studies, variation in study designs, and disparities between studies in consideration of confounding factors. Regardless, this review highlights the need for future studies to be conducted, particularly with birth cohorts that explore this relationship further. Such studies may assist in understanding more clearly the pathogenesis of these diseases, as well as other methods by which these diseases could be treated.
Relative impact of meteorological factors and air pollutants on childhood allergic diseases in Shanghai, China.
Hu Yabin,Xu Zhiwei,Jiang Fan,Li Shenghui,Liu Shijian,Wu Meiqin,Yan Chonghuai,Tan Jianguo,Yu Guangjun,Hu Yi,Yin Yong,Tong Shilu
The Science of the total environment
BACKGROUND:Non-optimal weather conditions and air pollution pose a significant threat to children's health. However, the relative impact of different environmental exposures on childhood allergic diseases remains unclear. OBJECTIVES:This study aimed to quantify the relative impact of meteorological factors and air pollutants on childhood allergic diseases in Shanghai, China. METHODS:Data on clinical visits due to childhood asthma, allergic rhinitis (AR) and atopic dermatitis (AD) from 2007 to 2017 in Shanghai were collected from Shanghai Children's Medical Center and Xinhua Hospital. The meteorological data (i.e. daily mean temperature, temperature difference, air pressure, air pressure difference, precipitation, relative humidity, sunshine and wind speed) for the same period were obtained from the Shanghai Meteorological Center. Air pollution data (PM, PM, NO, SO and O) were provided by the Shanghai Environmental Protection Agency. Quasi-Poisson regression with distributed lag non-linear models and Poisson regression combined with generalized linear models were used to assess the relative impact of meteorological factors and air pollutants on childhood allergic diseases. RESULTS:There were a total of 2,410,392 cases of childhood allergic diseases, including 975,771 asthma, 646,975 AR and 787,646 AD. Most of environmental factors were significantly associated with childhood allergic diseases. Daily mean temperature (standard β: -0.076 (95% confidence interval (CI): -0.086, -0.067)) and air pressure (standard β: 0.075 (95% CI: 0.068, 0.082)) seemed to play more important roles than other environmental factors in the occurrence of these allergic diseases. The numbers of these allergic diseases attributable to an interquartile range (IQR) change in meteorological factors also appeared to be greater than those attributable to an IQR change in air pollutants. CONCLUSIONS:Both climatic variation and air pollution were associated with childhood allergic diseases, but the former appeared to play a more important role in the occurrence of these diseases. These findings may have significant implications for the development of tailored strategies to prevent these rapidly-increasing diseases worldwide.
Effectiveness of air purifier on health outcomes and indoor particles in homes of children with allergic diseases in Fresno, California: A pilot study.
Park Hye-Kyung,Cheng Kai-Chung,Tetteh Afua O,Hildemann Lynn M,Nadeau Kari C
The Journal of asthma : official journal of the Association for the Care of Asthma
OBJECTIVE:Epidemiologic studies indicate that indoor air pollution is correlated with morbidity caused by allergic diseases. We evaluated the effectiveness of reducing the levels of indoor fine particulate matter <2.5 micrometer diameter (PM) in Fresno, California using air purifiers on health outcomes in children with asthma and/or allergic rhinitis. METHODS:The active group (with air purifiers) and the control group consisted of eight houses each. Air purifiers were installed in the living rooms and bedrooms of the subjects in the active group during the entire 12-week study duration. Childhood asthma control test, peak flow rate monitoring, and nasal symptom scores were evaluated at weeks 0, 6, and 12. RESULTS:At 12 weeks, the active group showed a trend toward an improvement of childhood asthma control test scores and mean evening peak flow rates, whereas the control group showed deterioration in the same measures. Total and daytime nasal symptoms scores significantly reduced in the active group (p = 0.001 and p = 0.011, respectively). The average indoor PM concentrations reduced by 43% (7.42 to 4.28 μg/m) in the active group (p = 0.001). CONCLUSIONS:Intervention with air purifiers reduces indoor PM levels with significant improvements in nasal symptoms in children with allergic rhinitis in Fresno.
Decline of ambient air pollution levels due to measures to control automobile emissions and effects on the prevalence of respiratory and allergic disorders among children in Japan.
Hasunuma Hideki,Ishimaru Yasushi,Yoda Yoshiko,Shima Masayuki
BACKGROUND:In Japan, air pollution due to nitrogen oxides (NOx) and particulate matter (PM) has been gradually reduced since control measures based on the Automobile NOx/PM law were enforced beginning in 2001. The effects of decrease in air pollutants due to the control measures during the past decade on the prevalence of respiratory and allergic disorders such as asthma in children were evaluated. METHODS:Using data of 618,973 children collected in 28 regions of Japan from 1997 to 2009, we evaluated whether reductions in the concentrations of nitrogen dioxide (NO2) and suspended particulate matter (SPM) contribute to the decrease in the prevalence of asthma, wheezing, bronchitis, allergic rhinitis, and atopic dermatitis by multiple linear regression analysis, including adjustments for related factors. RESULTS:The annual rates of decrease in air pollution in the PM-law-enforced areas were 2.0 and 2.5 times higher for NO2 and SPM, respectively, compared with those in the non-enforced areas. The prevalence of asthma decreased significantly at -0.073% per year in the areas in which measures based on the Automobile NOx/PM law were taken but not in area where such measures were not applied. Multiple linear regression analysis showed a reduction in the ambient air pollution was significantly associated with a reduction in the prevalence of asthma, with a rate of 0.118% [95% confidence interval (CI): 0.012-0.225] per 1 ppb for NO2, and 0.050% [95% CI: 0.020-0.080] per 1 μg/m(3) for SPM. An increase in the ambient air pollution was associated with an increase in the prevalence of atopic dermatitis of 0.390% [95% CI: 0.107-0.673] per 1 ppb for NO2, 0.141% [95% CI: 0.058-0.224] per 1 μg/m(3) for SPM. The changes in the prevalence of wheezing and allergic rhinitis were not significantly correlated with changes in air pollutant concentrations. CONCLUSIONS:The enforcement of measures to control automobile emissions based on the Automobile NOx/PM law was shown to have reduced air pollution and contributed to decreases in the prevalence of respiratory and allergic disorders in 3-year-old children.
Analysis of the association between air pollution and allergic diseases exposure from nearby sources of ambient air pollution within elementary school zones in four Korean cities.
Kim H-H,Lee C-S,Jeon J-M,Yu S-D,Lee C-W,Park J-H,Shin D-C,Lim Y-W
Environmental science and pollution research international
The objectives of this study were to survey elementary school students regarding the environmental conditions of their elementary schools and to assess the relationship between air pollution and allergic disease using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Therefore, this study was designed as a cross-sectional study. In this study, seven elementary schools were selected and they were classified into three categories. The selection included one school with no traffic-related or other pollutants, three with traffic-related pollutants, and three with traffic-related and other pollutants from industrial and filling station sources. The ISAAC questionnaire survey was given to all of the students except to those in the 1st grade who were presumed to be less likely to be exposed to the school environment than the remainder of the students attending those seven schools. The assessment of allergic disease was conducted on a total of 4,545 students. Three school zones with critical exposure were selected within each school and they were evaluated based on the levels of black carbon (BC), PM10, SO2, NO2, and O3. There was a significant increase in the risks based on the odds ratios of treatment experiences (within 1 year) for allergy-related diseases such as asthma and allergic rhinitis (a) in the school group with traffic-related pollutants and the school group with complex pollutants were 2.12 (1.41-3.19) and 1.59 (1.06-2.37), respectively, in comparison to the school groups with no exposure to pollutants. This was determined based on the odds ratio of symptoms and treatment experiences for allergy-related diseases by group based on the home town zone as a reference. Also, in the case of atopic dermatitis, the odds ratio of treatment experiences (within 1 year) was 1.42 (1.02-1.97), which indicated elevated risks compared to the students in the S1 school. A regression analysis was used to assess the relationship between the substances and the symptomatic experiences within the last year. There were significant increases in the odds ratio of the symptoms associated with allergic rhinitis and the BC and SO2 in the complex pollution areas. The results of the assessment of the relationship between atopic dermatitis-associated symptoms and O3 showed that the odds ratio increased with statistical significance.
Time-series studies on air pollution and daily outpatient visits for allergic rhinitis in Beijing, China.
Zhang Fengying,Wang Wuyi,Lv Jinmei,Krafft Thomas,Xu Jin
The Science of the total environment
To investigate the effects of urban air quality change on health, we carried out a time-series analysis of daily general practitioner consultations for allergic rhinitis (AR) in Beijing, China. Non-parametric generalized additive model (GAM) was used to analyze the highly non-linear or non-monotonic exposure-response relationship between three air pollutants (namely PM₁₀, SO₂ and NO₂) and daily outpatient visits for AR, after controlling for long term trends, the 'day of the week' effect and confounding meteorological factors. The objective of this study was to assess the possible effects of air pollutants on outpatient visits caused by AR in Beijing during the period 2009-2010. Our work indicates that strong associations exist between daily concentration of the three air pollutants and the daily number of outpatients for AR.
Risk effects of high and low relative humidity on allergic rhinitis: Time series study.
Duan Jun,Wang Xu,Zhao Desheng,Wang Shusi,Bai Lijun,Cheng Qiang,Gao Jiaojiao,Xu ZiHan,Zhang Yanwu,Zhang Heng,Su Hong
BACKGROUND:The relationship between environmental factors and allergic rhinitis (AR) has become a focal point recently. However, few studies have investigated the adverse effects of both high relative humidity (RH) and low relative humidity. Moreover, the laged effect and disease burden of RH on AR were also neglected. OBJECTIVES:To explore the association of both high and low RH on daily AR hospital outpatients, and to quantify the corresponding disease burden attributable to RH. METHODS:In our study, we define 95th as high RH and 5th as low RH. A distributed lag non-linear model (DLNM) combined with a Poisson generalized linear regression model were applied to analyze the relationship between RH and hospital outpatients for AR. All patients were retrieved from Anhui Provincial Children's Hospital (n = 37,221) from January 2015 to December 2016. Daily meteorological and air pollutant data were collected by Hefei Meteorological Bureau and Environmental Protection Agency. Subgroup analyses were conducted by gender and occupational groups. RESULTS:Acute adverse effects of high and low RH on AR were explored respectively, with an increase of daily AR outpatients when encountered high and low RH. The low RH presented a risk effect at current day and lasted up to the eighth day. However, high RH began to appear a risk effect on the fourth day. Notably, the fraction of hospital outpatients attributable to low RH was 5.22% (95% CI: 1.92%, 8.33%) and high RH was 4.07% (95% CI: 1.13%, 7.30%) in the backward perspective. Additionally, male and students apparent to be more sensitive to the effects of low RH. CONCLUSION:This study suggests that both high and low RH are potential trigger for AR hospital outpatients in Hefei, China. Our studies might offer valuable messages to health practitioners and useful direction to decisions-makers respectively.
[Air pollution and recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years].
Arnedo-Pena Alberto,García-Marcos Luis,Carvajal Urueña Ignacio,Busquets Monge Rosa,Morales Suárez-Varela María,Miner Canflanca Izaskun,Batlles Garrido José,Blanco Quirós Alfredo,López-Silvarrey Varela Angel,García Hernández Gloria,Aguinaga Ontoso Inés,González Díaz Carlos
Archivos de bronconeumologia
OBJECTIVE:The objective of the study was to analyze the relationship between air pollutants and the prevalence of recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years. PATIENTS AND METHODS:The prevalence of recent (previous 12 months) symptoms of allergic diseases was obtained by means of the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), Spain, with the participation of 7 centers (Asturias, Barcelona, Bilbao, Cartagena, La Coruña, Madrid, and Valencia) and 20 455 schoolchildren aged between 6 and 7 years, from 2002 to 2003. The pollutant detection systems of the aforementioned centers provided the mean annual concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and total suspended particulate matter. RESULTS:The annual average concentration of SO2 showed a significant association with a higher prevalence of recent severe asthma (adjusted odds ratio [aOR] between level-1 and level-3 pollution, 1.32; 95% confidence interval [CI], 1.01-1.73), rhinitis (aOR, 1.56; 95% CI, 1.39-1.75), and rhinoconjunctivitis (aOR, 1.70; 95% CI, 1.45-2.00). The annual average concentration of CO was associated with a higher prevalence of rhinitis (aOR, 1.65; 95% CI, 1.34-2.04), rhinoconjunctivitis (aOR, 1.76; 95% CI, 1.31-2.37), and eczema (aOR, 1.55; 95% CI, 1.17-2.04). The annual average concentration for NO2 and total suspended particulate matter showed inverse associations with the prevalence of nocturnal dry cough. CONCLUSIONS:Findings suggest that air pollutants such as SO2 and CO increase the risk of recent symptoms of asthma and allergic rhinitis in schoolchildren aged between 6 and 7 years in Spain.
An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011.
Wang X D,Zheng M,Lou H F,Wang C S,Zhang Y,Bo M Y,Ge S Q,Zhang N,Zhang L,Bachert C
BACKGROUND:The prevalence of allergic rhinitis (AR) has increased worldwide in recent decades. This study was conducted to investigate the prevalence of self-reported AR and profiles of AR-related comorbidities in the adult population of China over time. METHODS:This study surveyed residents of 18 major cities in mainland China. Telephone interviews were conducted with study participants after sampling target telephone numbers by random digit dialing. The questions asked during telephone interviews were based on those included in validated questionnaires and focused on topics regarding AR, nonallergic rhinitis (NAR), acute/chronic rhinosinusitis (ARS/CRS), asthma, and atopic dermatitis (AD). RESULTS:During 2011, a total of 47 216 telephone interviews were conducted, and the overall response rate was 77.5%. When compared with the AR prevalence in 11 cities surveyed in 2005, there was a significant increase in self-reported adult AR in eight of those cities (P < 0.01). In 2011, the standardized prevalence of self-reported adult AR in the 18 cities was 17.6%. The concentration of SO2 was positively correlated with the prevalence of AR (r = 0.504, P = 0.033). A multiple regression model showed that the absolute change in household yearly income was significantly associated with the change in the prevalence of AR (R(2) = 0.68), after adjusting for PM10 , SO2 , NO2, temperature, and humidity. The overall prevalences of NAR, ARS, CRS, asthma, and AD in the general population were 16.4%, 5.4%, 2.1%, 5.8%, and 14%, respectively. CONCLUSION:During a 6-year period, there was a significant increase in the prevalence of self-reported AR in the general Chinese adult population. The incidence of AR being accompanied by rhinosinusitis, asthma, or AD was significantly higher among individuals having self-reported AR compared with the general population.
Air pollution exposure and daily clinical visits for allergic rhinitis in a subtropical city: Taipei, Taiwan.
Chen Chih-Cheng,Chiu Hui-Fen,Yang Chun-Yuh
Journal of toxicology and environmental health. Part A
This study was undertaken to determine whether there was an association between air pollutant level exposure and daily clinic visits for allergic rhinitis (AR) in Taipei, Taiwan. Daily clinic visits for AR and ambient air pollution data for Taipei were obtained for the period of 2006-2011. The relative risk for clinic visits for AR was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single-pollutant models, on warm days (>23ºC) significant positive associations were found for increased rate of AR occurrence and ambient levels of particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3). On cool days (<23ºC), all air pollutants were significantly associated with elevated number of AR visits except SO2. For the two-pollutant models, PM10, O3, and NO2 were significantly associated with higher rate of AR visits in combination with each of the other four pollutants on cool days. On warm days, CO levels remained significantly related with increased AR visits in all two-pollutant models. This study provides evidence that higher levels of ambient air contaminants enhance the risk of elevated frequency of clinic visits for AR.
The effects of particulate matters on allergic rhinitis in Nanjing, China.
Chu Haiyan,Xin Junyi,Yuan Qi,Wang Meilin,Cheng Lei,Zhang Zhengdong,Lu Meiping
Environmental science and pollution research international
Particulate matter pollution is a serious environmental problem. Individuals exposed to particulate matters have an increased prevalence to diseases. In the present study, we performed an epidemiological study to investigate the effects of particulate matter less than 10 μm in aerodynamic diameter (PM) and particulate matter less than 2.5 μm in aerodynamic diameter (PM) on allergic rhinitis in Nanjing, China. Daily numbers of allergic rhinitis patients (33,063 patients), PM, PM, and weather data were collected from January 2014 to December 2016 in Nanjing, China. Generalized additive models (GAM) were used to evaluate the effects of PM and PM on allergic rhinitis. We found that the interquartile range (IQR) increases in PM (difference of estimates, 5.86%; 95% CI, 3.00-8.81%; P = 4.72 × 10) and PM (difference of estimates, 5.39%; 95% CI, 2.73-8.12%; P = 5.67 × 10) concentrations were associated with the higher increased numbers of allergic rhinitis patients with 3-day cumulative effects in single-pollutant model. In addition, we found that the IQR increase in PM (age ≥ 18 years: 7.37%, 3.91-10.96%, 2.14 × 10; 0-17 years: 0.83%, - 4.00-5.91%, 0.740) and PM (age ≥ 18 years: 7.00%, 3.78-10.32%, 1.40 × 10; 0-17 years: 0.40%, - 4.10-5.10%, 0.866) increased the number of allergic rhinitis patients in adults, but not in children. In summary, our findings suggested that exposure to PM and PM was associated with the risk of allergic rhinitis.
The short-term effects of cold spells on pediatric outpatient admission for allergic rhinitis in Hefei, China.
Cheng Qiang,Wang Xu,Wei Qiannan,Bai Lijun,Zhang Yanwu,Gao Jiaojiao,Duan Jun,Xu Zihan,Yi Weizhuo,Pan Rubing,Su Hong
The Science of the total environment
BACKGROUND:Some studies have reported that cold weather is associated with the development of allergic rhinitis (AR), but the study of extreme cold temperatures and AR is scarced. This study was conducted to find out the optimal definition of the cold spells in Hefei and to explore the relationship between cold spells and childhood AR, further to identify potential susceptible populations. METHODS:Data of daily AR, meteorological variables and air pollutants from January 1, 2014 to December 31, 2016 were collected in Hefei. Poisson generalized linear regression with a distributed-lag nonlinear model (DLNM) was used to explore the relationship between cold spells and daily pediatric outpatient with allergic rhinitis, by comparing the number of the admission during the cold spells with those during non-cold spells in cold seasons (December to April), after adjusting for relative humidity, air pollutants, seasonality, long-term trends, calendar month, holiday and day of the week (DOW). RESULTS:All definitions of cold spells both had a certain impact on children with allergic rhinitis, and the trend of their effects was similar. The optimal cold spells was defined as the daily average temperature for below 10th with two consecutive days during the study period, and the greatest impact of cold spells was at lag0, with a 12.5% (95%CI: 6.3%-19.1%) increase of AR than non-cold spell days, and its impact could last for 2 days. Male children, children aged 5-18 years and non-scattered children were considered to be more vulnerable to AR in cold spell days. CONCLUSIONS:There was evidence showed that the cold spells may significantly increase the pediatric outpatient admission for allergic rhinitis, especially for male children, children aged 5-18 years and non-scattered children. For the serious threat posed by cold spells, caregivers and health practitioners should strengthen their awareness of the prevention of vulnerable people.
Asthma, allergic rhinitis and eczema among parents of preschool children in relation to climate, and dampness and mold in dwellings in China.
Wang Juan,Zhao Zhuohui,Zhang Yinping,Li Baizhan,Huang Chen,Zhang Xin,Deng Qihong,Lu Chan,Qian Hua,Yang Xu,Sun Yuexia,Sundell Jan,Norbäck Dan
The main aim was to study associations between asthma, allergic rhinitis and eczema among adults across China and dampness and mold at home. Young adults (N = 40,279) in eight cities in China answered a questionnaire in 2010-2012 (response rate 75.0%). Data on asthma, allergic rhinitis, eczema and the home environment was assessed by the questionnaire. Climate data was obtained from China Meteorological Administration and the website of Weather Underground. Health associations were analyzed by two-level logistic regression models, adjusting for covariates. Totally 1.6% had asthma, 6.6% allergic rhinitis and 2.2% eczema. Mold odor was associated with asthma (OR = 1.90) and allergic rhinitis (OR = 1.25-1.44). Window pane condensation in winter was associated with asthma (OR = 1.39), allergic rhinitis (OR = 1.26-1.58) and eczema (OR = 1.36-1.77). Presence of mold spots or damp stains was related to asthma (OR = 1.58-2.49), allergic rhinitis (OR = 1.35-1.76) and eczema (OR = 1.47-1.70). Water damage was related to asthma (OR = 1.69-1.82), allergic rhinitis (OR = 1.40-1.45) and eczema (OR = 1.44-1.96). Damp bed clothing was related to asthma (OR = 1.23), allergic rhinitis (OR = 1.23) and eczema (OR = 1.35). A higher dampness score was associated with increased odds ratios for diseases. Those living in older buildings had more asthma (OR = 1.39-1.76) and allergic rhinitis (OR = 1.16-1.21). Those living in suburban or rural areas had less asthma, allergic rhinitis and eczema as compared to those living in urban areas (OR values from 0.24 to 0.66). Stronger health associations with dampness and mold were found in southern China and in newer buildings (constructed after 2005). In conclusion, dampness and mold at home can be risk factors for asthma, allergic rhinitis and eczema among adults in China. Living in older buildings can be risk factors for asthma or allergic rhinitis while living in less urbanized areas can be protective.
The association between PM exposure and daily outpatient visits for allergic rhinitis: evidence from a seriously air-polluted environment.
Wang Mengying,Wang Siyue,Wang Xiaowen,Tian Yaohua,Wu Yao,Cao Yaying,Song Jing,Wu Tao,Hu Yonghua
International journal of biometeorology
Limited evidence was seen as the association between fine particulate matter (PM) and physician visits for allergic rhinitis (AR), especially in countries with extreme air pollution exposure. This paper addressed the issues about the association between PM and daily outpatient visits for AR among individuals residing in Beijing, China. Data on daily outpatient visits for AR obtained from Beijing Medical Claim Data for Employees and daily PM concentrations available from US embassy reports were linked by date from January 1, 2010, to June 30, 2012. A time-series analysis was conducted with a generalized additive Poisson model to assess the association between PM and AR, adjusting for daily average temperature, relative humidity, day of the week, calendar time, and public holiday. Totally, 229,685 outpatient visits for AR were included in the analysis. The daily mean (SD) concentration of PM was 99.5 (75.3) μg/m during the study period. We found that a 10-μg/m increase in PM content was associated with a 0.47% (95% CI: 0.39% to 0.55%) increase in the number of outpatient visits on the same day. Furthermore, results from subgroup analyses suggested that the association was consistently significant among the groups of different ages (< 65 years and ≥ 65 years) and gender. However, this study failed to find a statistically significant association in the autumn season but found significant positive associations during the spring and summer seasons (P for interaction < 0.001). This study indicated a possible association between PM and AR outpatients, which may benefit further researches in studying PM and its influence on diseases in a real and seriously air-polluted context.
Increased incidence of allergic rhinitis, bronchitis and asthma, in children living near a petrochemical complex with SO pollution.
Chiang Tzu-Ying,Yuan Tzu-Hsuen,Shie Ruei-Hao,Chen Chen-Fang,Chan Chang-Chuan
This study aims to investigate incidence of allergic rhinitis, bronchitis and asthma, in children living near a petrochemical complex with SO pollution obtained by air monitoring stations. A total of 587 children aged 11 to 14 were recruited and classified into high and low exposure groups based on a radius of 10km from the complex. To study the influence of health on children since the operation of complex in 1999 and observe the difference of these diseases' short-term and long-term impact, we obtained the incidence rates of allergic rhinitis (ICD-9: 477), bronchitis (490-491) and asthma (493) from the Taiwan Health Insurance Database for three periods: 1999-2002, 1999-2006, and 1999-2010. Since 2001, the mean and 99th percentile of SO concentrations in the high exposure area have been significantly higher than those in low exposure area. There were significant differences between the high and low exposure groups in the percentage of smoking, alcohol consumption, passive smoking exposure and incense burning habits. The incidence rates of three intervals were 26.9%, 35.7%, 41.7%; 8.3%, 8.8%, 10.2%; 18.5%, 25.0%, 26.9% for allergic rhinitis, bronchitis and asthma in high exposure group. Significant differences were found between groups for allergic rhinitis in all periods, bronchitis in the first two periods, and asthma in the first period using Student's t-test. After we adjusted age, gender, group, living near roads, incense burning and passive smoking exposure, the hazard ratios between exposure groups were 3.05, 2.74, and 1.93 for allergic rhinitis with significant difference in three periods, and 2.53, 1.92 and 1.72 for bronchitis with significant difference in first period and 1.60, 1.28 and 1.29 for asthma with significant difference in first period by Cox regression. The higher incidence of allergic rhinitis was related to boys and living near roads and the higher incidence of asthma was also related to younger children, boys, and passive smoking exposure.
Interactions Between Air Pollution and Pollen Season for Rhinitis Using Mobile Technology: A MASK-POLLAR Study.
Bédard Annabelle,Sofiev Mikhail,Arnavielhe Sylvie,Antó Josep M,Garcia-Aymerich Judith,Thibaudon Michel,Bergmann Karl Christian,Dubakiene Ruta,Bedbrook Anna,Onorato Gabrielle L,Annesi-Maesano Isabella,Pépin Jean-Louis,Laune Daniel,Zeng Stéphane,Bousquet Jean,Basagaña Xavier
The journal of allergy and clinical immunology. In practice
BACKGROUND:Several studies have suggested an interaction between air pollution and pollen exposure with an impact on allergy symptoms. However, large studies with real-life data are not available. OBJECTIVE:To investigate associations between major air pollutants (ozone and particulate matter with a diameter of <2.5 μm) and allergic rhinitis (AR) control during grass and birch pollen seasons as well as outside the pollen season. METHODS:The daily impact of allergic symptoms was recorded by the Allergy Diary (Mobile Airways Sentinel NetworK [MASK-air]) app (a validated mHealth tool for rhinitis management) using visual analog scales (VASs) in Northern and Central Europe users in 2017 and 2018. Uncontrolled AR was defined using symptoms and medications. Pollutant levels were assessed using the System for Integrated modeLing of Atmospheric coMposition database. Pollen seasons were assessed by regions using Google Trends. Generalized estimating equation models were used to account for repeated measures per user, adjusting for sex, age, treatment, and country. Analyses were stratified by pollen seasons to investigate interactions between air pollutants and pollen exposure. RESULTS:A total of 3323 geolocated individuals (36,440 VAS-days) were studied. Associations between uncontrolled rhinitis and pollutants were stronger during the grass pollen season. Days with uncontrolled AR increased by 25% for an interquartile range increase in ozone levels during the grass pollen season (odds ratio of 1.25 [95% CI, 1.11-1.41] in 2017 and of 1.14 [95% CI, 1.04-1.25] in 2018). A similar trend was found for particulate matter with a diameter of less than 2.5 μm, especially in 2017. CONCLUSIONS:These results suggest that the relationship between uncontrolled AR and air pollution is modified by the presence of grass pollens. This study confirms the impact of pollutants in the grass pollen season but not in the birch pollen season.
Childhood allergic rhinitis, traffic-related air pollution, and variability in the GSTP1, TNF, TLR2, and TLR4 genes: results from the TAG Study.
Fuertes Elaine,Brauer Michael,MacIntyre Elaina,Bauer Mario,Bellander Tom,von Berg Andrea,Berdel Dietrich,Brunekreef Bert,Chan-Yeung Moira,Gehring Ulrike,Herbarth Olf,Hoffmann Barbara,Kerkhof Marjan,Klümper Claudia,Koletzko Sibylle,Kozyrskyj Anita,Kull Inger,Heinrich Joachim,Melén Erik,Pershagen Göran,Postma Dirkje,Tiesler Carla M T,Carlsten Chris,
The Journal of allergy and clinical immunology
BACKGROUND:Associations between traffic-related air pollution (TRAP) and allergic rhinitis remain inconsistent, possibly because of unexplored gene-environment interactions. OBJECTIVE:In a pooled analysis of 6 birth cohorts (Ntotal = 15,299), we examined whether TRAP and genetic polymorphisms related to inflammation and oxidative stress predict allergic rhinitis and sensitization. METHODS:Allergic rhinitis was defined with a doctor diagnosis or reported symptoms at age 7 or 8 years. Associations between nitrogen dioxide, particulate matter 2.5 (PM2.5) mass, PM2.5 absorbance, and ozone, estimated for each child at the year of birth, and single nucleotide polymorphisms within the GSTP1, TNF, TLR2, or TLR4 genes with allergic rhinitis and aeroallergen sensitization were examined with logistic regression. Models were stratified by genotype and interaction terms tested for gene-environment associations. RESULTS:Point estimates for associations between nitrogen dioxide, PM2.5 mass, and PM2.5 absorbance with allergic rhinitis were elevated, but only that for PM2.5 mass was statistically significant (1.37 [1.01, 1.86] per 5 μg/m(3)). This result was not robust to single-cohort exclusions. Carriers of at least 1 minor rs1800629 (TNF) or rs1927911 (TLR4) allele were consistently at an increased risk of developing allergic rhinitis (1.19 [1.00, 1.41] and 1.24 [1.01, 1.53], respectively), regardless of TRAP exposure. No evidence of gene-environment interactions was observed. CONCLUSION:The generally null effect of TRAP on allergic rhinitis and aeroallergen sensitization was not modified by the studied variants in the GSTP1, TNF, TLR2, or TLR4 genes. Children carrying a minor rs1800629 (TNF) or rs1927911 (TLR4) allele may be at a higher risk of allergic rhinitis.
Early life exposure to traffic-related air pollution and allergic rhinitis in preschool children.
Deng Qihong,Lu Chan,Yu Yichen,Li Yuguo,Sundell Jan,Norbäck Dan
BACKGROUND:Evidence linking long-term exposure to outdoor air pollution with allergic rhinitis (AR) in children is scare, and the role of components of air pollution and timing of exposure remains unclear. OBJECTIVE:To assess the association of pre- and post-natal exposure to air pollution with life-time prevalence of AR in preschool children. METHODS:We conducted a cohort study of 2598 children aged 3-6 years in Changsha, China. The lifetime prevalence of AR was assessed by a questionnaire administered by parents. Children's exposures to dioxide nitrogen (NO), sulfur dioxide (SO) and particulate matter with an aerodynamic diameter ≤ 10 μm (PM) during different pre- and post-natal timing windows were estimated using the measured concentrations at monitoring stations. The odds ratio (OR) and 95% confidence interval (CI) of childhood AR for exposure to different air pollutants during different timing windows were assessed by logistic regression model in terms of an interquartile range (IQR) increase in exposure level. RESULTS:Life-time prevalence of AR in preschool children (7.3%) was associated with both pre- and post-natal exposure to traffic-related air pollution (TRAP), but only significant during the third trimester of pregnancy with adjusted OR = 1.40 (95% CI: 1.08-1.82) for a 15 μg/m increase in NO and during the first-year of life with adjusted OR = 1.36 (95% CI: 1.03-1.78) and 1.54 (95% CI: 1.07-2.21) respectively for 11 and 12 μg/m increase in NO and PM. The association of early life exposure to TRAP with childhood AR was robust by adjusting for other air pollutants and timing windows. Sensitivity analysis indicated that the association was higher in the children who are male, young, with genetic predisposition by parental atopy, and living in damp houses. CONCLUSION:Early life exposure to traffic-related air pollutant during pregnancy and first-year of life may contribute to childhood AR.
Exposure to outdoor air pollution during trimesters of pregnancy and childhood asthma, allergic rhinitis, and eczema.
Deng Qihong,Lu Chan,Li Yuguo,Sundell Jan,Dan Norbäck
BACKGROUND:Mounting evidence suggests that exposure to ambient air pollution is associated with the development of childhood allergic diseases, but the effect of prenatal exposure to air pollution on the risk of childhood asthma and allergy is unclear. OBJECTIVES:We evaluated the association between maternal exposure to outdoor air pollution during different trimesters of pregnancy and incidence of asthma, allergic rhinitis, and eczema in 2598 preschool children aged 3-6 years in China. METHODS:Children's lifetime incidence of allergic diseases was obtained using questionnaire. Individual exposure to outdoor air pollutants during trimesters of pregnancy was estimated by an inverse distance weighted (IDW) method based on the measured concentrations at monitoring stations. We used multiple logistic regression method to estimate the odds ratio (OR) of asthma, allergic rhinitis, and eczema for per interquartile range (IQR) increase in the exposure to air pollutant in each trimester, which was adjusted for the effect of other air pollutants and its effect in other trimesters by a multi-pollutant/trimester model. RESULTS:Incidence of asthma (6.8%), allergic rhinitis (7.3%), and eczema (28.6%) in children was associated with maternal exposure to traffic-related pollutant NO2 during entire pregnancy with OR (95% confidence interval [CI]) respectively 1.63 (0.99-2.70), 1.69 (1.03-2.77), and 1.37 (1.04-1.80). After adjustment for other pollutants and trimesters, we found the association was significant only in specific trimester: the first trimester for eczema (1.54, 1.14-2.09), the second trimester for asthma (1.72, 1.02-2.97), and the third trimester for allergic rhinitis (1.77, 1.09-2.89). Sensitivity analysis indicated that the trimester sensitive to the development of allergic diseases was stable. CONCLUSION:Maternal exposure to traffic-related air pollutant NO2 during pregnancy, especially in specific trimesters, is associated with an increased risk of developing asthma, rhinitis, and eczema in children. Our results support the hypothesis that childhood allergic diseases originate in fetal life and are triggered by traffic-related air pollution in sensitive trimesters.
Association Between Seasonal Allergic Rhinitis and Air Pollution, Meteorological Factors, and Grass Pollen Counts in Madrid (1996 and 2009).
Cabrera M,Garzón García B,Moreno Grau S,Subiza J
Journal of investigational allergology & clinical immunology
OBJECTIVE:The aim of this study was to assess the relationship between meteorological and pollution-related variables and the symptoms of patients with seasonal allergic rhinitis due to sensitization to grass pollen during 2 different time periods in Madrid, Spain. METHODS:Between March 23 and December 31 in 1996 and 2009, we carried out a daily count of grass pollen grains (Burkard spore trap) and recorded the rhinitis symptom scores in 2 groups of patients with a history of seasonal allergic rhinitis (n=25 in 1996 and n=23 in 2009). Descriptive statistics of the same variables during the study periods were recorded. Associations between variables were assessed using the paired-samples Wilcoxon test and categorical principal component analysis (CatPCA, SPSS24 package). RESULTS:The mean symptom score was low in 1996 and moderate in 2009. The 1996 and 2009 CatPCA analysis explained around 66.4% and 70.5% of the variance, respectively. The strongest relationships in 1996 were between symptoms and grass pollen counts (R=0.55) and between temperature and ozone (R=0.63). In 2009, the association between temperature and pollution-related variables was even stronger than in 1996 (ozone [R=0.53] and PM10 [R=0.34], with a positive sign in both cases). CONCLUSIONS:The effect of temperature and pollution (mainly ozone, even at lower atmospheric concentrations than in established guidelines for effects on health) may have contributed to the higher seasonal allergic rhinitis symptom score recorded in 2009.
The Association between Ambient Air Pollution and Allergic Rhinitis: Further Epidemiological Evidence from Changchun, Northeastern China.
Teng Bo,Zhang Xuelei,Yi Chunhui,Zhang Yan,Ye Shufeng,Wang Yafang,Tong Daniel Q,Lu Binfeng
International journal of environmental research and public health
With the continuous rapid urbanization process over the last three decades, outdoors air pollution has become a progressively more serious public health hazard in China. To investigate the possible associations, lag effects and seasonal differences of urban air quality on respiratory health (allergic rhinitis) in Changchun, a city in Northeastern China, we carried out a time-series analysis of the incidents of allergic rhinitis (AR) from 2013 to 2015. Environmental monitoring showed that PM and PM were the major air pollutants in Changchun, followed by SO₂, NO₂ and O₃. The results also demonstrated that the daily concentrations of air pollutants had obvious seasonal differences. PM had higher daily mean concentrations in spring (May, dust storms), autumn (October, straw burning) and winter (November to April, coal burning). The mean daily number of outpatient AR visits in the warm season was higher than in the cold season. The prevalence of allergic rhinitis was significantly associated with PM, PM, SO₂ and NO₂, and the increased mobility was 10.2% (95% CI, 5.5%-15.1%), 4.9% (95% CI, 0.8%-9.2%), 8.5% (95% CI, -1.8%-19.8%) and 11.1% (95% CI, 5.8%-16.5%) for exposure to each 1-Standard Deviation (1-SD) increase of pollutant, respectively. Weakly or no significant associations were observed for CO and O₃. As for lag effects, the highest Relative Risks (RRs) of AR from SO₂, NO₂, PM and PM were on the same day, and the highest RR from CO was on day 4 (L4). The results also indicated that the concentration of air pollutants might contribute to the development of AR. To summarize, this study provides further evidence of the significant association between ambient particulate pollutants (PM and PM, which are usually present in high concentrations) and the prevalence of respiratory effects (allergic rhinitis) in the city of Changchun, located in Northeastern China. Environmental control and public health strategies should be enforced to address this increasingly challenging problem.