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Kumar R, Gaur S, Agarwal M, Menon B, Goel N, Mrigpuri P, Spalgais S, Priya A, Kumar K, Meena R, Sankararaman N, Verma A, Gupta V, Sonal, Prakash A, Safwan MA, Behera D, Singh A, Arora N, Prasad R, Padukudru M, Kant S, Janmeja A, Mohan A, Jain V, Nagendra Prasad K, Nagaraju K, Goyal M. Indian Guidelines for diagnosis of respiratory allergy. INDIAN JOURNAL OF ALLERGY, ASTHMA AND IMMUNOLOGY 2023. [DOI: 10.4103/0972-6691.367373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Yang D, Yan Y, Pu K. The Association Between Air Pollutants and Daily Outpatient Visits for Allergic Rhinitis: A Time-Series Analysis Based on Distribution Lag Nonlinear Model in Chongqing, China. Healthc Policy 2022; 15:1501-1515. [PMID: 35966499 PMCID: PMC9374097 DOI: 10.2147/rmhp.s373085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Allergic rhinitis (AR) is a severe and the most common chronic allergic disease, affecting 10-40% of the world population. The effect of air pollutants on AR has been confirmed in clinical experiments. Purpose This study aimed to quantify the association between air pollutants and daily outpatient visits for AR in Chongqing, China. Methods Based on the data of AR outpatients in the primary urban area of Chongqing from 2016 to 2017, along with the atmospheric pollutants and meteorological data in the same period, the distributed lag nonlinear model (DLNM) and generalized additive model (GAM) were used to analyze the time-series. We examined the effects of the single and double pollutant models with a maximum lag day of 30 days. Effect estimates were described as relative risk (RR) and 95% confidence intervals (CIs) in daily outpatient visits for AR per 10 μg/m3 increases in PM2.5, PM10, SO2, NO2, O3, and per 1 mg/m3 increase in CO. Results A single pollutant's O3 level had an immediate positive effect on AR within two days, the relative risks (RR, 95% CI) were 1.066 (1.008-1.127), 1.057 (1.005-1.112) and 1.048 (1.002-1.097). PM2.5 had a lag effect within 11-18 days, the max relative risks (RR, 95% CI) were 1.083 (1.010-1.160). Moreover, O3, PM2.5, PM10, SO2 and NO2 had significant effects on AR in the two-pollutant model. The RR cumulative effect of PM2.5 became more pronounced as the concentration increased. The cumulative effect of NO2 was lesser than PM2.5. Conclusion Air pollutants were associated with the daily outpatient visits for AR, which may have considerable implications for developing tailored health policies and services to prevent AR in Chongqing and even all over the world.
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Affiliation(s)
- Dan Yang
- School of Medical Information, Chongqing Medical University, Chongqing, People's Republic of China
| | - Yongjie Yan
- School of Medical Information, Chongqing Medical University, Chongqing, People's Republic of China
| | - Kexue Pu
- School of Medical Information, Chongqing Medical University, Chongqing, People's Republic of China.,Medical Data Research Institute of Chongqing Medical University, Chongqing, People's Republic of China
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Jia X, Shen Z, Liu R, Han Y, Yang Y, Chen Q, Duan N. Association of fine particulate matter to allergic rhinitis: A systematic review and meta-analysis. EUR J INFLAMM 2022. [DOI: 10.1177/1721727x221089839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: Fine particulate matter (PM2.5) has become a major concern for global environmental health, as it can lead to inflammatory diseases, such as allergic rhinitis (AR) and cause a high burden of disease. The aim of this study is to carry out a systematic review and meta-analysis based on available research to present the link between ambient PM2.5 and the risk of AR in global populations. Methods: We systematically searched six databases from their inception to 30 November 2020. An expanded literature search was carried out using the references of the included studies. Data extraction was performed using Excel 2016 software, and meta-analysis and heterogeneity analysis were performed using Review Manager 5.3 software. Results: A total of 14 out of 1361 studies were included in the meta-analysis. The quality assessment showed these studies to be of high quality. Seven out of 14 studies reported a relationship between ambient PM2.5 and AR through Odds ratios (OR, ORoverall = 1.14, 95% CI [1.00, 1.29]), but with a non-significant statistical overall test result (the test result for overall effect was Z = 1.98, p =.05). For subgroups by ages and regions, ORChildren = 1.08 (95% CI [1.04, 1.13]), and OROther ages = 1.50 (95% CI [1.24, 1.81]. The differences between age-related subgroups were significant (p <.01). Meanwhile, the relationship between PM2.5 and the risk of AR in Asia was significant (ORAsia = 1.20, 95% CI [1.01, 1.44], p =.001); whereas the association studies from outside of Asia have reported the relationship as non-significant (OROut-Asia = 1.04, 95% CI [0.82, 1.31], p =.76). Conclusion: There are reports that recognize that the exposure to PM2.5 may contribute to the development of AR. An international framework with a whole-of-society approach, including air quality control efforts and well-being health promotion among AR patients and at-risk populations, should be implemented.
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Affiliation(s)
- Xiaofei Jia
- Department of Otolaryngology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhengzheng Shen
- Department of Otolaryngology, Shunyi Women and Children’s Hospital of Beijing Children’s Hospital, Beijing, China
| | - Rongrong Liu
- Department of Otolaryngology, Cangzhou Central Hospital, Cangzhou, China
| | - Yue Han
- Department of Otolaryngology, Aviation General Hospital, Beijing, China
| | - Yanzhong Yang
- Department of Otolaryngology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qi Chen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Naichao Duan
- Department of Otolaryngology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Wu R, Guo Q, Fan J, Guo C, Wang G, Wu W, Xu J. Association between air pollution and outpatient visits for allergic rhinitis: Effect modification by ambient temperature and relative humidity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 821:152960. [PMID: 35016948 DOI: 10.1016/j.scitotenv.2022.152960] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/02/2022] [Accepted: 01/04/2022] [Indexed: 06/14/2023]
Abstract
Mounting evidence indicated the associations between air pollution and outpatient visits for allergic rhinitis (AR), while few studies assessed the effect modification of these associations by ambient temperature and relative humidity (RH). In this study, dataset of AR outpatients was obtained from Chinese People's Liberation Army Strategic Support Force Characteristic Medical Center in Beijing during 2014 to 2019, and the average concentrations of air pollutants including particulate matter ≤2.5 μm in diameter (PM2.5) and ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and meteorological factors (temperature and RH) at the same period were collected from one nearby air monitoring station. We performed a time-series study with Poisson regression model to examine the effects of air pollutants on AR outpatients after adjustment for potential confounders. And the effects modification analysis was further conducted by stratifying temperature and RH by tertiles into three groups of low, middle and high. In total of 33,599 outpatient visits for AR were recorded during the study period. Results found that a 10 μg/m3 increase in PM2.5, PM10, NO2 and SO2 was associated with significant increases in AR outpatients of 1.24% (95% confidence interval (CI): 0.69%, 1.78%), 0.79% (95% CI: 0.43%, 1.15%), 3.05% (95% CI: 1.72%, 4.40%) and 5.01% (95% CI: 1.18%, 8.96%), respectively. Stronger associations were observed in males than those in females, as well as in young adults (18-44 years) than those in other age groups. Air pollution effects on AR outpatients increased markedly at low temperature (<33.3th percentile) and high RH (>66.7th percentile). Findings in this study indicate that air pollution is associated with increased risk of AR outpatients, and the effects of air pollution on AR could be enhanced at low temperature and high RH.
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Affiliation(s)
- Rongshan Wu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; Center for Environmental Health Risk Assessment and Research, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Qun Guo
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; Center for Environmental Health Risk Assessment and Research, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Jingpu Fan
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; Center for Environmental Health Risk Assessment and Research, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Changsheng Guo
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; Center for Environmental Health Risk Assessment and Research, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Gang Wang
- Department of Otolaryngology, Strategic Support Force Medical Center, Beijing 100005, China; State Environmental Protection Key Laboratory of Environmental Sense Organ Stress and Health, Beijing 100005, China
| | - Wei Wu
- Department of Otolaryngology, Strategic Support Force Medical Center, Beijing 100005, China; State Environmental Protection Key Laboratory of Environmental Sense Organ Stress and Health, Beijing 100005, China.
| | - Jian Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; Center for Environmental Health Risk Assessment and Research, Chinese Research Academy of Environmental Sciences, Beijing 100012, China.
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5
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Yum HY, Ha EK, Shin YH, Han MY. Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis. Clin Exp Pediatr 2021; 64:373-383. [PMID: 32777916 PMCID: PMC8342874 DOI: 10.3345/cep.2020.00822] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/15/2020] [Accepted: 07/27/2020] [Indexed: 12/17/2022] Open
Abstract
Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis, which involves nasal symptoms without evidence of systemic allergic inflammation or infection, is a heterogeneous entity with diverse manifestations and intensities. Nonallergic rhinitis accounts for 16%-89% of the chronic rhinitis cases, affecting 1%-50% (median 10%) of the total pediatric population. The clinical course of nonallergic rhinitis is generally rather mild and less likely to be associated with allergic comorbidities than allergic rhinitis. Here, we aimed to estimate the rate of coexisting comorbidities of nonallergic rhinitis. Nonallergic rhinitis is more prevalent during the first 2 years of life; however, its underestimation for children with atopic tendencies is likely due to low positive rates of specific allergic tests during early childhood. Local allergic rhinitis is a recently noted phenotype with rates similar to those in adults (median, 44%; range, 4%-67%), among patients previously diagnosed with nonallergic rhinitis. Idiopathic rhinitis, a subtype of nonallergic rhinitis, has been poorly studied in children, and its rates are known to be lower than those in adults. The prevalence of nonallergic rhinitis with eosinophilia syndrome is even lower. A correlation between nonallergic rhinitis and pollution has been suggested owing to the recent increase in nonallergic rhinitis rates in highly developing regions such as some Asian countries, but many aspects remain unknown. Conventional treatments include antihistamines, intranasal corticosteroids, and recent treatments include combination of intranasal corticosteroids with azelastin or decongestants. Here we review the prevalence, diagnosis, comorbidities, and treatment recommendations for nonallergic rhinitis versus allergic rhinitis in children.
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Affiliation(s)
- Hye Yung Yum
- Department of Pediatrics, Seoul Medical Center, Seoul, Korea
| | - Eun Kyo Ha
- Department of Pediatrics, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Yoon Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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Saha S, Vaidyanathan A, Lo F, Brown C, Hess JJ. Short term physician visits and medication prescriptions for allergic disease associated with seasonal tree, grass, and weed pollen exposure across the United States. Environ Health 2021; 20:85. [PMID: 34289856 PMCID: PMC8296728 DOI: 10.1186/s12940-021-00766-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/28/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND While year-round exposure to pollen is linked to a large burden of allergic diseases, location-specific risk information on pollen types and allergy outcomes are limited. We characterize the relationship between acute exposure to tree, grass and weed pollen taxa and two allergy outcomes (allergic rhinitis physician visit and prescription allergy medication fill) across 28 metropolitan statistical areas (MSA) in the United States. METHODS We obtained daily pollen data from National Allergy Bureau (NAB) monitors at these 28 MSAs for 2008-2015. We revised the NAB guidelines to classify taxa-specific pollen severity each day. Daily information on allergic rhinitis and prescribed allergy medications for individuals with employer-based health insurance from the IBM MarketScan Research database for these MSAs. We combined the daily pollen and health data for each MSA into a longitudinal dataset. We conducted a MSA-specific conditional quasi-Poisson regression analysis to assess how different levels of pollen concentration impact the health outcomes, controlling for local air pollution, meteorology and Influenza-like illness (ILI). We used a random effects meta-analysis to produce an overall risk estimate for each pollen type and health outcome. RESULTS The seasonal distribution of pollen taxa and associated health impacts varied across the MSAs. Relative risk of allergic rhinitis visits increased as concentrations increased for all pollen types; relative risk of medication fills increased for tree and weed pollen only. We observed an increase in health risk even on days with moderate levels of pollen concentration. 7-day average concentration of pollen had stronger association with the health outcomes compared to the same-day measure. Controlling for air pollution and ILI had little impact on effect estimates. CONCLUSION This analysis expands the catalogue of associations between different pollen taxa and allergy-related outcomes across multiple MSAs. The effect estimates we present can be used to project the burden of allergic disease in specific locations in the future as well inform patients with allergies on impending pollen exposure.
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Affiliation(s)
- Shubhayu Saha
- Centers for Disease Control and Prevention, National Center for Environmental Health, 4770 Buford Hwy, GA, 30341, Atlanta, USA.
| | - Ambarish Vaidyanathan
- Centers for Disease Control and Prevention, National Center for Environmental Health, 4770 Buford Hwy, GA, 30341, Atlanta, USA
| | - Fiona Lo
- Department of Atmospheric Sciences, College of the Environment, University of Washington, Seattle, WA, USA
| | - Claudia Brown
- Centers for Disease Control and Prevention, National Center for Environmental Health, 4770 Buford Hwy, GA, 30341, Atlanta, USA
| | - Jeremy J Hess
- Department of Emergency Medicine, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
- Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, USA
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7
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Lam HCY, Jarvis D, Fuertes E. Interactive effects of allergens and air pollution on respiratory health: A systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 757:143924. [PMID: 33310575 PMCID: PMC7812370 DOI: 10.1016/j.scitotenv.2020.143924] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Studies have demonstrated an adverse role of outdoor allergens on respiratory symptoms. It is unknown whether this effect is independent or synergistic of outdoor air pollutants. METHODS We systematically reviewed all epidemiological studies that examined interaction effects between counts of outdoor airborne allergens (pollen, fungal spores) and air pollutants, on any respiratory health outcome in children and adults. We searched the MEDLINE, EMBASE and Scopus databases. Each study was summarized qualitatively and assessed for quality and risk of bias (International Prospective Register for Systematic Reviews, registration number CRD42020162571). RESULTS Thirty-five studies were identified (15 timeseries, eight case-crossovers, 11 panels and one cohort study), of which 12 reported a significant statistical interaction between an allergen and air pollutant. Eight interactions were related to asthma outcomes, including one on lung function measures and wheeze, three to medical consultations for pollinosis and one to allergic symptoms (nasal, ocular or bronchial). There was no consensus as to which allergen or air pollutant is more likely to interact. No study investigated whether interactions are stronger in atopic individuals. CONCLUSION Despite strong evidence from small experimental studies in humans, only a third of studies identified significant allergen-pollutant interactions using common epidemiological study designs. Exposure misclassification, failure to examine subgroups at risk, inadequate statistical power or absence of population-level effects are possible explanations.
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Affiliation(s)
- Holly C Y Lam
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; MRC Centre for Environment & Health, Imperial College, London, United Kingdom.
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; MRC Centre for Environment & Health, Imperial College, London, United Kingdom.
| | - Elaine Fuertes
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.
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Shankar HM, Rice MB. Update on Climate Change: Its Impact on Respiratory Health at Work, Home, and at Play. Clin Chest Med 2021; 41:753-761. [PMID: 33153692 DOI: 10.1016/j.ccm.2020.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Climate change is a crisis of vast proportions that has serious implications for pulmonary health. Increasing global temperatures influence respiratory health through extreme weather events, wildfires, prolonged allergy seasons, and worsening air pollution. Children, elderly patients, and patients with underlying lung disease are at elevated risk of complications from these effects of climate change. This paper summarizes the myriad ways in which climate change affects the respiratory health of patients at home and in outdoor environments and outlines measures for patients to protect themselves.
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Affiliation(s)
- Hari M Shankar
- Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, 3400 Spruce Street, 839 West Gates Building, Philadelphia, PA 19104, USA.
| | - Mary B Rice
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, KS/BM23, 330 Brookline Avenue, Boston, MA 02215, USA
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The Impact of Climate Change on Pollen Season and Allergic Sensitization to Pollens. Immunol Allergy Clin North Am 2020; 41:97-109. [PMID: 33228876 DOI: 10.1016/j.iac.2020.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Pollens are a major cause of seasonal allergic diseases. Weather may alter the production of pollens. Increased atmospheric temperatures lead to earlier pollination of many plants and longer duration of pollination, resulting in extended pollen seasons, with early spring or late winter. Longer pollen seasons increase duration of exposure, resulting in more sensitization, and higher pollen concentrations may lead to more severe symptoms. Climate changes in contact to pollens may affect both allergic sensitization and symptom prevalence with severity. The future consequences of climate change, however, are speculative, because the influence on humans, is complex.
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Sofiev M, Palamarchuk Y, Bédard A, Basagana X, Anto JM, Kouznetsov R, Urzua RD, Bergmann KC, Fonseca JA, De Vries G, Van Erd M, Annesi-Maesano I, Laune D, Pépin JL, Jullian-Desayes I, Zeng S, Czarlewski W, Bousquet J. A demonstration project of Global Alliance against Chronic Respiratory Diseases: Prediction of interactions between air pollution and allergen exposure-the Mobile Airways Sentinel NetworK-Impact of air POLLution on Asthma and Rhinitis approach. Chin Med J (Engl) 2020; 133:1561-1567. [PMID: 32649522 PMCID: PMC7386352 DOI: 10.1097/cm9.0000000000000916] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Indexed: 02/07/2023] Open
Abstract
This review analyzes the state and recent progress in the field of information support for pollen allergy sufferers. For decades, information available for the patients and allergologists consisted of pollen counts, which are vital but insufficient. New technology paves the way to substantial increase in amount and diversity of the data. This paper reviews old and newly suggested methods to predict pollen and air pollutant concentrations in the air and proposes an allergy risk concept, which combines the pollen and pollution information and transforms it into a qualitative risk index. This new index is available in an app (Mobile Airways Sentinel NetworK-air) that was developed in the frame of the European Union grant Impact of Air POLLution on sleep, Asthma and Rhinitis (a project of European Institute of Innovation and Technology-Health). On-going transformation of the pollen allergy information support is based on new technological solutions for pollen and air quality monitoring and predictions. The new information-technology and artificial-intelligence-based solutions help to convert this information into easy-to-use services for both medical practitioners and allergy sufferers.
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Affiliation(s)
- Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Helsinki 00560, Finland
| | | | - Annabelle Bédard
- Barcelona Institute for Global Health, Centre for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER) Epidemiología y Salud Pública (CIBERESP), Barcelona 08003, Spain
- Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain
| | - Xavier Basagana
- Barcelona Institute for Global Health, Centre for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER) Epidemiología y Salud Pública (CIBERESP), Barcelona 08003, Spain
- Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain
- Institut Hospital del Mar d’Investigacions Mediques (IMIM), Barcelona 08003, Spain
| | - Josep M. Anto
- Barcelona Institute for Global Health, Centre for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER) Epidemiología y Salud Pública (CIBERESP), Barcelona 08003, Spain
- Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain
- Institut Hospital del Mar d’Investigacions Mediques (IMIM), Barcelona 08003, Spain
| | | | | | - Karl Christian Bergmann
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Berlin 10117, Germany
| | - Joao A. Fonseca
- Center for Health Technology and Services Research (CINTESIS), Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto; and Medida, Lda Porto s/n 4200-450, Portugal
| | | | | | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases Department, Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Université, Medical School Saint Antoine, Paris 75571, France
| | | | - Jean Louis Pépin
- Université Grenoble Alpes, Laboratoire HP2, Grenoble, INSERM, U1042 and CHU de Grenoble, Grenoble 38000, France
| | - Ingrid Jullian-Desayes
- Université Grenoble Alpes, Laboratoire HP2, Grenoble, INSERM, U1042 and CHU de Grenoble, Grenoble 38000, France
| | | | | | - Jean Bousquet
- University Hospital Montpellier, Montpellier 34000, France
- Contre les Maladies Chroniques pour un Vieillissement Actif en Languedoc Roussillon-France, Montpellier, France
- Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin 10117, Germany
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11
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Wang M, Wang S, Wang X, Tian Y, Wu Y, Cao Y, Song J, Wu T, Hu Y. The association between PM 2.5 exposure and daily outpatient visits for allergic rhinitis: evidence from a seriously air-polluted environment. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:139-144. [PMID: 31754771 DOI: 10.1007/s00484-019-01804-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/06/2019] [Accepted: 09/13/2019] [Indexed: 05/22/2023]
Abstract
Limited evidence was seen as the association between fine particulate matter (PM2.5) and physician visits for allergic rhinitis (AR), especially in countries with extreme air pollution exposure. This paper addressed the issues about the association between PM2.5 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 PM2.5 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 PM2.5 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 PM2.5 was 99.5 (75.3) μg/m3 during the study period. We found that a 10-μg/m3 increase in PM2.5 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 PM2.5 and AR outpatients, which may benefit further researches in studying PM2.5 and its influence on diseases in a real and seriously air-polluted context.
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Affiliation(s)
- Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Bédard A, Sofiev M, Arnavielhe S, Antó JM, Garcia-Aymerich J, Thibaudon M, Bergmann KC, Dubakiene R, Bedbrook A, Onorato GL, Annesi-Maesano I, Pépin JL, Laune D, Zeng S, Bousquet J, Basagaña X. Interactions Between Air Pollution and Pollen Season for Rhinitis Using Mobile Technology: A MASK-POLLAR Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:1063-1073.e4. [PMID: 31786252 DOI: 10.1016/j.jaip.2019.11.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 10/17/2019] [Accepted: 11/13/2019] [Indexed: 12/21/2022]
Abstract
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.
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Affiliation(s)
- Annabelle Bédard
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | | | - Josep M Antó
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Michel Thibaudon
- RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France
| | - Karl Christian Bergmann
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, member of GA2LEN, Berlin, Germany
| | - Ruta Dubakiene
- Clinic of Chest Diseases, Immunology and Allergology, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Anna Bedbrook
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
| | | | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Université, Medical School Saint Antoine, Paris, France
| | - Jean-Louis Pépin
- Université Grenoble Alpes, Laboratoire HP2, Grenoble, INSERM, U1042 and CHU de Grenoble, Grenoble, France
| | | | | | - Jean Bousquet
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France; University Hospital, Montpellier, France; INSERM U 1168, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
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Jones NR, Agnew M, Banic I, Grossi CM, Colón-González FJ, Plavec D, Goodess CM, Epstein MM, Turkalj M, Lake IR. Ragweed pollen and allergic symptoms in children: Results from a three-year longitudinal study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 683:240-248. [PMID: 31132703 DOI: 10.1016/j.scitotenv.2019.05.284] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/09/2019] [Accepted: 05/19/2019] [Indexed: 06/09/2023]
Abstract
Common ragweed is a highly allergenic invasive species in Europe, expected to become widespread under climate change. Allergy to ragweed manifests as eye, nasal and lung symptoms, and children may retain these throughout life. The dose-response relationship between symptoms and pollen concentrations is unclear. We undertook a longitudinal study, assessing the association between ragweed pollen concentration and allergic eye, nasal and lung symptoms in children living under a range of ragweed pollen concentrations in Croatia. Over three years, 85 children completed daily diaries, detailing allergic symptoms alongside daily location, activities and medication, resulting in 10,130 individual daily entries. The daily ragweed pollen concentration for the children's locations was obtained, alongside daily weather and air pollution. Parents completed a home/lifestyle/medical questionnaire. Generalised Additive Mixed Models established the relationship between pollen concentrations and symptoms, alongside other covariates. Eye symptoms were associated with mean daily pollen concentration over four days (day of symptoms plus 3 previous days); 61 grains/m3/day (95%CI: 45, 100) was the threshold at which 50% of children reported symptoms. Nasal symptoms were associated with mean daily pollen concentration over 12 days (day of symptoms plus 11 previous days); the threshold for 50% of children reporting symptoms was 40 grains/m3/day (95%CI: 24, 87). Lung symptoms showed a relationship with mean daily pollen concentration over 19 days (day of symptoms plus 18 previous days), with a threshold of 71 grains/m3/day (95%CI: 59, 88). Taking medication on the day of symptoms showed higher odds, suggesting responsive behaviour. Taking medication on the day prior to symptoms showed lower odds of reporting, indicating preventative behaviour. Different symptoms in children demonstrate varying dose-response relationships with ragweed pollen concentrations. Each symptom type responded to pollen exposure over different time periods. Using medication prior to symptoms can reduce symptom presence. These findings can be used to better manage paediatric ragweed allergy symptoms.
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Affiliation(s)
- Natalia R Jones
- School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, UK.
| | - Maureen Agnew
- School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, UK.
| | - Ivana Banic
- Srebrnjak Children's Hospital, Srebrnjak 100, 10000 Zagreb, Croatia.
| | - Carlota M Grossi
- School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, UK.
| | | | - Davor Plavec
- Srebrnjak Children's Hospital, Srebrnjak 100, 10000 Zagreb, Croatia; Faculty of Medicine, J.J. Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, Croatia.
| | - Clare M Goodess
- School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, UK.
| | - Michelle M Epstein
- Department of Dermatology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Mirjana Turkalj
- Srebrnjak Children's Hospital, Srebrnjak 100, 10000 Zagreb, Croatia; Faculty of Medicine, J.J. Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, Croatia; Catholic University of Croatia, Ilica 242, 10000 Zagreb, Croatia.
| | - Iain R Lake
- School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, UK.
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Neumann JE, Anenberg SC, Weinberger KR, Amend M, Gulati S, Crimmins A, Roman H, Fann N, Kinney PL. Estimates of Present and Future Asthma Emergency Department Visits Associated With Exposure to Oak, Birch, and Grass Pollen in the United States. GEOHEALTH 2019; 3:11-27. [PMID: 31106285 PMCID: PMC6516486 DOI: 10.1029/2018gh000153] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/24/2018] [Accepted: 11/28/2018] [Indexed: 05/18/2023]
Abstract
Pollen is an important environmental cause of allergic asthma episodes. Prior work has established a proof of concept for assessing projected climate change impacts on future oak pollen exposure and associated health impacts. This paper uses additional monitor data and epidemiologic functions to extend prior analyses, reporting new estimates of the current and projected future health burden of oak, birch, and grass pollen across the contiguous United States. Our results suggest that tree pollen in the spring currently accounts for between 25,000 and 50,000 pollen-related asthma emergency department (ED) visits annually (95% confidence interval: 14,000 to 100,000), roughly two thirds of which occur among people under age 18. Grass pollen in the summer season currently accounts for less than 10,000 cases annually (95% confidence interval: 4,000 to 16,000). Compared to a baseline with 21st century population growth but constant pollen, future temperature and precipitation show an increase in ED visits of 14% in 2090 for a higher greenhouse gas emissions scenario, but only 8% for a moderate emissions scenario, reflecting projected increases in pollen season length. Grass pollen, which is more sensitive to changes in climatic conditions, is a primary contributor to future ED visits, with the largest effects in the Northeast, Midwest, and Southern Great Plains regions. More complete assessment of the current and future health burden of pollen is limited by the availability of data on pollen types (e.g., ragweed), other health effects (e.g., other respiratory disease), and economic consequences (e.g., medication costs).
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Affiliation(s)
| | | | - Kate R. Weinberger
- Department of EpidemiologyBrown University School of Public HealthProvidenceRIUSA
| | | | | | | | | | - Neal Fann
- U.S. Environmental Protection Agency, Research Triangle ParkNorth CarolinaUSA
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15
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Caillaud D, Cheriaux M, Martin S, Ségala C, Dupuy N, Evrard B, Thibaudon M. Short-term effect of outdoor mould spore exposure on prescribed allergy medication sales in Central France. Clin Exp Allergy 2018; 48:837-845. [PMID: 29698555 DOI: 10.1111/cea.13160] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/23/2018] [Accepted: 04/16/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Outdoor moulds are classically associated with exacerbations of asthma. OBJECTIVE The aim of this paper was to examine nasal allergy morbidity by studying the short-term relationship between mould spore exposure and daily sales of reimbursable anti-allergic treatment in central France. METHODS The relationship between daily changes in mould concentrations and daily sales obtained from the national healthcare database was analysed with generalized additive models, taking into account confounding factors such as air pollution, weather conditions, pollen counts, and days of the week. RESULTS During the study, the average total yearly number of treated people was around 10 000 over approximately 230 000 surveyed. The relative risk (95% CI confidence interval) of sales of oral antihistamines with topical treatment associated with an interquartile increase in mould concentration was significant for Cladosporium 1.079 [1.019-1.142] and Aspergillus-Penicillium (Asp-Pen) 1.051 [1.021-1.082] in the whole population. When the influence of age and sex was considered, the relationship was significant only in male children aged 0-12 years and those aged between 13 and 49 years for Cladosporium: 1.256 [1.081-1.460] and 1.151 [1.063-1.245], respectively. The relationship was also significant for Asp-Pen: 1.038 [1.003-1.075] for those aged between 13 and 49 years and 1.056 [1.007-1.108] for adults over 50 years of age. CONCLUSION The association between prescribed daily sales of oral antihistamines with topical treatment sales is associated with temporal changes to Cladosporium and Aspergillus-Penicillium in the whole population. When the influence of age and sex was considered, these two moulds contributed to prescribed medication sales only in the male general population.
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Affiliation(s)
- D Caillaud
- Pulmonary Department, CHU Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - M Cheriaux
- Pulmonary Department, CHU Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | | | | | - N Dupuy
- Réseau National de Surveillance Aérobiologique, Brussieu, France
| | - B Evrard
- Service d'Immunologie, CHU Clermont-Ferrand, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
| | - M Thibaudon
- Réseau National de Surveillance Aérobiologique, Brussieu, France
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16
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Weinberger KR, Kinney PL, Robinson GS, Sheehan D, Kheirbek I, Matte TD, Lovasi GS. Levels and determinants of tree pollen in New York City. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:119-124. [PMID: 28000684 PMCID: PMC5479752 DOI: 10.1038/jes.2016.72] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/28/2016] [Indexed: 05/08/2023]
Abstract
Exposure to allergenic tree pollen is a risk factor for multiple allergic disease outcomes. Little is known about how tree pollen levels vary within cities and whether such variation affects the development or exacerbation of allergic disease. Accordingly, we collected integrated pollen samples at uniform height at 45 sites across New York City during the 2013 pollen season. We used these monitoring results in combination with adjacent land use data to develop a land use regression model for tree pollen. We evaluated four types of land use variables for inclusion in the model: tree canopy, distributed building height (a measure of building volume density), elevation, and distance to water. When included alone in the model, percent tree canopy cover within a 0.5 km radial buffer explained 39% of the variance in tree pollen (1.9% increase in tree pollen per one-percentage point increase in tree canopy cover, P<0.0001). The inclusion of additional variables did not improve model fit. We conclude that intra-urban variation in tree canopy is an important driver of tree pollen exposure. Land use regression models can be used to incorporate spatial variation in tree pollen exposure in studies of allergic disease outcomes.
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Affiliation(s)
- Kate R. Weinberger
- Institute at Brown for Environment and Society, Brown University, Providence, RI, 02912, USA
| | - Patrick L. Kinney
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Guy S. Robinson
- Louis Calder Center Biological Field Station, Fordham University, Armonk, New York, 10504, USA
- Department of Natural Sciences, Fordham College at Lincoln Center, New York, NY, 10023, USA
| | - Daniel Sheehan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Iyad Kheirbek
- New York City Department of Health and Mental Hygiene, Bureau of Environmental Surveillance and Policy, New York, NY, 10012, USA
| | - Thomas D. Matte
- New York City Department of Health and Mental Hygiene, Bureau of Environmental Surveillance and Policy, New York, NY, 10012, USA
| | - Gina S. Lovasi
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
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17
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The Disease Burden of Patients with Allergic Rhinitis from a Hospital Surveillance in Beijing. SUSTAINABILITY 2017. [DOI: 10.3390/su9030427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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The Association between Ambient Air Pollution and Allergic Rhinitis: Further Epidemiological Evidence from Changchun, Northeastern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030226. [PMID: 28241509 PMCID: PMC5369062 DOI: 10.3390/ijerph14030226] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 01/01/2023]
Abstract
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 PM2.5 and PM10 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. PM10 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 PM2.5, PM10, 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, PM10 and PM2.5 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 (PM2.5 and PM10, 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.
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Deng Q, Lu C, Yu Y, Li Y, Sundell J, Norbäck D. Early life exposure to traffic-related air pollution and allergic rhinitis in preschool children. Respir Med 2016; 121:67-73. [PMID: 27888994 DOI: 10.1016/j.rmed.2016.10.016] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/18/2016] [Accepted: 10/24/2016] [Indexed: 12/23/2022]
Abstract
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 (NO2), sulfur dioxide (SO2) and particulate matter with an aerodynamic diameter ≤ 10 μm (PM10) 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/m3 increase in NO2 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/m3 increase in NO2 and PM10. 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.
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Affiliation(s)
- Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; XiangYa School of Public Health, Central South University, Changsha, Hunan, China.
| | - Chan Lu
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China
| | - Yichen Yu
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Jan Sundell
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; School of Architecture, Tsinghua University, Beijing, China
| | - Dan Norbäck
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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20
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Chen CC, Chiu HF, Yang CY. Air pollution exposure and daily clinical visits for allergic rhinitis in a subtropical city: Taipei, Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2016; 79:494-501. [PMID: 27294298 DOI: 10.1080/15287394.2016.1182002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
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.
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Affiliation(s)
- Chih-Cheng Chen
- a Department of Pediatrics , Kaohsiung Chang-Gung Memorial Hospital , Kaohsiung , Taiwan
- b Chang-Gung University, College of Medicine , Kaohsiung , Taiwan
| | - Hui-Fen Chiu
- c Department of Pharmacology , College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan
| | - Chun-Yuh Yang
- d Faculty of Public Health , College of Health Sciences, Kaohsiung Medical University , Kaohsiung , Taiwan
- e Division of Environmental Health and Occupational Medicine , National Health Research Institute , Miaoli , Taiwan
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21
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Kinney PL, Matte T, Knowlton K, Madrigano J, Petkova E, Weinberger K, Quinn A, Arend M, Pullen J. New York City Panel on Climate Change 2015 Report. Chapter 5: Public health impacts and resiliency. Ann N Y Acad Sci 2015; 1336:67-88. [PMID: 25688947 PMCID: PMC4749144 DOI: 10.1111/nyas.12588] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Patrick L Kinney
- Mailman School of Public Health, Columbia University, New York, NY
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22
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Caillaud DM, Martin S, Ségala C, Vidal P, Lecadet J, Pellier S, Rouzaire P, Tridon A, Evrard B. Airborne pollen levels and drug consumption for seasonal allergic rhinoconjunctivitis: a 10-year study in France. Allergy 2015; 70:99-106. [PMID: 25204990 DOI: 10.1111/all.12522] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 08/19/2014] [Accepted: 09/03/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Few time-series studies, and none lasting longer than 4 years, have investigated the etiology of treated seasonal allergic rhinoconjunctivitis (SAR) on the basis of anti-allergic medication prescriptions. The aim of this article was to study the short-term relationship between pollen exposure and drug-treated SAR over 10 years in an urban area in central France. METHODS A SAR case was defined as the association between an oral antihistamine and a local anti-allergic drug on the same prescription. The relationship between daily changes in pollen concentrations and daily changes in the number of treated SAR cases was analysed using generalized additive models, taking into account confounding factors such as air pollution, weather and days of the week. RESULTS Between 2003 and 2012, the total yearly number of treated SAR cases rose from 7265 to 11 315. The relative risk of treated SAR associated with an interquartile increase in pollen concentration increased significantly for Fraxinus, Betula, Carpinus, Platanus, Poaceae and Urticaceae for the whole pollen season, and for Urticaceae in the first semester. CONCLUSIONS The prevalence of treated SAR cases rose by about 55% in 10 years. The study not only confirmed the highly allergenic role of Fraxinus, Betula and Poaceae pollens but also showed a relatively unknown association between treated SAR and Carpinus and Platanus pollens, despite their pollen counts being <1% of overall pollen concentration. It also showed robust correlations with Urticaceae pollens, especially during the first semester, suggesting a potential allergenic role of Parietaria pollination in this non-Mediterranean area.
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Affiliation(s)
- D. M. Caillaud
- Service de Pneumologie-Allergologie; Hôpital Gabriel Montpied; Auvergne University; Clermont-Ferrand France
| | | | | | - P. Vidal
- Direction Régionale Service Médical Auvergne; Clermont-Ferrand France
| | - J. Lecadet
- Direction Régionale Service Médical Auvergne; Clermont-Ferrand France
| | | | - P. Rouzaire
- Service d'Immunologie; Hôpital Estaing; Auvergne University; Clermont-Ferrand France
| | - A. Tridon
- Service d'Immunologie; Hôpital Estaing; Auvergne University; Clermont-Ferrand France
| | - B. Evrard
- Service d'Immunologie; Hôpital Estaing; Auvergne University; Clermont-Ferrand France
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Rice MB, Thurston GD, Balmes JR, Pinkerton KE. Climate change. A global threat to cardiopulmonary health. Am J Respir Crit Care Med 2014; 189:512-9. [PMID: 24400619 DOI: 10.1164/rccm.201310-1924pp] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Recent changes in the global climate system have resulted in excess mortality and morbidity, particularly among susceptible individuals with preexisting cardiopulmonary disease. These weather patterns are projected to continue and intensify as a result of rising CO2 levels, according to the most recent projections by climate scientists. In this Pulmonary Perspective, motivated by the American Thoracic Society Committees on Environmental Health Policy and International Health, we review the global human health consequences of projected changes in climate for which there is a high level of confidence and scientific evidence of health effects, with a focus on cardiopulmonary health. We discuss how many of the climate-related health effects will disproportionally affect people from economically disadvantaged parts of the world, who contribute relatively little to CO2 emissions. Last, we discuss the financial implications of climate change solutions from a public health perspective and argue for a harmonized approach to clean air and climate change policies.
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Affiliation(s)
- Mary B Rice
- 1 Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, Massachusetts
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Charpin D, Caillaud D. Épidémiologie de l’allergie pollinique. Rev Mal Respir 2014; 31:365-74. [DOI: 10.1016/j.rmr.2013.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 12/31/2013] [Indexed: 02/02/2023]
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Wang KY, Chau TT. An association between air pollution and daily outpatient visits for respiratory disease in a heavy industry area. PLoS One 2013; 8:e75220. [PMID: 24204573 PMCID: PMC3808380 DOI: 10.1371/journal.pone.0075220] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 08/14/2013] [Indexed: 11/19/2022] Open
Abstract
In this work we used daily outpatient data from the Landseed Hospital in a heavily industrial area in northern Taiwan to study the associations between daily outpatient visits and air pollution in the context of a heavily polluted atmospheric environment in Chung-Li area during the period 2007–2011. We test the normality of each data set, control for the confounding factors, and calculate correlation coefficient between the outpatient visits and air pollution and meteorology, and use multiple linear regression analysis to seek significance of these associations. Our results show that temperature and relative humidity tend to be negatively associated with respiratory diseases. NO and are two main air pollutants that are positively associated with respiratory diseases, followed by , , , CO, and . Young outpatients (age 0–15 years) are most sensitive to changing air pollution and meteorology factors, followed by the eldest (age 66 years) and age 16–65 years of outpatients. Outpatients for COPD diseases are most sensitive to air pollution and meteorology factors, followed by allergic rhinitis, asthma, and pneumonia diseases. In the context of sex difference to air pollution and meteorological factors, male outpatients are more sensitive than female outpatients in the 16–65 age groups, while female outpatients are more sensitive than male outpatients in the young 0–15 age groups and in the eldest age groups. In total, female outpatients are more sensitive to air pollution and meteorological factors than male outpatients.
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Affiliation(s)
- Kuo-Ying Wang
- Department of Atmospheric Sciences, National Central University, Chung-Li, Taiwan
- * E-mail:
| | - Tang-Tat Chau
- Department of Community Medicine, Taiwan Landseed Hospital, Ping-Jen, Taiwan
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Extricating sex and gender in air pollution research: a community-based study on cardinal symptoms of exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3801-17. [PMID: 23975108 PMCID: PMC3799513 DOI: 10.3390/ijerph10093801] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 07/25/2013] [Accepted: 08/09/2013] [Indexed: 11/17/2022]
Abstract
This study investigated sex and gender differences in cardinal symptoms of exposure to a mixture of ambient pollutants. A cross sectional population-based study design was utilized in Sarnia, ON, Canada. Stratified random sampling in census tracts of residents aged 18 and over recruited 804 respondents. Respondents completed a community health survey of chronic disease, general health, and socioeconomic indicators. Residential concentrations of NO2, SO2, benzene, toluene, ethylbenzene and o/m/p-xylene were estimated by land use regression on data collected through environmental monitoring. Classification and Regression Tree (CART) analysis was used to identify variables that interacted with sex and cardinal symptoms of exposure, and a series of logistic regression models were built to predict the reporting of five or more cardinal symptoms (5+ CS). Without controlling for confounders, higher pollution ranks increased the odds ratio (OR) of reporting 5+ CS by 28% (p < 0.01; Confidence Interval (CI): 1.07–1.54). Females were 1.52 (p < 0.05; CI: 1.03–2.26) times more likely more likely to report 5+ CS after controlling for income, age and chronic diseases. The CART analysis showed that allergies and occupational exposure classified the sample into the most homogenous groups of males and females. The likelihood of reporting 5+ CS among females was higher after stratifying the sample based on occupational exposure. However, stratifying by allergic disease resulted in no significant sex difference in symptom reporting. The results confirmed previous research that found pre-existing health conditions to increase susceptibility to ambient air pollution, but additionally indicated that stronger effects on females is partly due to autoimmune disorders. Furthermore, gender differences in occupational exposure confound the effect size of exposure in studies based on residential levels of air pollution.
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Correia-Deur JEDM, Claudio L, Imazawa AT, Eluf-Neto J. Variations in peak expiratory flow measurements associated to air pollution and allergic sensitization in children in Sao Paulo, Brazil. Am J Ind Med 2012; 55:1087-98. [PMID: 22544523 DOI: 10.1002/ajim.22060] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2012] [Indexed: 01/19/2023]
Abstract
BACKGROUND In the last 20 years, there has been an increase in the incidence of allergic respiratory diseases worldwide and exposure to air pollution has been discussed as one of the factors associated with this increase. The objective of this study was to investigate the effects of air pollution on peak expiratory flow (PEF) and FEV1 in children with and without allergic sensitization. METHODS Ninety-six children were followed from April to July, 2004 with spirometry measurements. They were tested for allergic sensitization (IgE, skin prick test, eosinophilia) and asked about allergic symptoms. Air pollution, temperature, and relative humidity data were available. RESULTS Decrements in PEF were observed with previous 24-hr average exposure to air pollution, as well as with 3-10-day average exposure and were associated mainly with PM(10), NO(2), and O(3) in all three categories of allergic sensitization. Even though allergic sensitized children tended to present larger decrements in the PEF measurements they were not statistically different from the non-allergic sensitized. Decrements in FEV1 were observed mainly with previous 24-hr average exposure and 3-day moving average. CONCLUSIONS Decrements in PEF associated with air pollution were observed in children independent from their allergic sensitization status. Their daily exposure to air pollution can be responsible for a chronic inflammatory process that might impair their lung growth and later their lung function in adulthood.
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Zhang F, Krafft T, Zhang D, Xu J, Wang W. The association between daily outpatient visits for allergic rhinitis and pollen levels in Beijing. THE SCIENCE OF THE TOTAL ENVIRONMENT 2012; 417-418:39-44. [PMID: 22261403 DOI: 10.1016/j.scitotenv.2011.12.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 11/30/2011] [Accepted: 12/06/2011] [Indexed: 05/31/2023]
Abstract
To investigate the effects of aerosol pollen on human health, we carried out a time-series analysis of daily general practitioner consultations for allergic rhinitis (AR) in Beijing. The objective of this study was to assess the possible effects of pollen on clinic visits for allergic rhinitis in Beijing during the pollen season. We found a strong association between the concentration of pollen in ambient air and the number of consultations for allergic rhinitis. Females had significantly more outpatient visits than males when the levels of pollen increased. Young people (20-60 years old) had had significantly more outpatient visits than older people (over 60 years old) when the levels of pollen increased. After adjusting for air pollutants, the relative risks of pollen on daily number of outpatient for AR were increased.
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Affiliation(s)
- Fengying Zhang
- China National Environmental Monitoring Centre, Beijing 100012, China
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Zhang F, Wang W, Lv J, Krafft T, Xu J. Time-series studies on air pollution and daily outpatient visits for allergic rhinitis in Beijing, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2011; 409:2486-92. [PMID: 21514624 DOI: 10.1016/j.scitotenv.2011.04.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 03/30/2011] [Accepted: 04/01/2011] [Indexed: 05/09/2023]
Abstract
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.
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Affiliation(s)
- Fengying Zhang
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
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30
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Sheffield PE, Weinberger KR, Ito K, Matte TD, Mathes RW, Robinson GS, Kinney PL. The association of tree pollen concentration peaks and allergy medication sales in new york city: 2003-2008. ISRN ALLERGY 2011; 2011:537194. [PMID: 23724230 PMCID: PMC3658798 DOI: 10.5402/2011/537194] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 03/08/2011] [Indexed: 11/23/2022]
Abstract
The impact of pollen exposure on population allergic illness is poorly characterized. We explore the association of tree pollen and over-the-counter daily allergy medication sales in the New York City metropolitan area. Dates of peak tree pollen (maple, oak, and birch) concentrations were identified from 2003 to 2008. Daily allergy medication sales reported to the city health department were analyzed as a function of the same-day and lagged tree pollen peak indicators, adjusting for season, year, temperature, and day of week. Significant associations were found between tree pollen peaks and allergy medication sales, with the strongest association at 2-day lag (excess sales of 28.7% (95% CI: 17.4-41.2) over the average sales during the study period). The cumulative effect over the 7-day period on and after the tree pollen peak dates was estimated to be 141.1% (95% CI: 79.4-224.1). In conclusion, tree pollen concentration peaks were followed by large increases in over-the-counter allergy medication sales.
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Affiliation(s)
- Perry E. Sheffield
- Departments of Pediatrics and Preventive Medicine, Mount Sinai School of Medicine, 1 Gustave L. Levy Pl., Box 1512, New York, NY 10029, USA
| | - Kate R. Weinberger
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032-3727, USA
| | - Kazuhiko Ito
- Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Thomas D. Matte
- Urban Public Health Program, Hunter College, City University of New York School of Public Health, New York, NY 10010, USA
| | - Robert W. Mathes
- New York City Department of Health and Mental Hygiene, Bureau of Environmental Surveillance and Policy, New York, NY 10007, USA
| | - Guy S. Robinson
- Louis Calder Center, Biological Field Station, Fordham University, Armonk, New York, NY 10504-1104, USA
| | - Patrick L. Kinney
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032-3727, USA
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Nasal nitric oxide and other diagnostic procedures in seasonal allergic rhinitis: elderly vs juvenile patients. Am J Otolaryngol 2011; 32:105-8. [PMID: 20378200 DOI: 10.1016/j.amjoto.2009.11.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2009] [Revised: 11/07/2009] [Accepted: 11/16/2009] [Indexed: 11/20/2022]
Abstract
PURPOSE The type of allergy and other diagnostic procedures were analyzed in a group of elderly seasonal allergic rhinitis (SAR) patients and were compared with young SAR people and a control group. MATERIALS AND METHODS Study group consisted of 248 patients with mean age 64.1 ± 4.2 years. They were compared with 289 young SAR people (mean age, 23.7 ± 5.8 years) and with a control group. Allergic sensitization was assessed using the skin prick test (SPT) and specific immunoglobulin (Ig) E measurements. The SAR symptoms were monitored using visual graphic scale. Measurement of nasal fractional exhaled nitric oxide (FeNO) level obtained with handheld chemiluminescence analyzer during and after pollen season was compared with control groups. RESULTS In the elderly patient group, a prevalence of allergy to grass, rye, and mugwort was noticed. In 134 (54%) patients, SPT results to grass were positive; and the specific IgE level was elevated (mean value, 22.8 ± 13.1 IU/mL), whereas in 83 (33%) subjects, positive SPT results to mugwort and elevated serum specific IgE concentration (mean value, 31.9 ± 9.1 IU/mL) were observed. During the pollen season, a significantly higher FeNO level was noted in both young and elderly SAR patients in comparison with their respective control groups. In young patients, the mean FeNO level was 61.8 ± 17.2 parts per billion, whereas in the elderly group, it was 58.2 ± 11.8 parts per billion. CONCLUSIONS SAR in elderly patients is a problem that cannot be neglected. The natural course of SAR in the elderly is similar to other age groups. However, hypersensitivity to different pollens in the analyzed group needs further study.
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Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LTT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FER, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 Suppl 86:8-160. [PMID: 18331513 DOI: 10.1111/j.1398-9995.2007.01620.x] [Citation(s) in RCA: 3022] [Impact Index Per Article: 188.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/etiology
- Asthma/therapy
- Child
- Global Health
- Humans
- Prevalence
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/therapy
- Risk Factors
- World Health Organization
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Affiliation(s)
- J Bousquet
- University Hospital and INSERM, Hôpital Arnaud de Villeneuve, Montpellier, France
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Caillaud D, Sarter H, Thibaudon M, Lecadet J, Zeghnoun A, Delmas M, Fuhrman C. Exposition aux pollens et consommation de médicaments antiallergiques. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.allerg.2008.01.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hanigan IC, Johnston FH. Respiratory hospital admissions were associated with ambient airborne pollen in Darwin, Australia, 2004-2005. Clin Exp Allergy 2007; 37:1556-65. [PMID: 17883735 DOI: 10.1111/j.1365-2222.2007.02800.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although the role of pollen and fungus in specific allergic disorders has been well established, the public health impacts of ambient concentrations of airborne pollen and fungal spores; the shapes of concentration-response relationships; and the relative effects of different taxa are gaps in current knowledge. OBJECTIVE To investigate associations between daily average ambient pollen and fungal spore concentrations with hospital admissions for total respiratory diseases; asthma; chronic obstructive pulmonary disease (COPD); and respiratory infections in Darwin, Australia, during the period from April 2004 to November 2005. METHODS We assessed these relationships in a two-stage modelling approach designed to quantify potential non-linear relationships. First, generalized additive models determined the shapes of concentration-response relationships. Second, linear associations were examined using generalized linear models. Non-linear relationships were analysed by categorizing pollen and fungal spore concentrations based on their distributions. RESULTS Positive linear associations were found between total pollen concentrations and hospital admissions for total respiratory diseases and COPD. While our exploratory first-stage analysis suggested non-linear relationships for total pollen with asthma and respiratory infections, no convincing evidence for these relationships was found in the second-stage analysis. When individual taxa were investigated, associations were the strongest in relation to Myrtaceae pollen (the dominant tree taxa in the region), while positive associations not attaining statistical significance were observed for Poaceae, Cyperaceae and Arecaceae. No associations were evident for any conditions with fungal spores. CONCLUSIONS Our finding of an association between pollen count and respiratory hospital admissions that could not be explained by asthma admissions suggests that ambient airborne pollens might have a wider public health impact than previously recognized.
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Affiliation(s)
- I C Hanigan
- School of Environmental Research, Charles Darwin University, Darwin, NT, Australia.
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Fuhrman C, Sarter H, Thibaudon M, Delmas MC, Zeghnoun A, Lecadet J, Caillaud D. Short-term effect of pollen exposure on antiallergic drug consumption. Ann Allergy Asthma Immunol 2007; 99:225-31. [PMID: 17910325 DOI: 10.1016/s1081-1206(10)60657-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Several studies have investigated the association between pollen exposure and asthma emergency admissions, but only 2 have investigated the effect of airborne allergens on consultations for rhinitis or conjunctivitis and none has used drug consumption as the health indicator. OBJECTIVE To analyze the short-term association between pollen exposure and antiallergic drug consumption in the urban area of Clermont-Ferrand, France, taking into account the potentially confounding effect of air pollution and meteorological factors. METHODS We used the French health insurance database to select all individuals from the Clermont-Ferrand urban area having benefited from reimbursement for antiallergic treatment from January 1, 2000, through December 31, 2001, and from January 1, 2003, through December 31, 2004. An episode of treated allergic rhinitis, rhinosinusitus, or conjunctivitis (ARC) was defined as the association of an oral antihistamine and a local antiallergic drug on the same prescription. The relations between daily changes in pollen concentrations and daily changes in the number of treated ARC cases were analyzed using a Poisson regression model with penalized spline functions. RESULTS The risk of treated ARC associated with an interquartile increase in pollen concentration increased significantly for Poaceae (5%, P < .001), Fraxinus (7%, P < .001), Betula (7%, P < .001), and Corylus (2%, P < .02). This increase was significant in all age groups for Poaceae and Fraxinus pollen and in people younger than 65 years for Betula pollen. The effect was mainly concentrated on the present day, except for Poaceae pollens, for which the risk remained significantly (P < .001) increased until 3 days lag time. CONCLUSIONS This study showed a significant increase in treated ARC cases related to Poaceae, Fraxinus, and Betula. Specific risks are difficult to evaluate for species that share the same pollination period. Time-series studies based on drug consumption are useful to highlight and to supervise pollen-related diseases requiring ambulatory care.
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MESH Headings
- Adolescent
- Adult
- Age Factors
- Aged
- Anti-Allergic Agents/therapeutic use
- Antigens, Plant/immunology
- Betula/immunology
- Child
- Child, Preschool
- Conjunctivitis, Allergic/drug therapy
- Conjunctivitis, Allergic/epidemiology
- Environmental Exposure
- Female
- France/epidemiology
- Fraxinus/immunology
- Humans
- Hypersensitivity, Immediate/drug therapy
- Hypersensitivity, Immediate/epidemiology
- Male
- Middle Aged
- Poaceae/immunology
- Pollen/immunology
- Rhinitis/drug therapy
- Rhinitis/epidemiology
- Rhinitis, Allergic, Seasonal/drug therapy
- Rhinitis, Allergic, Seasonal/epidemiology
- Risk Assessment
- Seasons
- Sinusitis/drug therapy
- Sinusitis/epidemiology
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Affiliation(s)
- Claire Fuhrman
- Institut de Veille Sanitaire, Département Santé Environnement, Saint-Maurice, France.
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