Early childhood traffic-related air pollution and risk of allergic rhinitis at 2–4 years of age modification by family stress and male gender: a case-control study in Shenyang, China

Abstract

Background Few studies have explored the modifications by family stress and male gender in the relationship between early exposure to traffic-related air pollution (TRAP) and allergic rhinitis (AR) risk in preschool children. Methods We conducted a case-control study of 388 children aged 2–4 years in Shenyang, China. These children AR were diagnosed by clinicians. By using measured concentrations from monitoring stations, we estimated the exposures of particulate matter less than 10 μm in diameter (PM10), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), and sulfur dioxide (SO2) in preschool children aged 2–4 years. After adjusted potential confounding factors, we used logistic regression model to evaluate the odds ratio (OR) and 95% confidence interval (CI) for childhood AR with exposure to different air pollutants according to the increasing of the interquartile range (IQR) in the exposure level. Results The prevalence of AR in children aged 2–4 years (6.4%) was related to early TRAP exposure. With an IQR (20 μg/m3) increase in PM10 levels, an adjusted OR was significantly elevated by 1.70 (95% CI, 1.19 to 2.66). Also, with an IQR (18 μg/m3) increase in NO2, an elevated adjusted OR was 1.85 (95% CI, 1.52 to 3.18). Among children with family stress and boys, PM10 and NO2 were positively related to AR symptoms. No significant association was found among children without family stress and girls. Conclusions Family stress and male gender may increase the risk of AR in preschool children with early exposure to PM10 and NO2.

Prenatal and early-life exposure to traffic-related air pollution and allergic rhinitis in children: A systematic literature review

“…After a mean 17-year follow-up of 1286 children based on the Toronto Child Health Assessment Questionnaire (T-CHEQ) study, Teresa To et al [ 29 ] found that early life exposure to ozone and nitrogen dioxide contributed to the development of asthma and eczema but no significant association with developing AR. Shuai Hao et al [ 30 ] used the average daily concentration of pollutants from 2 years old to the day of AR diagnosis as the early childhood exposure level and considered the effect of floor level of residence, distance between home and kindergarten on exposure estimates. This case-control study found that preschool children exposed to PM 10 and NO 2 had an increased risk of AR by 70% and 85% respectively with family stress and male gender may increase the susceptibility to AR.…”

Air pollution and rhinitis

“…These pollutants can modify pollen content, morphology, production, immunomodulatory properties, and immunogenicity of allergenic proteins. Consequently, they influence the severity of symptoms, particularly in sensitized individuals (40,(45)(46)(47)(48)(49)(50)(51)(52). For instance, PM 10 and PM 2.5 have been implicated in enhancing the release of Humulus pollen protein, while O 3 has shown potential to exacerbate its allergenicity, particularly in regions such as China (52).…”

“…Living in close proximity to traffic roads intensified the adverse effects of household environmental factors while diminishing the protective effect of domestic dogs against childhood rhinitis ( 42 – 44 ). Additionally, family stress and male gender were identified as potential risk factors for allergic rhinitis in preschool children, particularly in the presence of early exposure to PM 10 and NO 2 ( 45 ).…”

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

“…who reported that PM 2.5 exposure may be correlated with childhood AR. Hao et al 951 . studied children aged 2–4 years and found that those with family stress and boys compared to girls were particularly vulnerable to increased risk of AR with early exposure to traffic‐related air pollution (Table VIII.B.3).…”