The Association between Ambient Air Pollution and Allergic Rhinitis: Further Epidemiological Evidence from Changchun, Northeastern China

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.

Onset and remission of rhinitis among students in relation to the home and school environment—A cohort study from Northern China

“…40 Moreover, we found that PM 10 outside the schools (mean 168 µg/m 3 ) was associated with onset of rhinitis. This is in agreement with previous prevalence studies reporting associations between childhood rhinitis and outdoor PM 10 in Changchun, China, 18 in Shanghai, 19 and in a six cities study among school children in France. 41 The proposed mechanism could be neutrophilic inflammation in the nasal mucosa.…”

“…In China, outdoor air pollution is an important issue and has been demonstrated to be associated with rhinitis. A time series analysis from Changchun (northeastern China) found an increase in allergic rhinitis outpatient visits during days with higher outdoor concentrations of PM 2.5 , PM 10 , SO 2 , and NO 2 . A nationwide cross‐sectional study from Taiwan found associations between outdoor NOx, CO, and SO 2 and allergic rhinitis among school children .…”

“…A time series analysis from Changchun (northeastern China) found an increase in allergic rhinitis outpatient visits during days with higher outdoor concentrations of PM 2.5 , PM 10 , SO 2 , and NO 2 . 18 A nationwide cross-sectional study from Taiwan found associations between outdoor NOx, CO, and SO 2 and allergic rhinitis among school children. 19 Finally, one time series analysis from Shanghai found that childhood allergic rhinitis outpatient visits increased with increased outdoor concentrations of O 3 , SO 2 , and PM 10 .…”

Air pollutants and primary allergy prevention

“…Another meta-analysis that used largely the same cohort data also found no evidence that PM2.5 and NO2 exposure increases the risk for allergic rhinitis [51]. A number of recently published results from Chinese cross-sectional studies report positive links between PM2.5 and NO2 and allergic rhinitis in children [52][53][54]. It is not possible to conclusively assess to what extent the methodological weaknesses of a cross-sectional study, regional and cultural lifestyle factors, or, lastly, the significantly higher exposure levels in China are decisive for the differing results compared with the European and North American studies.…”

Associations among air pollutants, grass pollens, and daily number of grass pollen allergen‐positive patients: a longitudinal study from 2012 to 2016

“…Recent studies have shown an association between high levels of air pollution and an increased risk of allergic sensitization, as well as between high levels of air pollution and prevalence of AR . Teng et al . revealed that the prevalence of AR was significantly associated with levels of PM2.5, PM 10 µm in diameter (PM10), SO 2 , and NO 2 in a large population‐based sample.…”