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J Allergy Clin Immunol. 2020 Jan 17. pii: S0091-6749(19)31636-7. doi: 10.1016/j.jaci.2019.11.040. [Epub ahead of print]

Long-term air pollution exposure is associated with increased severity of rhinitis in 2 European cohorts.

Author information

1
INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France; University of Versailles St-Quentin-en-Yvelines, UMR 1168, Montigny le Bretonneux, France; ISGLobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
2
Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France.
3
Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
4
INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France; University of Versailles St-Quentin-en-Yvelines, UMR 1168, Montigny le Bretonneux, France; University Hospital, Montpellier, France; MACVIA-France, Contre les MAladies Chroniques pour un Vieillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.
5
Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Inserm U1209, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), Grenoble, France.
6
Department of Public Health and Pediatrics, University of Turin, Turin, Italy.
7
ISGLobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
8
Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
9
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
10
CHU de Lyon, Pneumology Department, Lyon, France.
11
Ludwig Maximilians University Munich, University Hospital Munich, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany.
12
Allergology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Armand-Trousseau, Paris, France; Sorbonne Université Paris 6, Paris, France.
13
Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Inserm U1209, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), Grenoble, France; Pediatrie, CHU de Grenoble Alpes, Grenoble, France.
14
Santé Publique France, Saint-Maurice, France.
15
Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
16
National Heart and Lung Institute, Imperial College London, London, United Kingdom; MRC Centre for Environment and Health, School of Public Health, London, United Kingdom.
17
INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France; University of Versailles St-Quentin-en-Yvelines, UMR 1168, Montigny le Bretonneux, France.
18
INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France; University of Versailles St-Quentin-en-Yvelines, UMR 1168, Montigny le Bretonneux, France; ISGLobal, Barcelona, Spain; Department of Public Health and Pediatrics, University of Turin, Turin, Italy. Electronic address: benedicte.jacquemin@inserm.fr.

Abstract

BACKGROUND:

Very few studies have examined the association between long-term outdoor air pollution and rhinitis severity in adults.

OBJECTIVE:

We sought to assess the cross-sectional association between individual long-term exposure to air pollution and severity of rhinitis.

METHODS:

Participants with rhinitis from 2 multicenter European cohorts (Epidemiological Study on the Genetics and Environment on Asthma and the European Community Respiratory Health Survey) were included. Annual exposure to NO2, PM10, PM2.5, and PMcoarse (calculated by subtracting PM2.5 from PM10) was estimated using land-use regression models derived from the European Study of Cohorts for Air Pollution Effects project, at the participants' residential address. The score of rhinitis severity (range, 0-12), based on intensity of disturbance due to symptoms reported by questionnaire, was categorized into low (reference), mild, moderate, and high severity. Polytomous logistic regression models with a random intercept for city were used.

RESULTS:

A total of 1408 adults with rhinitis (mean age, 52 years; 46% men, 81% from the European Community Respiratory Health Survey) were included. The median (1st quartile-3rd quartile) score of rhinitis severity was 4 (2-6). Higher exposure to PM10 was associated with higher rhinitis severity (adjusted odds ratio [95% CI] for a 10 μg/m3 increase in PM10: for mild: 1.20 [0.88-1.64], moderate: 1.53 [1.07-2.19], and high severity: 1.72 [1.23-2.41]). Similar results were found for PM2.5. Higher exposure to NO2 was associated with an increased severity of rhinitis, with similar adjusted odds ratios whatever the level of severity. Adjusted odds ratios were higher among participants without allergic sensitization than among those with, but interaction was found only for NO2. CONCLUSIONS: People with rhinitis who live in areas with higher levels of pollution are more likely to report more severe nasal symptoms. Further work is required to elucidate the mechanisms of this association.

KEYWORDS:

Rhinitis; air pollution; allergic sensitization; environment; respiratory disease; severity

PMID:
31983528
DOI:
10.1016/j.jaci.2019.11.040

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