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. Author manuscript; available in PMC: 2016 Nov 1.
Published in final edited form as: Int Forum Allergy Rhinol. 2015 Jun 16;5(11):996–1003. doi: 10.1002/alr.21573

Table 5.

Exposure assessment, approach to confounding, exposure parameterization, and primary associations reported for eligible ENVIRONMENTAL studies

First author, Year
Quality rankinga 		Exposure assessment Approach to Confounding Exposure Parameterization Primary Association
Alexiou, 201120b

PROBABLE CRS 		Interviewer-administered survey: 3 independent experts classified environmental exposure as none, not certain, and evident based on participant-reported past/current address; distance of homes from pollutant activities (e.g., industry, traffic); use of wood stove in home. Same procedure was followed for occupational exposure Adjusted for sex, smoking habits, allergy history and education (medium, high, and superior) Environmental exposure and occupational exposures: none, uncertain or certain
Duration of occupational exposure: none, minimal to short, or long term		 OR (95% CI) for prevalent NP:

  1. Environmental exposure: evident vs. none: 15.0 (1.2–186.9)

  2. Occupational exposure: evident vs. none: 21.4 (3.36–136.25)

  3. Duration of occupational exposure: at least short vs. none: 4.91 (1.43–16.86)
Kim, 200221b

PROBABLE CRS 		Written survey: exposure to woodstoves, occupational exposures, indoor tobacco smoke, pets, and dust. Phone survey: duration and intensity of exposure to woodstoves Adjusted for age, woodstove use, male sex, allergy, aspirin intolerance, occupational exposures, tobacco smoke, and pets Yes/no to use/presence of exposure:

  1. Woodstove use

  2. Occupational exposure

  3. Indoor tobacco smoke

  4. Pets

  5. Dust

 OR (95% CI) for NP:

  1. Woodstove use vs. no: 30.6 (6.9–135.6)

  2. Occupational exposures vs. no: 7.2 (1.8–29.7)

  3. Indoor tobacco smoke vs. no: 2.0 (0.6–7.1)

  4. Pets vs. no: 0.2 (0.1–0.9)
Tammemagi, 20109b

PROBABLE CRS 		Phone survey: exposure to air pollution and chemicals or respiratory tract irritants at work, through hobbies, and from other sources Matched on age, sex, and race Yes/no:

  1. Air pollution

  2. Work exposure to chemicals

  3. Hobby exposures to chemicals

  4. Nonwork and nonhobby exposures to chemicals

 Unadjusted OR (95% CI):

  1. Air pollution vs. no: 1.59 (1.10–2.30)

  2. Work exposure vs. no: 2.59 (1.58–4.24)

  3. Hobby exposure vs. no: 2.92 (1.56–5.49)

  4. Nonwork and nonhobby exposure vs. no: 1.52 (1.08–2.11)
Villeneuve, 200929

POSSIBLE CRS 		GIS to determine distance between home and intensive hog farm Adjusted for age, sex, cigarette smoking, and household income Distance from home to hog farm (adults):

  1. < 3 km

  2. 3 – < 9 km

  3. ≥ 9 km

 OR (95% CI) for sinusitis in adults

  • 1 vs. 3: 1.34 (0.78–2.30)

  • 2 vs. 3: 0.67 (0.36–1.24)
a

CRS probable: objective evidence of disease (by sinus CT scan, nasal endoscopy, X-ray); diagnosis by an ear, nose and throat (ENT) physician; or history of endoscopic sinus surgery for treatment of sinusitis. CRS possible: EPOS (European Position Paper on Rhinosinusitis and Nasal Polyps) CRS epidemiologic definition; diagnosis from a physician (ENT status not specified) based on a physical exam; or self-report of a physician diagnosis. Least likely CRS: CRS definitions that did not meet criteria for probable or possible CRS.

b

Study has both occupational and environmental data

CI: confidence interval; CRS: chronic rhinosinusitis; OR: Odds ratio; NP: Nasal polyps