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. Author manuscript; available in PMC: 2020 Jun 10.
Published in final edited form as: Int Forum Allergy Rhinol. 2018 Feb;8(2):108–352. doi: 10.1002/alr.22073

TABLE VI.D.

Evidence for the effects of pollution exposure on the development of allergic rhinitis

Study Year LOE Study design Study groups Clinical endpoint Conclusion
Codispoti et al.578 2015 2b Prospective cohort DEP exposure at 1 year:
  1. ≥66th percentile;

  2. <66th percentile

Development of AR by age 4 years High DEP exposure did not correlate with the development of AR.
Gehring et al.580 2015 2b Pooled prospective cohort
  1. High exposure to NO2, PM2.5, PM10;

  2. Low exposure to air pollutants

Incidence and prevalence of rhinoconjunctivitis from age 4 to 14–16 years No association between air pollution exposure and rhinoconjunctivitis incidence or prevalence at various ages.
Kim et al.579 2011 2b Prospective cohort Concentrations of 5 air pollutants (NO2, O3, SO2, CO, PM10):
  1. Industrial area;

  2. Metropolitan city

Development of AR in children over 2 years Incidence of AR is not associated with air pollutants; however, there was a positive association between higher O3 levels and AR in industrial areas.
Chiang et al.587 2016 3b Case-control study Exposure to SO2 over 11 years:
  1. High exposure;

  2. Low exposure

Diagnosis of AR in children High exposure to SO2 correlates with an increased diagnosis of AR.
Chung et al.588 2016 3b Case-control study Exposure to 5 air pollutants (PM10, NOx, SO2, CO, O3):
  1. High exposure;

  2. Low exposure

Diagnosis of AR in preschool children Prediagnosis levels of CO and NOx were significantly related to AR diagnosis.
Deng et al.557 2016 4 Cross-sectional Exposure to 3 air pollutants (PM10, NO2, SO2):
  1. High exposure;

  2. Low exposure

Diagnosis of AR in kindergarten children Prenatal exposure to high NO2 correlated with AR; postnatal exposure to high PM10 correlated with AR.
Kim et al.476 2016 4 Cross-sectional Exposure to 5 air pollutants (PM10, NO2, SO2, CO, O3):
  1. High exposure;

  2. Low exposure

Diagnosis of AR by the age of 6–7 years Higher exposure to CO was associated with an increased lifetime prevalence of physician-diagnosed AR.
Kim et al.589 2016 4 Cross-sectional Exposure to 5 air pollutants (PM10, NOx, SO2, BC, O3):
  1. High exposure;

  2. Low exposure

AR treatment over the past 12 months in children High exposure to BC, SO2, and NO2 were significantly associated with increased treatment of AR.
Liu et al.586 2016 4 Cross-sectional Exposure to 3 air pollutants (PM10, NO2, SO2):
  1. High exposure;

  2. Low exposure

Diagnosis of AR in children High exposures to NO2 during gestation, the first year of life, second year, and throughout life correlated with the development of AR.
Singh et al.584 2016 4 Cross-sectional Frequent passage of trucks near home:
  1. Almost all day;

  2. Less frequent

Diagnosis of AR in children ages 6–7 and 13–14 years Frequent passage of trucks was correlated with the occurrence of AR in both age groups.
Wang et al.585 2016 4 Cross-sectional Exposure to 6 air pollutants (PM10, PM2.5, NO2, SO2, CO, O3):
  1. High exposure;

  2. Low exposure

Diagnosis of AR in children High levels of PM2.5 correlate with an increased risk of AR.
Jung et al.582 2015 4 Cross-sectional
  1. Living less than 75 m from main road;

  2. Living more than 75 m from main road

Lifetime AR, past-year AR symptoms, diagnosed AR, and treated AR in children Positive correlation between distance from main road and AR symptoms, diagnosis, and treatment.
Shirinde et al.583 2015 4 Cross-sectional
  1. Trucks passing near residence almost all day;

  2. Trucks passing less frequently

Diagnosis of AR in 13-year-old to 14-year-old children Diagnosis of AR is significantly associated with the frequency of trucks passing by the residence.
Anderson et al.581 2010 4 Cross-sectional study
  1. Exposure to PM10:

  2. High exposure;

  3. Low exposure

Diagnosis of rhinoconjunctivitis at ages 6–7 and 13–14 years Only significantly increased association between PM10 levels and rhinoconjunctivitis and atopy in 13-year-olds to 14-year-olds in countries with more than 1 testing center.

AR = allergic rhinitis; BC = black carbon; CO = carbon monoxide; DEP = diesel exhaust particles; LOE = level of evidence; NO2 = nitrogen dioxide; NOx = nitrogen oxides; O3 = ozone; PM10 = particulate matter <10 μm; PM2.5 = particulate matter <2.5 μm; SO2 = sulfur dioxide.

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