Allergic rhinitis is associated with atmospheric SO2: Follow-up study of children from elementary schools in Ulsan, Korea.

Suk Hwan Kim,Chang Sun Sim,Yangho Kim,Jiho Lee,Jungsun Park,Yeonsuh Oh,Jin-Hee Bang,Inbo Oh,Qinghua Sun

doi:10.1371/journal.pone.0248624

Abstract

ObjectivesThe purpose of this study was to examine the association of allergic rhinitis with air pollutant concentrations using the follow-up data of elementary school children in Ulsan, Korea.MethodsAll students of four elementary schools in Ulsan, South Korea were surveyed at two-year intervals. The survey used data collected five times, over a nine-year period from June 2009 to April 2018. The questionnaire used in the survey was a modified version of the ISAAC (International society of asthma and allergy of children) questionnaire. A skin prick test (SPT) was performed with 24 standard antigens. To estimate the levels of exposure to outdoor air pollution, the concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), and particulate matter 10 μm or less in diameter (PM10) were used. As a dependent variable, a history of allergic rhinitis diagnosed by a doctor during the last 1-year was considered. Logistic regression analysis was used to select variables suitable for the statistical model. The selected variables were then used to assess their association with the dependent variable using the generalized estimation equation.ResultsAmong environmental factors, SO2 was associated with a high risk and PM10 was associated with a low risk of allergic rhinitis. The risk of allergic rhinitis from living in a house built within the last year was high, and the risk from living in a multi-family house or apartment was higher than that from living in a segregated house. History of allergic diseases in the family was a high-risk factor for allergic rhinitis. There was a relationship between a history of bronchiolitis at less than 2 years of age and a high risk of allergic rhinitis. Boys were at a higher risk than girls.ConclusionFrom the follow-up data of elementary school students in Ulsan, Korea, the concentration of SO2, which is an indicator of the degree of industrialization, was related to the prevalence of allergic rhinitis. Among all the risk factors, history of allergic disease in the parents was the most important factor, and the study reconfirmed the results of the previous studies.

Highlights

According to a report by the World Allergy Organization in 2013, approximately 20% of the global population has an allergic disease such as asthma, allergic rhinitis, atopic dermatitis, and allergic conjunctivitis [1]
SO2 was associated with a high risk and PM10 was associated with a low risk of allergic rhinitis
From the follow-up data of elementary school students in Ulsan, Korea, the concentration of SO2, which is an indicator of the degree of industrialization, was related to the prevalence of allergic rhinitis

Summary

Introduction

According to a report by the World Allergy Organization in 2013, approximately 20% of the global population has an allergic disease such as asthma, allergic rhinitis, atopic dermatitis, and allergic conjunctivitis [1]. A recent systematic review of the prevalence rates of allergic diseases in Korea over the past 30 years found continuous increases in the rates of allergic rhinitis, allergic conjunctivitis, atopic dermatitis, and food allergy, there was no distinct trend in the prevalence of asthma [2]. A notable observation was that the prevalence of allergic rhinitis in children has continuously increased in recent decades [2,3,4].

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