Abstract
Allergic diseases, affecting a variety of organs, have continuously increased both in developed and developing countries. Tobacco smoke exposure increases prevalence of allergic rhinitis (AR) and may affect allergic sensitization. This study was designed to compare indoor-aeroallergen sensitization between those not exposed and exposed to tobacco smoke in university students and staff with allergic rhinitis. A cross-sectional descriptive study among university students and staff with allergic rhinitis was performed from February 1, 2018, to March 31, 2019. Questionnaires regarding demography, clinical symptoms, and tobacco smoke exposure were implemented. A current smoker was defined as using, at least, 1 cigarette per day for, at least, 1 month. A secondhand smoker was defined as the one who never smoked, but lived with a current smoker, at least, for 1 month. A skin prick test for eight common indoor aeroallergens, Dermatophagoides pteronyssinus, Dermatophagoides farinae, Periplaneta americana, cat dander, dog dander, para grass, careless weed, and Cladosporium spp., was performed. Sensitization was defined as positivity to, at least, 1 aeroallergen. One hundred and twenty-eight adult patients were eligible participants for the study, and 68 cases (53.10%) were classified as having tobacco smoke exposure. Among these, most of them were secondhand smokers (50 cases, 73.50%). There was no statistically significant difference between exposure and nonexposure to tobacco smoke and indoor aeroallergen sensitization, except for the Periplaneta americana antigen (p=0.013). Most of those in the nonexposure group (34 cases, 56.70%) were classified as having intermittent allergic rhinitis, whereas the tobacco exposure group had significantly more prevalence of severe clinical symptoms. In conclusion, tobacco smoke exposure did not appear to have much influence on aeroallergen sensitization for 7 of the 8 antigens examined. However, for the Periplaneta americana antigen, there was a highly significant correlation with patients experiencing worsened allergic rhinitis symptoms. Overall, it was observed that allergic rhinitis patients exposed to tobacco smoke had more severe clinical symptoms. Future studies should look for other potential antigens of interest, such as mould. Implementation of public health practices reducing exposure to tobacco smoke could have benefits in allergic rhinitis patients.
Highlights
Stimulation of allergic diseases affects a variety of organ systems including respiratory, gastrointestinal, and dermatological as a result of the pathophysiology
One hundred and twenty-eight participants met the inclusion criteria of adults with allergic rhinitis (AR) at Walailak University during the study period. All of these were previously diagnosed as AR or had developed a clinical history of AR, at least, 12 months prior based on the ARIA guidelines [38] and accepted the performance of skin prick testing. e exclusion criteria included individuals who currently used antihistamines or related medications within 7 days prior to enrolment, had active skin lesions such as urticaria, eczema, and impetigo, dermatographism, uncontrolled asthma, HIV/AIDs, hepatitis B, and hepatitis C, or were unwilling to be a participant
Demographic Characteristics of Participants. is study was performed from February 1, 2018, to March 31, 2019, at Walailak University Hospital out-patient department
Summary
Stimulation of allergic diseases affects a variety of organ systems including respiratory, gastrointestinal, and dermatological as a result of the pathophysiology. Symptoms can affect patients in many ways including the nasal mucosa (rhinorrhea and sneezing), conjunctiva (itching and watery eyes), respiratory mucosa (cough, bronchospasm, and asthma), gastrointestinal tract (nausea, abdominal pain, and diarrhea), and skin (rashes, hives, and urticaria). Epidemiologic data show that allergic diseases have continuously increased both in developed and developing countries [1]. In the US, food allergy prevalence appears to increase as well, with 1–10% of adults and 8% of children being affected [4, 5]. Different definitions of food allergy, categories of food, and inclusion and diagnostic criteria all affect different estimates of disease prevalence [6]. Direct and indirect negative impacts of AR include acute and chronic sinusitis, otitis media, sleep disruption, concentration difficulties, and behavioural disturbances [7]
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