Rhinitis In Children Research Articles

Clinical and molecular analysis of longitudinal rhinitis phenotypes in an urban birth cohort

BackgroundChronic rhinitis symptoms cause significant health burden among children and can have a heterogeneous presentation. Defining phenotypes of childhood chronic rhinitis and associated pathobiology may lead to prevention or improved treatments. ObjectivesTo identify longitudinal patterns of rhinitis symptoms in childhood and determine their associations with early life risk factors, allergic comorbidities, and nasal epithelial cell gene expression. MethodsChronic rhinitis symptoms were evaluated from ages 1 through 11 years in 485 urban children at high risk for allergic disease in the Urban Environment and Childhood Asthma (URECA) birth cohort. We identified longitudinal rhinitis phenotypes and their relationships to early life exposures, atopic comorbidities, and patterns of nasal epithelial gene expression at age 11 years. ResultsChronic rhinitis symptoms started early in many children and were a risk factor for developing aeroallergen sensitization. We identified four longitudinal rhinitis phenotypes: low/minimal disease, persistent, persistent decreasing, and late increasing. Persistent rhinitis was most closely linked to allergic sensitization and asthma. Risk factors for persistent rhinitis included frequent colds (p<0.001), antibiotic use (p<0.001), and reduced exposure to common indoor aeroallergens (p=0.003). Compared to low/minimal disease, rhinitis phenotypes were associated with increased expression of canonical Type 2 genes and decreased expression of immune response genes. ConclusionsIn urban children, rhinitis symptoms often precede aeroallergen sensitization. Rhinitis phenotypes based on symptoms had distinct risk factors and nasal transcriptome. These results suggest that focusing on early life risk factors and distinct immune mechanisms may be a target to preventing chronic rhinitis in childhood.

Topical Nasal Steroids for Allergic Rhinitis in Children. Is One Better Than the Others? Protocol for a Systematic Review and Network Meta-analysis.

Background The present protocol is registered in the International Prospective Register of Systematic Reviews PROSPERO under de ID code CRD42023476313, and adheres the PRISMA-P 2015 statement. The complete checklist can be consulted in the extended data section. Allergic Rhinitis (AR) is the most common chronic disease in children worldwide. According to many guidelines topical nasal steroids (TNS) are the first-line treatment for moderate/severe AR in children, nevertheless there is no conclusive evidence about which of them is superior in terms of efficacy and safety, including their impact on child’s growth. Methods We will conduct a systematic review of randomized controlled trials evaluating TNS in the treatment of children with moderate/severe AR. The primary outcome is the efficacy measured with the Total Nasal Symptom Severity Score (TNSS). Secondary outcomes are quality of life, adverse events (AE), and growth velocity. We will search Medline, Embase, CENTRAL, LILACS, clinicaltrials.gov, WHO trials database and grey literature resources. Two reviewers will independently screen titles and abstracts, review full texts, extract information, and assess the risk of bias and the confidence in the estimate (with the grading of recommendations, assessment, development, and evaluation [GRADE] approach). We will conduct a random-effects NMA to combine the pooled direct and indirect treatment effect estimates for each outcome if adequate data is available and transitivity and coherence assumptions are considered justifiable. Subgroup and sensitivity analyses are planned to evaluate the impact of some potential effect modifiers such as doses, co-intervention with oral antihistamines, the type of AR (intermittent or persistent), sponsorship of the study, the time of outcomes measurement and the risk of bias. We will use GRADE approach to draw conclusions from NMA. Discussion This systematic review and network meta-analysis aims to determine the relative efficacy and safety of the TNS for treatment of children with moderate/severe AR. The results will provide valuable information to assist clinicians, guideline developers, patients, and policy makers about the management of these patients, based on the best available evidence. Systematic review registration: PROSPERO number: CRD42023476313.

Effects of an online mindfulness-based cognitive therapy for caregivers of children with allergic rhinitis.

The incidence of allergic rhinitis in children is high across the world, as well as in China. Allergic rhinitis in children has serious impact on physical and mental health of the children. At the same time, the caregivers of allergic rhinitis children have heavy burden of care, and their mental problems are severe. It is necessary to implement timely psychological intervention for the caregivers of allergic rhinitis children. Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective psychological therapy, and the effect of online intervention can be comparable to the traditional face-to-face intervention program. This study focused on the mental health status in the main caregivers of children with allergic rhinitis, and conducted a modified online MBCT intervention on the caregivers, in order to improve their adverse mental state, meanwhile, improve the quality of care they provide. The results show that online MBCT intervention is applicable to the main caregivers of children with allergic rhinitis, and can effectively reduce caregiver burden, relieve anxiety and depression, and improve the level of mindfulness in the caregivers.

Research and Analysis on the Pathogenesis of Allergic Rhinitis in Children and Its Treatment by Chinese and Western Medicine

Allergic rhinitis in children is a common allergic disease, when it recurs, the symptoms are significant, long-lasting, to children's daily life and learning has brought a huge burden.Western medicine has abundant clinical experience in treating this kind of disease, but the unique dialectical thinking and treatment system of traditional Chinese medicine also show undeniable advantages.The purpose of this study was to explore the etiology of allergic rhinitis in children, the relationship between allergic rhinitis and TCM syndrome types, and the advantages and disadvantages of TCM and WM treatment.It is found that allergen, heredity, environmental factors and immune imbalance are the common causes leading to high incidence of diseases. On the whole, TCM can classify different syndrome types and apply corresponding treatment methods, effective relief of the disease, improve the quality of life.We hope this paper can provide a new perspective and guidance for clinical diagnosis and treatment.

Prenatal and postnatal early life exposure to greenness and particulate matter of different size fractions in relation to childhood rhinitis - A multi-center study in China

The impact of early life exposure to residential greenness on childhood rhinitis and its interaction with particulate matter (PM) of different size fractions remain inconsistent. Herein, we recruited 40,486 preschool children from randomly selected daycare centers in 7 cities in China from 2019 to 2020, and estimated exposure to residential greenness by the normalized difference vegetation index (NDVI) with a 500 m buffer. Exposure to ambient PM (PM1, PM2.5, and PM10) was evaluated using a satellite-based prediction model (daily, at a resolution of 1 km × 1 km). By mixed-effect logistic regression, NDVI values during pregnancy, in the first (0–1 year old) and the second (1–2 years old) year of life were negatively associated with lifetime rhinitis (LR) and current rhinitis (CR) (P < 0.001). PM in the same time windows was associated with increased risks of LR and CR in children, with smaller size fraction of PM showing greater associations. The negative associations between prenatal and postnatal NDVI and LR and CR in preschool children remained robust after adjusting for concomitant exposure to PM, whereas the associations of postnatal NDVI and rhinitis showed significant interactions with PM. At lower levels of PM, postnatal NDVI remained negatively associated with rhinitis and was partly mediated by PM (10.0–40.9 %), while at higher levels of PM, the negative associations disappeared or even turned positive. The cut-off levels of PM were identified for each size fraction of PM. In conclusion, prenatal exposure to greenness had robust impacts in lowering the risk of childhood rhinitis, while postnatal exposure to greenness depended on the co-exposure levels to PM. This study revealed the complex interplay of greenness and PM on rhinitis in children. The exposure time window in prenatal or postnatal period and postnatal concomitant PM levels played important roles in influencing the associations between greenness, PM and rhinitis.

To Explore the Etiology, Pathogenesis, Diagnosis and Treatment Ideas of Allergic Rhinitis in Children based on the Triple Energizer Theory

To Explore the Etiology, Pathogenesis, Diagnosis and Treatment Ideas of Allergic Rhinitis in Children based on the Triple Energizer Theory

Perinatal Risk Factors for Asthma and Allergic Rhinitis in Children and Adolescents.

In this study, we evaluated the associations between birth-related exposures, postnatal factors, and the risk of allergic rhinitis and asthma in children and adolescents. We performed a comprehensive search of five literature databases up to May 2023. To quantify the associations of birth-related exposures (birth weight, delivery mode, prematurity, sex, maternal age, and parental allergy history) and postnatal factors (birth order, number of siblings, breastfeeding exclusivity, and breastfeeding duration) with allergic disease, we calculated pooled odds ratios and 95% confidence intervals. We conducted subgroup analyses for allergic disease type, birth order, number of siblings, and parental allergy history. The methodological quality of the identified studies was evaluated using the Newcastle-Ottawa Scale. This meta-analysis included 31 studies, encompassing 218,899 patients in total. The birth-related exposures of low birth weight, maternal age, and prematurity (less than 37 weeks gestation) were not significantly associated with the risk of asthma or allergic rhinitis during childhood or adolescence. Male sex, family history of allergy, and cesarean delivery were linked to an elevated risk of asthma or allergic rhinitis. Among postnatal factors, exclusive breastfeeding, breastfeeding for longer than 6 months, second or later birth order, and having siblings exhibited protective effects against allergic diseases in offspring. The risks of allergic rhinitis and asthma were elevated in male patients, those delivered by cesarean section, and those with a family history of allergy. Conversely, exclusive breastfeeding, breastfeeding for longer than 6 months, and having siblings corresponded to a reduced risk of respiratory allergic diseases.

The Associations of Prenatal Exposure to Fine Particulate Matter and Its Chemical Components with Allergic Rhinitis in Children and the Modification Effect of Polyunsaturated Fatty Acids: A Birth Cohort Study.

Polyunsaturated fatty acids (PUFAs) have been shown to protect against fine particulate matter in aerodynamic diameter ()-induced hazards. However, limited evidence is available for respiratory health, particularly in pregnant women and their offspring. We aimed to investigate the association of prenatal exposure to and its chemical components with allergic rhinitis (AR) in children and explore effect modification by maternal erythrocyte PUFAs. This prospective birth cohort study involved 657 mother-child pairs from Guangzhou, China. Prenatal exposure to residential mass and its components [black carbon (BC), organic matter (OM), sulfate (), nitrate (), and ammonium ()] were estimated by an established spatiotemporal model. Maternal erythrocyte PUFAs during pregnancy were measured using gas chromatography. The diagnosis of AR and report of AR symptoms in children were assessed up to 2 years of age. We used Cox regression with the quantile-based g-computation approach to assess the individual and joint effects of components and examine the modification effects of maternal PUFA levels. Approximately and 8.07% of children had AR and related symptoms, respectively. The average concentration of prenatal was . was positively associated with the risk of developing AR [hazard ratio ; 95% confidence interval (CI): 1.16, 2.96 per ] and its symptoms (; 95% CI: 1.22, 2.62 per ) after adjustment for confounders. Similar associations were observed between individual components and AR outcomes. Each quintile change in a mixture of components was associated with an adjusted HR of 3.73 (95% CI: 1.80, 7.73) and 2.69 (95% CI: 1.55, 4.67) for AR and AR symptoms, with BC accounting for the largest contribution. Higher levels of n-3 docosapentaenoic acid and lower levels of n-6 linoleic acid showed alleviating effects on AR symptoms risk associated with exposure to and its components. Prenatal exposure to and its chemical components, particularly BC, was associated with AR/symptoms in early childhood. We highlight that PUFA biomarkers could modify the adverse effects of on respiratory allergy. https://doi.org/10.1289/EHP13524.

Investigation of the Comorbidity of Bronchial Asthma and Allergic Rhinitis in Children

Today there is an increasing tendency for all allergic diseases, including a high prevalence of bronchial asthma (BA), as well as an increasing number of patients with co-morbidities. Allergic rhinitis leads in frequency of occurrence with bronchial asthma. In the last decade, the term comorbidity has often been used to define the interrelation as well as the mutual influence of 2 or more syndromes, diseases in one patient. The aim of the research was to study the comorbidity of bronchial asthma and allergic rhinitis in children in the Department of Pulmonology. The retrospective study included an analysis of 51 case histories of children diagnosed with atopic bronchial asthma. Of the 51 patients, 28 children (54.9±7%) were diagnosed with allergic rhinitis after examination by an ENT specialist.

Tic disorder in allergic rhinitis children and adolescents: a case-control study

BackgroundAllergic rhinitis is the most common allergic disease. It can accompany psychological disorders such as tic disorders due to the prolonged course of the symptoms of allergic rhinitis. This pioneer case-control study aims to investigate tic disorders in children and adolescents under 18 years of age diagnosed with allergic rhinitis.MethodThe case group in this study consisted of patients who had both allergic rhinitis and tic disorders. Patients with allergic rhinitis without tic disorders were also enrolled as the control group with matched gender and age. Demographic characteristics, tic classifications, and contributing factors for allergic rhinitis and tic disorders were studied among the cases. Tic disorders were evaluated using DSM-5 criteria for the classification of tic disorders.Results47 patients in the case group and 47 patients in the control group were included in this study. 53.2% and 46.8% were males and females in the case group, respectively. The mean age of the patients was 10.46 ± 3.97 years old. Sound tics were more common among the patients compared to motor tics. Patients with concomitant AR and tic disorders had more days per week with AR symptoms (P-value ≤ 0.001; OR (every day vs. three days a week = 11.02(2.98, 40.76))). Most patients with sound tick were women (p: 0.026), and most patients with motion tic were in the Provisional tic disorder group (p: 0.001). The history of infantile eczema was seen more in patients without sound tic (p: 0.025), and otitis media was significantly less common among patients with sound tics (p: 0.026). Provisional tic disorder was the most common class among the patients. In the case group (coexistence between allergic rhinitis and tic) compared to the control group, patients had significantly more days with AR symptoms per week.ConclusionThis preliminary study indicates that Provisional tic disorder was the most common classification of tic among patients with allergic rhinitis, especially in patients with motor tics. Asthma in motor tics, a history of food allergy in infancy, and a history of infantile eczema were also common among patients with vocal tics. Also, patients with allergic rhinitis and tic had more severe disease (more symptoms per week) than those with rhinitis alone. These findings emphasize the association of tic disorders with immunological pathways.

IL-1β and iNOS can drive the asthmatic comorbidities and decrease of lung function in perennial allergic rhinitis children.

Allergic asthma and rhinitis (AR) are closely linked, with a significant proportion of AR patients developing asthma. Identification of the early signs of comorbidity of AR and asthma can enable prompt treatment and prevent asthma progression. This study investigated the role of interleukin-1β (IL-1β), a pro-inflammatory cytokine, and inducible nitric oxide synthase (iNOS) in the comorbidity of AR and asthma and lung function in Korean children with perennial AR (PAR). A cohort of 240 subjects (6 to 10 years old) with PAR (PAR alone: 113 children, PAR and asthma: 127 children) was analyzed for various biomarkers, including IL-1β, iNOS, and epithelial-mesenchymal transition (EMT) markers in serum. The blood levels of eosinophils and immunoglobulin E (IgE) were examined. IL-1β, CCL-24, E-cadherin, and vimentin were measured by enzyme-linked immunosorbent assay (ELISA). Epithelial iNOS was measured by the NOS kit. Elevated levels of IL-1β, iNOS, and vimentin in the serum were identified as significant indicators of the likelihood of comorbidity of PAR and asthma in children. Furthermore, higher concentrations of IL-1β, iNOS, and vimentin have been linked to reduced lung function in PAR children. Notably, IL-1β expression shows a relationship with the levels of E-cadherin, vimentin, and CCL-24. However, no correlation was found between IL-1β and iNOS expressions. This study suggests that IL-1β and iNOS can be biomarkers in the progression of PAR and asthma and decreased lung function, suggesting potential targets for early intervention and treatment.

Sublingual immunotherapy in the management of local allergic rhinitis in childhood: a case report

Sublingual immunotherapy in the management of local allergic rhinitis in childhood: a case report

Exploiting the nanotechnological approaches for traditional Chinese medicine in childhood rhinitis: A review of future perspectives

Exploiting the nanotechnological approaches for traditional Chinese medicine in childhood rhinitis: A review of future perspectives

Allergic Rhinitis in Children: An Underestimated Disease.

Allergic rhinitis affects approximately 40% of children. This study aimed at determining the prevalence, sociodemographic features, comorbid illnesses, complications and quality of life in children referred to the outpatient clinic of "Allergic Rhinitis" in Penteli Children Hospital, Athens, Greece. We analyzed 590 pediatric patients referred to the outpatient clinic of "Allergic Rhinitis" in Penteli Children Hospital, Athens, Greece from 26/01/2012 to 20/11/2022. Allergic rhinitis was recorded as the one and only allergic disease in 59% of the children diagnosed with allergic rhinitis, concomitant asthma in 16% of them, atopic dermatitis in 8% and allergic conjunctivitis in 5%. 54% of asthmatic children was diagnosed allergic rhinitis, while 16% of allergic rhinitis children was diagnosed asthma. Skin tests were important diagnostic tools, not being necessary the measurement of total IgE in plasma. Eosinophils from nasal secretions were increased in 19% of the children with non-diagnostic cases and the diagnosis was local allergic rhinitis (LAR). Clinical presentations of allergic rhinitis were mainly nasal blockage, runny nose, recurrent sneezing and nasal itching. The most common complication was acute or chronic sinusitis 35%. Major associated comorbid illnesses among were tonsils hypertrophy, adenoid hypertrophy and inferior turbinate hypertrophy. Allergic rhinitis was reported in 78% of studied children and was frequently characterized by significant morbidity. Allergic rhinitis affected all paediatric age group and was peaked at age group 11-14years and 5-7years. There were associated epidemiological features, clinical manifestations, comorbid illnesses, complications and affectation of the quality of life in children.

No associations between type 1 diabetes and atopic dermatitis, allergic rhinitis, or asthma in childhood: a nationwide Danish case-cohort study

Studies examining the association between type 1 diabetes (T1D) and atopic diseases, i.e., atopic dermatitis, allergic rhinitis and asthma have yielded conflicting results due to different algorithms for classification, sample size issues and risk of referral bias of exposed cohorts with frequent contact to health care professionals. Using Danish national registries and well-established disease algorithms, we examined the bidirectional association between T1D and atopic diseases in childhood and adolescence using Cox Proportional Hazard regression compared to two different unexposed cohorts from a population of 1.5 million Danish children born from 1997 to 2018. We found no associations between T1D and atopic dermatitis, allergic rhinitis, or asthma (defined after age five). However, in multivariable analysis we found an increased risk of persistent wheezing (defined as asthma medication before age five) after T1D with an adjusted hazard ratio (aHR) of 1.70 [1.17–2.45]. We also identified an increased risk of developing T1D after persistent wheezing with aHR of 1.24 [1.13–1.36]. This study highlights similar risks of atopic diseases in children with T1D and of T1D in children with atopic disease after age of five years versus healthy controls. However, more research is needed to understand the possible early immunological effects of the link between persistent wheezing and T1D.

Atopic March in Children: A Case Report and Review of Current Literature

Background: The concept of atopic march was introduced about 15 years ago to define the temporal progression of different allergic conditions, from atopic dermatitis and food allergies in earliest childhood to the development of asthma and allergic rhinitis in older children. Case Presentation: The authors describe a case report of a young girl who went through the stages of atopic march. The child first showed atopic dermatitis and food allergy in infancy, and, after-wards, she manifested allergic rhinitis and asthma in childhood. Discussion: This timeline reflects the atopic march's spatial evolution, beginning with the skin and gastrointestinal tract and progressing to the upper and lower airways. Conclusion: In accord with the most recent evidence, rather than being defined in terms of chrono-logical progression, atopic diseases should be investigated as a spectrum of atopic disorders that might take various developmental paths. According to this theory, the use of Component Resolved Diagnosis in atopic children can be beneficial for highlighting and predicting the atopic profile du-ring the earliest years of life before symptoms arise, helping to stratify the clinical risk and preven-ting the onset of the atopic march and severe responses.

Nasal microbes in allergic rhinitis children with or without sublingual immunotherapy.

The mechanism of allergic rhinitis (AR) remains unclear. Most researchers believe that AR is the result of a combination of environmental and genetic factors. Sublingual immunotherapy (SLIT) is a treatment that can change the natural course of AR through immunomodulatory mechanism and maintain efficacy after the treatment. Nasal cavity is the main site where AR patients contact with external allergens, produce inflammatory reactions and nasal symptoms. Therefore, in this study, we investigate the nasal microbiome in AR patients, and the changes after SLIT. In this cross-sectional study, nasal swabs for microbiome analysis were collected from 3 groups: SLIT-naïve AR patients (AR group), AR patients undergoing SLIT treatment over 2 years (SLIT group) and a control group (CG). The characteristics of nasal microbiome of each groups were produced by 16s-rDNA sequencing technology. The Simpson index of AR group was significantly higher than that of CG and SLIT groups, but not different between SLIT group and CG group. The abundance of Bacteroidete and Firmicutes remarkably increased in the AR group, but Bacteroidete reduced to CG level after SLIT. AR patients have different nasal microbiome composition, but we do not know how it happened and whether the AR condition affected nasal microbiome composition or nasal microbiome affected AR.

A Clinical Approach of Allergic Rhinitis in Children.

Allergic rhinitis is an important disease with a global footprint and a growing prevalence, affecting children and adults. Although it is commonly under-diagnosed and under-treated, it causes important social and economic effects (diminished quality of life, poor academic performance, escalated medical visits, heightened medication usage, and effects in other chronic conditions, e.g., asthma). It is characterized by distinctive, easily identifiable symptoms (sneezing, nasal discharge, nasal congestion, nasal-eye-palatal itching) and indirect accompanying indicators (fatigue and decreased school performance). The classification of allergic rhinitis hinges upon its nature and chronic distribution (seasonal or perennial) and its intensity, which spans from mild to moderate and severe. The diagnostic process primarily relies upon recognizing key clinical indicators, evaluating historical records, and considering risk factors. It is supported by abnormal laboratory findings, like in vitro allergen-specific IgE tests (enzyme immunoassay-EIA, chemiluminense immunoassay-CLIA) or in vivo skin prick tests for specific allergens. In the differential diagnosis, other chronic diseases manifesting with chronic rhinitis should be excluded (e.g., rhinosinusitis, chronic non-allergic rhinitis, rhinitis triggered by medications). The treatment of allergic rhinitis in children is mainly chronic and is focused on allergen exposure prevention, drug therapy, and immunotherapy in severe cases. Locally administered intranasal corticosteroids are the cornerstone of therapy. They are safe, effective, and have a favorable safety profile even during long-term use. Choosing a suitable intranasal corticosteroid drug with low systemic bioavailability makes long-term treatment even safer. Combinations of intranasal corticosteroids and H1 antihistamines are available in several countries and are widely used in more severe cases and the presence of year-round symptoms. Adding newer-generation oral H1-antihistamines broadens the available therapeutic inventory without significant effects compared to using previous-generation, once widely available, H1-antihistamines. Treatment of allergic rhinitis is complex and multi-dimensional, requiring an effective approach by a specialized group of specialized pediatricians, and is severely affected by the concurrent presence or development of other diseases in the spectrum of allergic diseases (conjunctivitis, asthma).

Clinical Characteristics and Risk Factors for Allergic Rhinitis in Children with Epistaxis.

Epistaxis is frequently observed in children with allergic rhinitis. However, few studies have addressed the clinical characteristics and risk factors for allergic rhinitis in children with epistaxis. This study aimed to describe the factors associated with allergic rhinitis in children with epistaxis. In total, we recruited 80 children (aged 3-14 years) who presented with epistaxis at a tertiary hospital between January 2014 and January 2022. The follow-up duration was at least 3 months, and we performed a multivariate logistic regression analysis to identify the risk factors for allergic rhinitis. Among the 80 children examined, 57 (71.25%) had allergic rhinitis. Epistaxis mainly occurred in autumn in children with allergic rhinitis; in contrast, it mostly occurred in summer in children without it (P = 0.029). Mites are common allergens for allergic rhinitis in children with epistaxis; the univariate analysis revealed significant differences between allergic-rhinitis group and nonallergic-rhinitis group in the number of allergens (P < 0.001) and total IgE (P < 0.001). The difference in severity of nasal symptoms between the two groups was statistically significant and included nasal obstruction (P < 0.001), rhinorrhea (P < 0.001), sneezing (P < 0.001), and nasal itching (P < 0.001). After adjusting for potential confounders, the severity of rhinorrhea symptoms was found to be associated with an increased risk of allergic rhinitis in children with epistaxis (odds ratio: 3.86; 95% confidence interval: 1.61-9.26; P = 0.003). Observing the onset season, number of allergens, total IgE, and nasal symptoms in cases of epistaxis could suggest the presence of associated allergic rhinitis and reduce the number of missed diagnoses; antiallergic drugs could help control epistaxis in these cases.

The Relationship Between Family Smoking Habits and the Use of Room Perfume with Complaints of Allergic Rhinitis in Children Aged 13-14 Years in Rungkut District, Surabaya City

ABSTRACT Background: Allergic rhinitis is defined clinically as a symptom of nasal hypersensitivity triggered by a certain allergen present in the environment. The prevalence of allergic rhinitis has increased over the past 5 years. Indoor air quality is influenced by the number of pollutants according to the place, climate, culture, local ambient air, characteristics of buildings and indoor activities. Objectives: To analyze the relationship between family smoking habits and room perfume use with complaints of allergic rhinitis in children aged 13-14 years in Rungkut District, Surabaya City. Methods: This research method was quantitative research with an analytical type of observational research with a cross-sectional research design. The sample size in this study was 94 children aged 13-14 years and the sample was taken using systematic random sampling. Data collection by conducting interviews, observations and measurements directly. The test used is chi-square Results: There was a relationship between family smoking habits and complaints of allergic rhinitis in children (p = 0.000) and there was a relationship between the use of room perfume and complaints of rhinitis in children (p = 0.029). Conclusion: Family smoking habits and the use of room perfume have a significant relationship with complaints of allergic rhinitis in children. Families are encouraged to eliminate smoking and minimize the use of room perfume in order to minimize risk factors for complaints of allergic rhinitis in children.