Self-reported Allergic Rhinitis Research Articles

Greenness and its composition and configuration in association with allergic rhinitis in preschool children

BackgroundFew studies focus on the associations of green space composition and configuration with children's allergic rhinitis (AR). MethodsA multi-center population-based cross-sectional study was performed in 7 cities in mainland of China between 2019 and 2020, recruiting 36,867 preschool children. Information on the current AR symptoms and demographics were collected by questionnaire. Exposure to residential greenness was estimated by Normalized Difference Vegetation Index (NDVI, 1000 m buffer) around the residences. Greenness composition was estimated in 3 main categories: forest, grassland, shrubland. Configuration of each category and total greenness (a spatial resolution of 10 m × 10 m) was estimated by 6 landscape pattern metrics to quantify their area, shape complexity, aggregation, connectivity, and patch density. Exposure to daily ambient particulate matter (PM1, PM2.5 and PM10, a spatial resolution of 1 km × 1 km) was estimated. Multilevel logistic regression models were applied to analyze the associations of greenness and its composition and configuration with AR, and mediation effects by PMs were examined by mediation analysis models. ResultsThe prevalence of self-reported current AR in preschool children was 33.1%. Two indicators of forest, Aggregation Index of forest patches (AIforest) (odds ratio (OR):0.92, 95% Confidential Interval (CI): 0.88–0.97), and Patch Cohesion of forest (COHESIONforest) (OR: 0.93, 95% CI:0.89–0.98) showed significantly negative associations with AR symptoms. Mediation analyses found the associations were partially mediated by PMs. Age, exclusive breastfeed duration and season were the potential effect modifiers. The associations varied across seven cities. ConclusionOur findings suggest the inverse associations of the aggregation and connectivity of forest patches surrounding residence addresses with AR symptoms. Since the cross-sectional study only provides associations rather than causation, further studies are needed to confirm our results as well as the underlying mechanisms.

Self-Reported Allergic Rhinitis Prevalence and Risk Factors in Employees of the China National Railway.

BACKGROUND: Allergic rhinitis (AR) is a common allergic disease globally and its prevalence is increasing year by year. This study aimed to analyze the prevalence and risk factors of self-reported AR among the Chinese National Railway train crew in the China Railway Beijing Group.METHODS: This prospective questionnaire study surveyed 1511 randomly recruited train crewmembers from 20 cities in the China National Railway network, and 494 reported having AR. A structured questionnaire was tailored, designed, and delivered electronically to all subjects. Prevalence of and risk factors for AR were analyzed based on self-reported results.RESULTS: The prevalence of self-reported AR among train crewmembers was 32.6%. Among respondents, 86.03% worked in passenger cars and 64.6% reported having worse AR symptoms while on trains. AR frequencies were 40.15% perennially and 59.85% seasonally. Among the Total Nasal Symptoms Scores (TNSS), significant differences were found between rhinorrhea and sneezing and between nasal itching and sneezing. The Rhino-Conjunctivitis Quality of Life Questionnaire (RQLQ) showed significant correlations between all seven sections. TNSS was significantly associated with the RQLQ. Scores of both the TNSS and RQLQ showed that the severity of AR symptoms (rp = 0.103) and the impact on quality of life (rp = 0.113) correlated significantly with seniority.CONCLUSIONS: The prevalence of self-reported AR among train crew working in passenger cars is higher than that of the general Chinese population. The severity of AR symptoms and the impact on quality of life are associated with seniority, meaning the number of years working on trains.Yu R-L, Ning H-Y, Lan T-F, He H, Zheng C-B, Wang X-Y, Wang H-T, Wang X-Y. Self-reported allergic rhinitis prevalence and risk factors in employees of the China National Railway. Aerosp Med Hum Perform. 2023; 94(11):821-826.

Epidemiology of Allergic Rhinitis in Children: a Systematic Review and Meta-Analysis.

Allergic Rhinitis (AR) is associated with significant clinical and socio-economic burdens. AR is a frequent risk factor for other atopic diseases, such as asthma. Thus, a comprehensive updated description of the epidemiology of AR in the pediatric population is needed to understand its implications better. To determine the incidence, prevalence and epidemiology of AR among children over the last ten years. We conducted a systematic review and meta-analysis using a protocol registered and published with the international prospective register of systematic reviews (PROSPERO register number: CRD42022332667). We searched databases, registers, and websites for cohort or cross-sectional studies published between 2012 and 2022, evaluating the epidemiology (incidence or prevalence) of AR in the pediatric population. We assessed study quality and risk of bias using items derived from the Strengthening the Reporting of Observational Studies in Epidemiology Statement. Twenty-two studies were included in the analysis. The overall prevalence of physician-diagnosed AR was 10.48%, the overall prevalence of self-reported current (last 12 months) AR was 18.12%, the overall prevalence of self-reported lifetime AR was 19.93%. Incidence could not be determined. The analysis of prevalence of AR over the time showed a rising trend in physician-diagnosed AR over the years (8.39% in 2012-2015 vs 19.87% in 2016-2022). AR has significant impacts on the pediatric population, with an increasing trend for diagnosed AR over the years. Further investigations concerning incidence, comorbidities, diagnosis and treatment are needed to provide a complete overview of the disease, its burden and management.

Association between urban garbage exposure and allergic diseases among sanitation practitioners: A cross-sectional study

BackgroundThe prevalence of allergic diseases has increased significantly in China over the last few decades, and there have been very few reports of allergic diseases in certain occupational specialties, with almost no reports among sanitation workers. ObjectiveOur objective was to investigate the prevalence of allergic diseases and the prevalence of common allergen sensitization in the population engaged in sanitation, and to try to answer the connection between urban garbage waste exposure and the development of allergic diseases. MethodsWe conducted a cross-sectional survey of people working in sanitation-related jobs in Liwan District, Guangzhou, China. A total of 893 people completed the questionnaire for this study, and 500 of them were further screened and tested for allergens specific IgE and IgG4. Combining the questionnaire and test results, we investigated the incidence of allergy disorders and patterns of sensitization to allergens in this community, and evaluated the presence of occupational-related risk factors in this particular population. ResultsOf the 893 sanitation workers, 166 (18.59%) self-reported allergic diseases, predominantly suffering from allergic rhinitis (AR) (n = 98, 10.97%), followed by drug allergy (n = 31, 3.47%), atopic dermatitis (n = 27, 3.02%), food allergy (n = 21, 2.35%), and asthma (n = 9, 1.00%), in that order. In addition to dust mites (32.20%), which had the highest sensitization rate, the subject population had relatively high sensitization rates to ragweed (7.00%) and moulds mixture (8.20%) when compared with the rates of sensitization to moulds and ragweed in the general population; the top 3 sIgG4 positivity rates were egg (50.00%), milk (10.20%), and soybean (9.40%). The prevalence of self-reported AR was higher in office managers (the control group) than in cleaning staff (the exposed group), but there was no difference in sIgE positivity for serum allergens between the 2 groups. The chance of having AR may increase with management positions (crude OR 2.20, 95% CI 1.38–3.50), P = 0.001). ConclusionThis is the first study to investigate the prevalence of allergy illnesses in the sanitation workforce in mainland China. We identified a community of real sanitation workers with high ragweed and mycobacterial sensitization rates. Urban cleaning may be protective factor against AR at the symptom level, but the serological results did not show this to be the case.

Cutoff Values of MASK-air Patient-Reported Outcome Measures

In clinical and epidemiological studies, cutoffs of patient-reported outcome measures can be used to classify patients into groups of statistical and clinical relevance. However, visual analog scale (VAS) cutoffs in MASK-air have not been tested. To calculate cutoffs for VAS global, nasal, ocular, and asthma symptoms. In a cross-sectional study design of all MASK-air participants, we compared (1) approaches based on the percentiles (tertiles or quartiles) of VAS distributions and (2) data-driven approaches based on clusters of data from 2 comparators (VAS work and VAS sleep). We then performed sensitivity analyses for individual countries and for VAS levels corresponding to full allergy control. Finally, we tested the different approaches using MASK-air real-world cross-sectional and longitudinal data to assess the most relevant cutoffs. We assessed 395,223 days from 23,201 MASK-air users with self-reported allergic rhinitis. The percentile-oriented approach resulted in lower cutoff values than the data-driven approach. We obtained consistent results in the data-driven approach. Following the latter, the proposed cutoff differentiating "controlled" and "partly-controlled" patients was similar to the cutoff value that had been arbitrarily used (20/100). However, a lower cutoff was obtained to differentiate between "partly-controlled" and "uncontrolled" patients (35 vs the arbitrarily-used value of 50/100). Using a data-driven approach, we were able to define cutoff values for MASK-air VASs on allergy and asthma symptoms. This may allow for a better classification of patients with rhinitis and asthma according to different levels of control, supporting improved disease management.

Allergic disease and sensitization disparity in urban and rural China: A EuroPrevall-INCO study.

Studies in comparison with allergic diseases and sensitization between rural and urban environments in westernized countries might be biased and not adequately reflect countries undergoing rapid transition. A total of 5542 schoolchildren from urban area and 5139 from rural area were recruited for the EuroPrevall-INCO survey. A subsequent case-control sample with 196 children from urban area and 202 from rural area was recruited for a detailed face-to-face questionnaire and assessment of sensitization. Skin prick tests and serum-specific IgE measurements were used to assess sensitizations against food and aeroallergens. Logistic regression analysis was used to determine associations between risk/protective factors, food adverse reactions (FAR), allergic diseases, and sensitizations. Prevalence of self-reported allergic diseases, including asthma (6.6% vs.2.5%), rhinitis (23.2% vs.5.3%), and eczema (34.1% vs.25.9%), was higher in urban than in rural children. Urban children had a significantly higher prevalence of FAR and related allergic diseases, and lower food/inhalation allergen sensitization rate, than those of rural children. In urban children, frequent changing places of residency (odds ratio 2.85, 95% confidence interval: 1.45-5.81) and antibiotic usage (3.54, 1.77-7.32) in early life were risk factors for sensitization, while sensitization and family history of allergy were risk factors for allergic diseases. In rural children, exposure to rural environments in early life was protective against both allergen sensitizations (0.46, 0.21-0.96) and allergic diseases (0.03, 0.002-0.19). We observed a disparity in rates of allergic diseases and allergen sensitization between rural and urban children. In addition to family history, the development of allergic diseases and allergen sensitization were associated with specific urban/rural environmental exposures in early life.

Rhinitis symptom in patients with self-reported allergic rhinitis is influenced by sensitization pattern: A cross-sectional study of China.

Allergic rhinitis (AR) is characterized by distinct clinical heterogeneity and allergic sensitization patterns. We aimed to quantify rhinitis symptoms in patients with self-reported allergic rhinitis according to the potential sensitization patterns for relevant allergens in China. We used latent class analysis (LCA; a subset of structural equation modeling) to independently cluster patients into different patterns of atopic sensitization in an unsupervised manner, based on specific immunoglobulin E tests. AR symptom severity was assessed by the visual analogue scale. We evaluated the association between the severity of AR and the allergen sensitization patterns. LCA revealed four phenotypes of atopic sensitization among 967 patients with self-report AR. We labeled latent classes as: Class 1, weed pollens and indoor sensitization (n = 74 [7.7%]); Class 2, weed pollen with low indoor sensitization (n = 275 [28.4%]); Class 3, low or no sensitization (n = 350 [36.2%]); and Class 4, house dust mite-dominated sensitization (n = 268 [27.7%]). AR was more severe in Class 2 compared to the other 3 classes, indicating that upper respiratory symptoms are more severe among patients with isolated seasonal rhinitis. We have identified four sensitization patterns in patients with self-reported AR, which were associated with different clinical symptoms and comorbidities.

Association of self-reported allergic rhinitis with dengue severity: A case-control study

BackgroundThe severity of dengue infection has been reportedly associated with patients’ allergic reactions. To further elucidate the role of allergy in dengue severity, we conducted a matched case-control study to assess the association between allergic background and dengue shock syndrome. MethodsThis is a matched case-control study that was carried out in the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam from January to December 2017. Dengue infection was determined by non-structure protein 1 (NS1) diagnostic quick test or anti-dengue antibodies (IgM). The total and dengue-specific IgE levels were measured using ELISA. Patients’ demographics, clinical, and allergic profiles were collected using a structured questionnaire. ResultsA total of 572 dengue patients with positive NS1 (92.7%) or IgM antibodies (7.3%) results were included in this study. Of these patients, 143 patients developed dengue shock syndrome (case group) while the other 429 patients did not (control group). None of the baseline characteristics including age, sex, or being overweight was significantly different between the two groups (p>0.05). In multivariable analysis, having a history of dengue infection (OR=3.35, 95% CI: 1.8–6.17, p<0.001) and allergic rhinitis (OR=1.95, 95% CI: 1.11–3.4, p = 0.019) were found to be associated with dengue shock syndrome. Higher levels of dengue-specific IgE were not associated with worse outcomes in patients with allergies (p = 0.204) or allergic rhinitis (p = 0.284). ConclusionDengue patients presenting with a history of a previous dengue infection or allergic rhinitis should be considered high-risk patients for the development of dengue shock syndrome.

Prevalence Of Allergic Rhinitis and Its Perceived Effect on Academic Activity Among College Students – A Cross-Sectional Study

Background: Allergic rhinitis (AR) is a widespread and under diagnosed upper airway disease. It has significant social and economic burden. Symptoms may cause fatigue, mood changes and difficult sleep that may have deleterious effect on student’s academic activity. Methods: This was an observational cross-sectional study among 1337 college students in Vadodara city of Gujarat, selected by cluster sampling method. Response was recorded using SFAR (Score for allergic rhinitis) scale and a semi structured questionnaire. Results: Prevalence of AR using SFAR was 19.22% among college students, out of them 65.4% were girls and 34.6% boys. The prevalence of two major variant of AR, perennial and seasonal was 38.91% and 51.75% respectively. 81.32% were aware about their allergy, 20.23% had gone for allergy test and 73.08% among them resulted positive. 82.49% students had perceived that AR is affecting their academic activity among SFAR≥7 group. Conclusion: The results of this survey showed elevated prevalence of AR among college students in Vadodara city; however, allergy tests and physician visits for AR conditions were less. Major proportion that had self-reported AR has shown associated comorbidity. Students with AR, perceive a negative effect on their academic activity that equally affects girls and boys.

Analysis of Prevalence and Risk Factors of Adult Self-Reported Allergic Rhinitis and Asthma in Plain Lands and Hilly Areas of Shenmu City, China.

Objective: The main aim of this study was to investigate the prevalence and risk factors of adult self-reported allergic rhinitis and asthma in plain lands and hilly areas of Shenmu City in China, and analyze the differences between regions.Methods: The multi-stage stratified random sampling was applied in a cross-sectional survey of adult residents in Shenmu City, from September to December 2019. The unconditional logistic regression analysis was used to screen the influence factors of allergic rhinitis and asthma.Results: 4,706 adults participated in the survey, and 99% (4,655 in 4,706) completed the questionnaires. The prevalence of allergic rhinitis was 25.4%, and the prevalence of asthma was 9.4%. The prevalence of the allergic rhinitis without asthma, asthma without allergic rhinitis, and the combined allergic rhinitis with asthma were 18.9, 2.9, and 6.5%, respectively. The prevalence of allergic rhinitis and asthma existed regional differences. The prevalence of adult self-reported allergic rhinitis was 41.5% in plain lands areas and 22.1% in hilly areas. The prevalence of adult self-reported asthma was 12.8% in plain lands and 8.8% in hilly areas. The prevalence of allergic rhinitis and asthma existed seasonal differences, with the highest prevalence from July to September. The analysis of risk factors showed that higher education [middle and high school (OR 1.72, 95%CI 1.42–2.07); college and above (OR 2.67, 95%CI 1.99–3.59)], comorbidities of other allergic diseases (OR 3.90, 95%CI 3.23–4.70), family history of allergies (OR 2.89, 95%CI 2.36–3.53), and plain lands areas (OR 2.51, 95%CI 2.06–3.05) were the risk factors for the allergic rhinitis without asthma. Aging [40–49 years old (OR 4.29, 95%CI 1.02–18.13); 50–59 years old (OR 5.89, 95%CI 1.40–24.76); ≥60 years old: (OR 6.14, 95%CI 1.41–26.71)], never-smokers (OR 1.66, 95%CI 0.99–2.80), comorbidities of other allergic disorders (OR 2.17, 95%CI 1.42–3.32), and family history of allergies (OR 2.20, 95%CI 1.40–3.47) were the risk factors for the asthma without allergic rhinitis. Advanced age [30–39 years (OR 2.16, 95%CI 1.23–3.82); 40–49 years (OR 2.86, 95%CI 1.56 to 5.25); 50–59 years (OR 2.95, 95%CI 1.58–5.51); ≥60 years old (OR 2.27, 95%CI 1.09–4.72)], higher education [middle and high school (OR 2.23, 95%CI 1.62–3.07); college and above (OR 4.28, 95%CI 2.72–6.74)], non-agricultural workers (OR 1.70, 95%CI 1.18–2.43),never-smokers (OR 2.26, 95%CI 1.51–3.39), comorbidities of other allergic diseases (OR 4.45, 95%CI 3.37–5.88), family history of allergies (OR 5.27, 95%CI 3.98–6.97), and plain lands areas (OR 2.07, 95%CI 1.51–2.86) were the risk factors for the combined allergic rhinitis with asthma.Conclusions: The prevalence of allergic rhinitis and asthma in Shenmu City was relatively high, with regional differences. Genetic and environmental factors were the important risk factors associated with allergic rhinitis and asthma. Our research would provide data support for preventing and controlling allergic rhinitis and asthma in this region in the future, and appropriate prevention and control programs should be formulated according to the characteristics of different regions.

Association of Self-Reported Allergic Rhinitis with Dengue Severity: A Case-Control Study

Association of Self-Reported Allergic Rhinitis with Dengue Severity: A Case-Control Study

A Multicenter Study Assessing Risk Factors and Aeroallergens Sensitization Characteristics in Children with Self-Reported Allergic Rhinitis in China.

BackgroundUp to now, epidemiological studies on allergy rhinitis (AR) have primarily focused on determining the risk of disease in Chinese adults, with the majority of them designed by single centers, while cross-sectional and epidemiological data describing allergic sensitization in children with self-reported AR are scarce.ObjectiveThis study was estimating of the latest information about the sensitization patterns and risk factors of clinical AR to develop effective strategies for the prevention and treatment of AR.MethodsWe conducted a cross-sectional survey between January 2020 and June 2021 involving children from seven cities in China who reported AR. A total of 762 children participated in this survey. To evaluate the risk factors and specific sensitization patterns of clinical AR through questionnaires and specific immunoglobulin E to 11 aeroallergens.ResultsOf the 762 patients, 593 (77.8%) had at least one positive IgE level. Aged 7–14 years (OR 1.503, (95% CI 1.058–2.136), P = 0.023); With allergic conjunctivitis (OR 1.843, (95% CI 1.297–2.620), P = 0.001) and living in the Eastern (OR 1.802, (95% CI 1.263–2.573), P = 0.001) all elevated the risk of clinical AR associated with aeroallergens. The sensitization rates of D. pteronyssinus and D. farinae were higher than those of other allergens in the 0–6 and 7–14 years old age groups. The most common aeroallergens among self-reported children with AR in the eastern were D. farinae (74.9%) and D. pteronyssinus (74.3%), while in the western were mugwort (60.0%) and marguerite (56.6%). Majority of sIgE-positive subjects were sensitized to three or more of the tested pollen allergens in the Western (52.1%), compared with 5.7% in the Eastern.ConclusionThere was an apparent geographic variation in childhood allergies in China. Age factors also had strong impacts on the allergen sensitization rate of children, but these impacts differed across regions.

The Prevalence of Allergic Rhinitis, its Triggers, and Associated Factors in Commonwealth of Independent States Countries (Ukraine, Kazakhstan, and Azerbaijan): Results of the CORE Study

Background: In the Commonwealth of Independent States (CIS) countries the epidemiology of allergic rhinitis (AR) is poorly characterized. The rationale and design of the CORE (Chronic Obstructive REspiratory diseases) study have been described elsewhere. Methods: A total of 2,842 adults (≥18 years) were recruited (964 in Kiev, Ukraine, 945 in Almaty, Kazakhstan, and 933 in Baku, Azerbaijan) between 2013 and 2015 and interviewed during household visits. Two-step cluster randomization was used for the sampling strategy. “Doctor-diagnosed AR” was considered when the respondent had previously been diagnosed with AR by a doctor, “self-reported AR symptoms” (was defined as watery runny nose during the last 12 months alone or in combination with any of the following: sneezing, nasal obstruction, nasal itching, or conjunctivitis). Results: The prevalence of doctor-diagnosed AR was 33.4, 92.1, and 82.7 per 1,000 persons, and the prevalence of self-reported AR symptoms was 44.7, 97.4, and 85.7 per 1,000 persons, in Ukraine, Kazakhstan, and Azerbaijan, respectively. In Ukraine, the peak of AR symptoms was in May, in Kazakhstan – in May–September, and in Azerbaijan in March–May. Sneezing and nasal congestion were the most frequent symptoms. Pollen as AR trigger was reported by 71.9% respondents in Ukraine, 70.1% in Kazakhstan, and 68.8% in Azerbaijan. Only 35–56% respondents with doctor diagnosed AR have had specific investigations (skin test, analysis for immunoglobulin etc.). The percent of subjects with chronic (nonrespiratory) health condition was higher in the respondents with self-reported AR symptoms compared to rest of the respondent: 100 versus 42% in Ukraine, 100 versus 21% in Kazakhstan, and 100 versus 50% in Azerbaijan, respectively. Conclusion: In CIS countries, the prevalence of self-reported AR symptoms was slightly higher than the prevalence of doctor-diagnosed AR. Compared to countries from other continents, the prevalence of doctor-diagnosed AR was similar; however, the prevalence of AR symptoms seems to be relatively lower.

Self-Reported Allergic Rhinitis Prevalence and Related Factors in Civil Aviation Aircrew of China.

INTRODUCTION: Allergic rhinitis (AR) is a global health problem with gradually increasing prevalence. No large-scale, systematic, and comprehensive study on AR among civil aviation aircrew of China has been reported. We aimed to demonstrate the prevalence of and risk factors for self-reported AR among Chinese civil aviation aircrew.METHODS: This study randomly surveyed 4059 civil aviation aircrew members from 12 cities in mainland China. A structured questionnaire was tailored, designed, and electronically delivered to all participants. Based on self-reported results, prevalence of and risk factors for AR were calculated/analyzed.RESULTS: The prevalence of self-reported AR was 23.38%. Among aircrew members, 10.37% presented with ear barotraumas, whereas 9.95% reported symptom aggravation during flight. Of aircrew members, 10.32% had symptoms related to flight duration, whereas 4.43% of symptoms related to flight altitude. Significant differences between rhinorrhea and sneezing, as well as between nasal itching and sneezing, were observed in the Total Nasal Symptoms Scores (TNSS). The Rhino-conjunctivitis Quality of Life Questionnaire (RQLQ) showed significant correlation between each section. TNSS was significantly related to RQLQ. Both TNSS and RQLQ significantly correlated with flight time.CONCLUSIONS: The prevalence of self-reported AR among civil aviation aircrew is higher than the general population in China. The severity of nasal symptoms and complications are significantly associated with quality of life and flying duties.Bai Y, Hu M, Ma F, Liu K, Xu H, Wu X, Wang H. Self-reported allergic rhinitis prevalence and related factors in civil aviation aircrew of China. Aerosp Med Hum Perform. 2021; 92(1):2531.

Reduction of allergic rhinitis symptoms with face mask usage during the COVID-19 pandemic

Reduction of allergic rhinitis symptoms with face mask usage during the COVID-19 pandemic

Construction of a nomogram for predicting the risk of allergic rhinitis among employees of long-distance bus stations in China.

This study examined indoor air pollutants and their health effects on allergic rhinitis in 3194 employees of 226 bus station halls and then constructed a nomogram model to predict allergic rhinitis risk in those employees. Indoor air temperature, relative humidity, PM10 , PM2.5 , total bacteria, and total fungi were measured, and questionnaires were used to collect basic station information and employee health information. The results revealed that the over-standard rates of PM10 , PM2.5 , total bacteria, and total fungi were 18.16%, 31.13%, 2.22%, and 55.89%, respectively. Seasonal variations were found in temperature, relative humidity, and PM2.5 . Passenger flow could affect temperature, and total bacteria. Central air conditioning could affect total bacteria. A total of 15.90% of the employees were diagnosed as allergic rhinitis by physicians. Relative humidity, fungi, self-reported allergic rhinitis symptoms, and exposure to smoking were the influencing factors for allergic rhinitis. These four variables were incorporated to construct a nomogram. The concordance index of the nomogram was 0.775 (95% CI: 0.745-0.806) and 0.749 (95% CI: 0.715-0.783) for the training cohort and test cohort, respectively. The calibration plot revealed that the nomogram model exhibited good discrimination and consistency. This nomogram model may help predict the occurrence of allergic rhinitis.

The impact of perennial allergic rhinitis with/without allergic asthma on sleep, work and activity level

BackgroundAllergic respiratory diseases such as allergic rhinitis (AR) and allergic asthma (AA) are common conditions that can influence sleep and daytime functioning. However, the significance of this impact is unclear—particularly in perennial allergy sufferers. This study investigates the impact of perennial allergy on sleep, daily activities and productivity.MethodsAdults with self-reported or physician-diagnosed perennial AR aged ≥ 18 years were recruited in Denmark, France, Germany and Sweden. Allergy sufferers were identified using online panels closely matching national population characteristics for each country. Impact on sleep, work, productivity and activity (by the Work, Productivity and Activity Index) were analysed. Descriptive analyses were conducted.ResultsIn total, 511 subjects with perennial AR (47.4% also with seasonal allergy) completed the survey. Most subjects (77.5%) had a physician-diagnosis of AR; 46.4% were diagnosed with both AA and AR. Most subjects (65.2%) reported sensitisation to house dust mites. Of all subjects, 66.0% reported sleep problems. Subjects with sleep problems woke, on average, 3.8 times per night, with 92.0% taking 15+ min to fall asleep (22.2% took 60+ min). Upon waking at night, 40.8% struggled to get back to sleep, and 69.2% had difficulties waking in the morning due to tiredness. Disturbances in daily functioning due to sleep issues were reported in 85.5–95.0% of subjects with sleep problems across all aspects investigated. Overall work and activity impairment were 53.3% and 47.1%, respectively. Sleep issues were more frequent (78.1% vs 54.7%) in those diagnosed with both AR and AA compared to AR alone, and more burdensome, with a greater impact on daily functioning (47.0% vs 33.3%) and impairment in work and activity (62.0% and 54.9% vs 39.3% and 35.2%, respectively). Of all subjects, 20.5% were receiving AIT at the time of the survey; of these, 36.4% reported moderate or great improvement in sleep due to allergy treatment.ConclusionsIn perennial AR sufferers, sleep problems are common and impact on daily functioning, with results indicating a greater burden in those with both AR and AA compared to AR alone.

Workplace Indirect Cost Impacts of Nasal and Sinus Symptoms and Related Conditions.

Evaluate associations of nasal and sinus and related symptoms, as well as selected health conditions which produce those symptoms, with total lost productive time (LPT) at work in the past 2 weeks. We used a cross-sectional analysis of 2402 currently working subjects. Self-reported physician diagnoses, condition statuses measured with standardized instruments, and symptom-based factor scores from an exploratory factor analysis were used in survey weighted log-binomial regression. Pain and pressure, nasal blockage and discharge, and asthma and constitutional symptom factor scores as well as self-reported allergic rhinitis were associated with higher total LPT. Individuals who met operationalized criteria for multiple health conditions, especially chronic rhinosinusitis, had the greatest total LPT. Better management of these symptoms, and awareness of how they impact an individual's ability to perform job-functions in the workplace, could improve overall productivity.

Allergic rhinitis: Disease characteristics and coping measures in Saudi Arabia.

BackgroundDespite allergic rhinitis (AR) being a highly prevalent disease, according to literature, it is often underdiagnosed or undertreated.AimThis study explored the disease characteristics of AR in the Saudi community and the non-conventional coping measures used to alleviate symptoms.MethodsThe study was a nationwide cross-sectional study, using a self-report electronic survey distributed via social media networks in 2018. The survey included an explanatory letter and consent. The sample size comprised 3,458 participants and 2,849 adults had at least one of the four signs of AR, i.e. watery-nose, sneezing, nasal obstruction, itchy nose, watery eyes, in the past year, not related to cold/flu. The outcomes of the study were the triggers, pattern, severity and the classification of AR (2016 ARIA guidelines) and coping measures. Descriptive statistics, univariate analytic statistics and binary logistic regression analyses were conducted. The P-value was considered statistically significant at <0.05.ResultsThe leading reported trigger of AR was dust (74%, n = 2118), followed by pollen (17%, n = 477), mold (5%, n = 140) and fur (4%, n = 114). The prevalence of intermittent AR was (54%, n = 1,635), while that of persistent AR was (46%, n = 1,314). Almost one-third (34%, n = 959) complained of mild forms of AR, while others complained of moderate to severe forms (66%, n = 1890). The coping measures were mainly shower/humidification 368(12.9%) and herbal hot drinks 266(9.3%). Older participants (adj.OR = 1.3[1.1–1.5]) and overweight participants, (adj.OR = 1.2[1.1–1.4]) reported more persistent forms of rhinitis compared to their counter groups, (adj.P<0.001 and adj.P = 0.032) respectively. Female participants (adj.OR = 0.8[0.7–0.9]) had significantly milder forms of AR, in comparison to males, adj.P = 0.006.ConclusionThis study presented the disease characteristics of self-reported AR and its associated factors in Saudi Arabia. Special attention should be paid to older age groups and overweight patients who reported persistent forms of AR. Males reported more severe and persistent forms of AR.

Sinonasal risk factors for eustachian tube dysfunction: Cross-sectional findings from NHANES 2011-2012.

Sinonasal pathology is frequently cited as a cause of eustachian tube dysfunction (ETD), despite a lack of evidence. Using a large, nationally representative sample, we investigated whether abnormal tympanometry, an objective marker of ETD, was associated with infectious, allergic, and exposure-related sinonasal risk factors. Relevant data were extracted from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). Tympanometric types (A, B, and C) were determined using peak pressure and compliance values. Participants with a type B or C tympanogram in at least one ear were classified as having ETD. Demographic and clinicopathologic risk factors with putative associations with ETD were determined. Statistical analysis, including regression modeling, was performed using Stata (version 15.1) to determine the correlation between sinonasal factors and ETD. The final analysis included 1253 subjects and 19 variables. We controlled for demographic data including age, gender, race, and income. In both univariate and multivariate logistic regression, statistically significant correlations were found between abnormal tympanometric values and: (1) having a persistent cold/flu in the last 12 months (univariate: adjusted odds ratio [OR], 2.42; p = 0.006; multivariate: adjusted OR, 2.15; p = 0.006); and (2) experiencing "hay fever" (ie, allergic rhinitis) within the last 12 months (univariate: adjusted OR, 1.95; p = 0.021; multivariate: adjusted OR, 1.71; p = 0.039). Using a large, representative data set, we identified significant correlations between ETD and (1) persistent cold/flu symptoms and (2) self-reported allergic rhinitis.