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Association between air pollution and the prevalence of allergic rhinitis in Chinese children:A Systematic Review and Meta-analysis
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  • Speng Zhang,
  • Qinwei Fu,
  • Xin Jin,
  • Junwen Tan,
  • Qinxiu Zhang,
  • Xinrong Li
Speng Zhang
Chengdu University of Traditional Chinese Medicine Affiliated Hospital
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Qinwei Fu
Chengdu University of Traditional Chinese Medicine Affiliated Hospital
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Xin Jin
Chengdu University of Traditional Chinese Medicine Affiliated Hospital
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Junwen Tan
Chengdu University of Traditional Chinese Medicine Affiliated Hospital
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Qinxiu Zhang
Chengdu University of Traditional Chinese Medicine Affiliated Hospital

Corresponding Author:[email protected]

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Xinrong Li
Chengdu University of Traditional Chinese Medicine Affiliated Hospital
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Abstract

Background Allergic rhinitis (AR) is a common chronic inflammatory disease with annoying symptoms. It has serious impacts on quality of lives, and affects economic growth indirectly. Children are more susceptible to allergic rhinitis, and the prevalence of it in children is 25% worldwide. However, effect of air pollution on the incidence of allergic rhinitis in children controversial. We aim to investigate the association between air pollution and the prevalence of allergic rhinitis in Chinese children. Methods We studied 160356 students aged 0-18 years old, in China, who completed a questionnaire about the accuracy of the International Study of Asthma and Allergies in Childhood (ISAAC), and who reported the average concentrations of air pollutants. The primary outcome was the prevalence of allergic rhinitis. We investigated the association between the air pollution and the prevalence of allergic rhinitis in Chinese children. We further examined this association, combing ISAAC data with data for concentrations of various air pollutants reported from 11 multinational prospective studies in a meta-analysis. Finally, we evaluated whether the different air pollutants affected morbidity rate. Results A total of 11 articles including 160356 Chinese children were included in this review. The difference in the effect of SO 2 exposure on the risk of childhood allergic rhinitis was found to be statistically significant (OR combined = 1.03, 95% CI [1.01, 1.05], P = 0.010), and the effect of NO 2 exposure on the risk of childhood allergic rhinitis was statistically significant (OR combined = 1.11, 95% CI [1.05, 1.18], P = 0.0006). The effect of PM 10 exposure on the risk of childhood allergic rhinitis was statistically significant (OR combined = 1.02, 95% CI [1.01, 1.03], P < 0.001), the effect of PM 2.5 exposure on the risk of childhood allergic rhinitis was statistically significant (OR combined = 1.15, 95% CI [1.03, 1.29], P = 0.02), and the effect of O 3 exposure on the risk of childhood allergic rhinitis was not statistically significant (OR combined = 0.98, 95% CI [0.67, 1.41], P = 0.13). Conclusions Among the air pollutants, NO 2, SO 2, PM 2.5 and PM 10 are associated with the incidence of allergic rhinitis in Chinese children, and PM 2.5 has the highest correlation with the incidence of it. Some research reports found PM 2.5 could induce oxidative stress and inflammatory response in human nasal epithelial cells, which could lead to rhinitis inflammatory diseases.