Pediatr Allergy Respir Dis.  2012 Mar;22(1):100-109.

The Social and Environmental Risk Factors of Allergic Rhinitis in Children

• Ahn SH
• Lee HY
• Song YE
• Park SY
• Lim DH
• Kim JH
• Son BK

Abstract

PURPOSE
We investigated the risk factors related to the development and aggravation of allergic rhinitis, which is associated with residential environment and lifestyle habits of children residing in Incheon.
METHODS
A total of 182 children diagnosed with moderate to severe allergic rhinitis and 67 healthy children were enrolled. A detailed questionnaire of the environmental characteristics and the dietary habits were completed by the parents. Further, skin prick tests with 14 common allergens were performed.
RESULTS
The mean age of the children with allergic rhinitis and healthy control was 8.2+/-2.8 and 9.4+/-2.0 years, respectively. The presence of indoor mold was associated with an increased risk of development of allergic rhinitis. (adjusted odds ratio [aOR], 4.26; 95% confidence interval [CI], 1.96-9.27) Among the food groups, there was no significant difference of the daily intake of milk and yogurt between the patients and the controls. However, daily intake of vegetables, except Kimchi, and daily intake of fruits or fruit juice were associated with a decreased risk of allergic rhinitis. (aOR, 0.43; 95% CI, 0.20-0.92 / aOR, 0.43; 95% CI, 0.13-0.90, respectively)
CONCLUSION
The results indicate that an indoor dampness is one of the risk factors of development and aggravation of allergic rhinitis. Control of indoor humidity and daily intake of fruits and vegetables can prevent the development and control symptoms of allergic rhinitis.

Keyword

Allergic rhinitis; Risk factors; Diet; Mold; Vegetable; Fruit; Children

MeSH Terms

Allergens
Child
Diet
Food Habits
Fruit
Fungi
Humans
Humidity
Life Style
Milk
Odds Ratio
Parents
Surveys and Questionnaires
Rhinitis
Rhinitis, Allergic, Perennial
Risk Factors
Skin
Vegetables
Yogurt
Allergens

Reference

1. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008. 63:Suppl 86. 8–160.

2. Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006. 368:733–743.

3. Hong SJ, Ahn KM, Lee SY, Kim KE. The prevalences of asthma and allergic diseases in Korean children. Pediatr Allergy Respir Dis. 2008. 18:15–25. (Korea).

4. Jee HM, Kim KW, Kim CS, Sohn MH, Shin DC, Kim KE. Prevalence of asthma, rhinitis and eczema in Korean children using the International Study of Asthma and Allergies in Childhood (ISAAC) Questionnaires. Pediatr Allergy Respir Dis. 2009. 19:165–172. (Korea).

5. Ahn K, Kim J, Kwon HJ, Chae Y, Hahm MI, Lee KJ, et al. The prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in Korean children: Nationwide cross-sectional survey using complex sampling design. J Korean Med Assoc. 2011. 54:769–778.

6. Selçuk ZT, Caglar T, Enünlü T, Topal T. The prevalence of allergic diseases in primary school children in Edirne, Turkey. Clin Exp Allergy. 1997. 27:262–269.

7. Seltzer JM, Fedoruk MJ. Health effects of mold in children. Pediatr Clin North Am. 2007. 54:309–333. viii–ix.

8. Kim JL, Elfman L, Mi Y, Wieslander G, Smedje G, Norbäck D. Indoor molds, bacteria, microbial volatile organic compounds and plasticizers in schools: associations with asthma and respiratory symptoms in pupils. Indoor Air. 2007. 17:153–163.

9. Santilli J. Health effects of mold exposure in public schools. Curr Allergy Asthma Rep. 2002. 2:460–467.

10. Garrett MH, Rayment PR, Hooper MA, Abramson MJ, Hooper BM. Indoor airborne fungal spores, house dampness and associations with environmental factors and respiratory health in children. Clin Exp Allergy. 1998. 28:459–467.

11. Strachan DP, Flannigan B, McCabe EM, McGarry F. Quantification of airborne moulds in the homes of children with and without wheeze. Thorax. 1990. 45:382–387.

12. Celtik C, Okten S, Okutan O, Aydogdu H, Bostancioglu M, Ekuklu G, et al. Investigation of indoor molds and allergic diseases in public primary schools in Edirne city of Turkey. Asian Pac J Allergy Immunol. 2011. 29:42–49.

13. Talay F, Kurt B, Tug T, Yilmaz F, Goksugur N. Prevalence and risk factors of asthma and allergic diseases among schoolchildren in Bolu, Turkey. Acta Paediatr. 2008. 97:459–462.

14. Demir AU, Karakaya G, Bozkurt B, Sekerel BE, Kalyoncu AF. Asthma and allergic diseases in schoolchildren: third cross-sectional survey in the same primary school in Ankara, Turkey. Pediatr Allergy Immunol. 2004. 15:531–538.

15. Lee SI, Shin MH, Lee HB, Lee JS, Son BK, Koh YY, et al. Prevalences of symptoms of asthma and other allergic diseases in Korean children: a nationwide questionnaire survey. J Korean Med Sci. 2001. 16:155–164.

16. Kwon JW, Seo JH, Yu J, Kim BJ, Kim HB, Lee SY, et al. Relationship between the prevalence of allergic rhinitis and allergen sensitization in children of Songpa area, Seoul. Pediatr Allergy Respir Dis. 2011. 21:47–55. (Korea).

17. Nam SY, Yoon HS, Kim WK. Prevalence of allergic disease in kindergarten age children in Korea. Pediatr Allergy Respir Dis. 2005. 15:439–445. (Korea).

18. Kim YH, Urm SH, Kim WK. Prevalence of allergic diseases and risk factors in preschool children, 2009. Pediatr Allergy Respir Dis. 2011. 21:165–175. (Korea).

19. Randriamanantany ZA, Annesi-Maesano I, Moreau D, Raherison C, Charpin D, Kopferschmitt C, et al. Alternaria sensitization and allergic rhinitis with or without asthma in the French Six Cities study. Allergy. 2010. 65:368–375.

20. Green BJ, Schmechel D, Sercombe JK, Tovey ER. Enumeration and detection of aerosolized Aspergillus fumigatus and Penicillium chrysogenum conidia and hyphae using a novel double immunostaining technique. J Immunol Methods. 2005. 307:127–134.

21. Downs SH, Mitakakis TZ, Marks GB, Car NG, Belousova EG, Leüppi JD, et al. Clinical importance of Alternaria exposure in children. Am J Respir Crit Care Med. 2001. 164:455–459.

22. Zureik M, Neukirch C, Leynaert B, Liard R, Bousquet J, Neukirch F, et al. Sensitisation to airborne moulds and severity of asthma: cross sectional study from European Community respiratory health survey. BMJ. 2002. 325:411–414.

23. O'Hollaren MT, Yunginger JW, Offord KP, Somers MJ, O'Connell EJ, Ballard DJ, et al. Exposure to an aeroallergen as a possible precipitating factor in respiratory arrest in young patients with asthma. N Engl J Med. 1991. 324:359–363.

24. Green BJ, O'Meara T, Sercombe J, Tovey E. Measurement of personal exposure to outdoor aeromycota in northern New South Wales, Australia. Ann Agric Environ Med. 2006. 13:225–234.

25. Driessen MN, Quanjer PH. Pollen deposition in intrathoracic airways. Eur Respir J. 1991. 4:359–363.

26. de Ana SG, Torres-Rodríguez JM, Ramírez EA, García SM, Belmonte-Soler J. Seasonal distribution of Alternaria, Aspergillus, Cladosporium and Penicillium species isolated in homes of fungal allergic patients. J Investig Allergol Clin Immunol. 2006. 16:357–363.

27. Bergamini BM, Grillenzoni S, Andreoni AD, Natali P, Ranzi A, Bertolani MF. Alternaria spores at different heights from the ground. Allergy. 2004. 59:746–752.

28. Kimber I. Allergy, asthma and the environment: an introduction. Toxicol Lett. 1998. 102-103:301–306.

29. Fogarty A, Britton J. The role of diet in the aetiology of asthma. Clin Exp Allergy. 2000. 30:615–627.

30. Ellwood P, Asher MI, Björkstén B, Burr M, Pearce N, Robertson CF. Diet and asthma, allergic rhinoconjunctivitis and atopic eczema symptom prevalence: an ecological analysis of the International Study of Asthma and Allergies in Childhood (ISAAC) data. ISAAC Phase One Study Group. Eur Respir J. 2001. 17:436–443.

31. Wong GW, Ko FW, Hui DS, Fok TF, Carr D, von Mutius E, et al. Factors associated with difference in prevalence of asthma in children from three cities in China: multicentre epidemiological survey. BMJ. 2004. 329:486.

32. Woods RK, Walters EH, Raven JM, Wolfe R, Ireland PD, Thien FC, et al. Food and nutrient intakes and asthma risk in young adults. Am J Clin Nutr. 2003. 78:414–421.

33. Shaheen SO, Sterne JA, Thompson RL, Songhurst CE, Margetts BM, Burney PG. Dietary antioxidants and asthma in adults: population-based case-control study. Am J Respir Crit Care Med. 2001. 164(10 Pt 1):1823–1828.

34. Hodge L, Salome CM, Peat JK, Haby MM, Xuan W, Woolcock AJ. Consumption of oily fish and childhood asthma risk. Med J Aust. 1996. 164:137–140.

35. Thien FC, Woods RK, Walters EH. Oily fish and asthma: a fishy story? Further studies are required before claims can be made of a beneficial effect of oily fish consumption on asthma. Med J Aust. 1996. 164:135–136.

36. Schwartz J. Role of polyunsaturated fatty acids in lung disease. Am J Clin Nutr. 2000. 71:1 Suppl. 393S–396S.

37. Troisi RJ, Willett WC, Weiss ST, Trichopoulos D, Rosner B, Speizer FE. A prospective study of diet and adult-onset asthma. Am J Respir Crit Care Med. 1995. 151:1401–1408.

38. Monteleone CA, Sherman AR. Nutrition and asthma. Arch Intern Med. 1997. 157:23–34.