Allergy Asthma Immunol Res.  2019 Mar;11(2):156-169. 10.4168/aair.2019.11.2.156.

Increasing Prevalence of Allergic Rhinitis in China

• Zhang Y
• Zhang L

• KMID: 2431849
• DOI: http://doi.org/10.4168/aair.2019.11.2.156

Abstract

Allergic rhinitis (AR) is a critical public health, medical and economic problem in China. AR is also an important risk factor which will cause many diseases or disorders, especially in children. The trend of AR incidence is still on the rise in recent years and has had a significant effect on the general public. This significant increase is alarming, which highlights an urgent need for better understanding of the prevalence status and characteristics, sensitization patterns, and the associated risk factors of AR in order to improve treatment and develop effective prevention strategies.

Keyword

Allergic rhinitis; prevalence; China; asthma; allergen

MeSH Terms

Asthma
Child
China*
Humans
Incidence
Prevalence*
Public Health
Rhinitis, Allergic*
Risk Factors

Figure

• 

  Fig. 1 Comparisons of the prevalence of self-reported AR in 11 major cities in China between 2005 and 2011 according to the study by Wang et al.14 AR, allergic rhinitis.

• 

  Fig. 2 Profile of risk factors influencing AR incidence according to studies in China. AR, allergic rhinitis.

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. Allergic rhinitis: common, costly, and neglected. Lancet. 2008; 371:2057.

3. Meltzer EO, Blaiss MS, Naclerio RM, Stoloff SW, Derebery MJ, Nelson HS, et al. Burden of allergic rhinitis: allergies in America, Latin America, and Asia-Pacific adult surveys. Allergy Asthma Proc. 2012; 33:Suppl 1. S113–S141.

4. Bauchau V, Durham SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J. 2004; 24:758–764.

5. 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.

6. Patil VK, Kurukulaaratchy RJ, Venter C, Grundy J, Roberts G, Dean T, et al. Changing prevalence of wheeze, rhinitis and allergic sensitisation in late childhood: findings from 2 Isle of Wight birth cohorts 12 years apart. Clin Exp Allergy. 2015; 45:1430–1438.

7. Baena-Cagnani CE, Canonica GW, Zaky Helal M, Gómez RM, Compalati E, Zernotti ME, et al. The international survey on the management of allergic rhinitis by physicians and patients (ISMAR). World Allergy Organ J. 2015; 8:10.

8. Zhang Y, Zhang L. Prevalence of allergic rhinitis in china. Allergy Asthma Immunol Res. 2014; 6:105–113.

9. Wang XD, Zheng M, Lou HF, Wang CS, Zhang Y, Bo MY, et al. An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011. Allergy. 2016; 71:1170–1180.

10. D'Amato G, Holgate ST, Pawankar R, Ledford DK, Cecchi L, Al-Ahmad M, et al. Meteorological conditions, climate change, new emerging factors, and asthma and related allergic disorders. A statement of the World Allergy Organization. World Allergy Organ J. 2015; 8:25.

11. D'Amato G, Vitale C, Rosario N, Neto HJ, Chong-Silva DC, Mendonça F, et al. Climate change, allergy and asthma, and the role of tropical forests. World Allergy Organ J. 2017; 10:11.

12. Verlato G, Corsico A, Villani S, Cerveri I, Migliore E, Accordini S, et al. Is the prevalence of adult asthma and allergic rhinitis still increasing? results of an Italian study. J Allergy Clin Immunol. 2003; 111:1232–1238.

13. Zhang L, Han D, Huang D, Wu Y, Dong Z, Xu G, et al. Prevalence of self-reported allergic rhinitis in eleven major cities in China. Int Arch Allergy Immunol. 2009; 149:47–57.

14. Wang XY, Ma TT, Wang XY, Zhuang Y, Wang XD, Ning HY, et al. Prevalence of pollen-induced allergic rhinitis with high pollen exposure in grasslands of Northern China. Allergy. 2018; 73:1232–1243.

15. Li CW, Chen DH, Zhong JT, Lin ZB, Peng H, Lu HG, et al. Epidemiological characterization and risk factors of allergic rhinitis in the general population in Guangzhou city in China. PLoS One. 2014; 9:e114950.

16. Zheng M, Wang X, Bo M, Wang K, Zhao Y, He F, et al. Prevalence of allergic rhinitis among adults in urban and rural areas of china: a population-based cross-sectional survey. Allergy Asthma Immunol Res. 2015; 7:148–157.

17. Tang SP, Liu YL, Wang SB, Weng SF, Chen S, Zhang MJ, et al. Trends in prevalence and risk factors of childhood asthma in Fuzhou, a city in Southeastern China. J Asthma. 2015; 52:10–15.

18. Huang C, Liu W, Hu Y, Zou Z, Zhao Z, Shen L, et al. Updated prevalences of asthma, allergy, and airway symptoms, and a systematic review of trends over time for childhood asthma in Shanghai, China. PLoS One. 2015; 10:e0121577.

19. Li F, Zhou Y, Li S, Jiang F, Jin X, Yan C, et al. Prevalence and risk factors of childhood allergic diseases in eight metropolitan cities in China: a multicenter study. BMC Public Health. 2011; 11:437.

20. Zhao J, Bai J, Shen K, Xiang L, Huang S, Chen A, et al. Self-reported prevalence of childhood allergic diseases in three cities of China: a multicenter study. BMC Public Health. 2010; 10:551.

21. Song Y, Wang M, Xie J, Li W, Zhang X, Wang T, et al. Prevalence of allergic rhinitis among elementary and middle school students in Changsha city and its impact on quality of life. J Laryngol Otol. 2015; 129:1108–1114.

22. Lin MH, Hsieh CJ, Caffrey JL, Lin YS, Wang IJ, Ho WC, et al. Fetal growth, obesity, and atopic disorders in adolescence: a retrospective birth cohort study. Paediatr Perinat Epidemiol. 2015; 29:472–479.

23. He S, Li YJ, Chen J. Clinical features of allergic rhinitis in children of Shanghai, China. Genet Mol Res. 2016; 15:1–13.

24. Yang Z, Zheng W, Yung E, Zhong N, Wong GW, Li J. Frequency of food group consumption and risk of allergic disease and sensitization in schoolchildren in urban and rural China. Clin Exp Allergy. 2015; 45:1823–1832.

25. Hong H, Yang Q, Zuo K, Chen X, Xia W, Lv M, et al. A hospital-based survey on the prevalence of bronchial asthma in patients with allergic rhinitis in Southern China. Am J Rhinol Allergy. 2013; 27:502–505.

26. Su N, Lin J, Liu G, Yin K, Zhou X, Shen H, et al. Asthma with allergic rhinitis management in China: a nationwide survey of respiratory specialists at tertiary hospitals. Int Forum Allergy Rhinol. 2015; 5:221–232.

27. Lin J, Su N, Liu G, Yin K, Zhou X, Shen H, et al. The impact of concomitant allergic rhinitis on asthma control: a cross-sectional nationwide survey in China. J Asthma. 2014; 51:34–43.

28. Li J, Sun B, Huang Y, Lin X, Zhao D, Tan G, et al. A multicentre study assessing the prevalence of sensitizations in patients with asthma and/or rhinitis in China. Allergy. 2009; 64:1083–1092.

29. Que Z, Ran Q, Lin D, Zhang Z, Cai J, Xu Y, et al. Allergen analysis of patients with allergic rhinitis in Quanzhou. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013; 27:1148–1150.

30. Zhao Y, Li W, Di R, Wang J, Hu P, Ji P. Prevalence of sensitization to allergens in 1 139 patients with allergic rhinitis in Zhengzhou area. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014; 49:858–860.

31. Lin H, Lin R, Li N. Sensitization rates for various allergens in children with allergic rhinitis in Qingdao, China. Int J Environ Res Public Health. 2015; 12:10984–10994.

32. Zhang L, Han B, Zhang Z, Liu A, Liu G, Du Z, et al. Skin prick test of inhalative allergens for patients with allergic rhinitis in Yichang. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014; 28:98–101.

33. Zhou J, Yan P, Zhang D, Ren X, Feng Y, Wang W, et al. Preliminary analysis of SPT tests on 5,843 allergic rhinitis patients from South Shanghai area. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014; 28:102–107. 112

34. Wang W, Huang X, Chen Z, Zheng R, Chen Y, Zhang G, et al. Prevalence and trends of sensitisation to aeroallergens in patients with allergic rhinitis in Guangzhou, China: a 10-year retrospective study. BMJ Open. 2016; 6:e011085.

35. Lou H, Ma S, Zhao Y, Cao F, He F, Liu Z, et al. Sensitization patterns and minimum screening panels for aeroallergens in self-reported allergic rhinitis in China. Sci Rep. 2017; 7:9286.

36. Qiu Q, Lu C, Han H, Chen S. Clinical survey and analysis of allergic rhinitis patients' allergens in Guangdong developed and developing regions. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013; 27:928–931.

37. Chen X, Chen J, Wang Q, Zhu H, Li G, Kong W. Analysis on allergen of clinical allergic rhinitis patients in North-west mountain area of Hubei Province. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015; 29:1203–1205.

38. Chan SK, Leung DY. Dog and cat allergies: current state of diagnostic approaches and challenges. Allergy Asthma Immunol Res. 2018; 10:97–105.

39. Douladiris N, Savvatianos S, Roumpedaki I, Skevaki C, Mitsias D, Papadopoulos NG. A molecular diagnostic algorithm to guide pollen immunotherapy in Southern Europe: towards component-resolved management of allergic diseases. Int Arch Allergy Immunol. 2013; 162:163–172.

40. Valenta R, Lidholm J, Niederberger V, Hayek B, Kraft D, Grönlund H. The recombinant allergen-based concept of component-resolved diagnostics and immunotherapy (CRD and CRIT). Clin Exp Allergy. 1999; 29:896–904.

41. Luo W, Huang H, Zheng P, Wei N, Luo J, Sun B, et al. Major grass pollen allergens and components detected in a Southern Chinese cohort of patients with allergic rhinitis and/or asthma. Mol Immunol. 2016; 78:105–112.

42. Chan TF, Ji KM, Yim AK, Liu XY, Zhou JW, Li RQ, et al. The draft genome, transcriptome, and microbiome of Dermatophagoides farinae reveal a broad spectrum of dust mite allergens. J Allergy Clin Immunol. 2015; 135:539–548.

43. Ma L, Chen DL, Zhang RX, Wang XL, Shi YJ, Ji C, et al. Genetic epidemiological study on allergic rhinitis in Nantong region of Jiangsu Province. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2007; 42:643–646.

44. Li Y, Jiang Y, Li S, Shen X, Liu J, Jiang F. Pre- and postnatal risk factors in relation to allergic rhinitis in school-aged children in China. PLoS One. 2015; 10:e0114022.

45. Wang X, Liu W, Hu Y, Zou Z, Shen L, Huang C. Home environment, lifestyles behaviors, and rhinitis in childhood. Int J Hyg Environ Health. 2016; 219:220–231.

46. Hsieh VC, Liu CC, Hsiao YC, Wu TN. Risk of allergic rhinitis, allergic conjunctivitis, and eczema in children born to mothers with gum inflammation during pregnancy. PLoS One. 2016; 11:e0156185.

47. Wei CC, Lin CL, Shen TC, Sung FC. Occurrence of common allergic diseases in children with idiopathic nephrotic syndrome. J Epidemiol. 2015; 25:370–377.

48. Lin CH, Lin WC, Wang YC, Lin IC, Kao CH. Association between neonatal urinary tract infection and risk of childhood allergic rhinitis. Medicine (Baltimore). 2015; 94:e1625.

49. Lin WY, Muo CH, Ku YC, Sung FC, Kao CH. Increased association between febrile convulsion and allergic rhinitis in children: a nationwide population-based retrospective cohort study. Pediatr Neurol. 2014; 50:329–333.

50. Ma R, Shen Y, Hou L, Yang Z, Feng N, Yan X, et al. The correlation of allergic rhinitis and trace elements in Ningxia region. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014; 49:1017–1020.

51. Lei Y, Yang H, Zhen L. Obesity is a risk factor for allergic rhinitis in children of Wuhan (China). Asia Pac Allergy. 2016; 6:101–104.

52. Wang J, Li B, Yu W, Yang Q, Wang H, Huang D, et al. Rhinitis symptoms and asthma among parents of preschool children in relation to the home environment in Chongqing, China. PLoS One. 2014; 9:e94731.

53. Dong GH, Qian ZM, Wang J, Trevathan E, Ma W, Chen W, et al. Residential characteristics and household risk factors and respiratory diseases in Chinese women: the Seven Northeast Cities (SNEC) study. Sci Total Environ. 2013; 463-464:389–394.

54. Huang SK, Zhang Q, Qiu Z, Chung KF. Mechanistic impact of outdoor air pollution on asthma and allergic diseases. J Thorac Dis. 2015; 7:23–33.

55. D'Amato G, Vitale C, Lanza M, Molino A, D'Amato M. Climate change, air pollution, and allergic respiratory diseases: an update. Curr Opin Allergy Clin Immunol. 2016; 16:434–440.

56. D'Amato G, Cecchi L, D'Amato M, Annesi-Maesano I. Climate change and respiratory diseases. Eur Respir Rev. 2014; 23:161–169.

57. Deng Q, Lu C, Yu Y, Li Y, Sundell J, Norbäck D. Early life exposure to traffic-related air pollution and allergic rhinitis in preschool children. Respir Med. 2016; 121:67–73.

58. Deng Q, Lu C, Ou C, Chen L, Yuan H. Preconceptional, prenatal and postnatal exposure to outdoor and indoor environmental factors on allergic diseases/symptoms in preschool children. Chemosphere. 2016; 152:459–467.

59. Deng Q, Lu C, Li Y, Sundell J, Dan Norbäck . Exposure to outdoor air pollution during trimesters of pregnancy and childhood asthma, allergic rhinitis, and eczema. Environ Res. 2016; 150:119–127.

60. Lam A, Wong GW, Poon CM, Lee SS. A GIS-based assessment of environmental influences on allergy development in children. Asia Pac J Public Health. 2014; 26:575–587.

61. Ouyang Y, Xu Z, Fan E, Li Y, Zhang L. Effect of nitrogen dioxide and sulfur dioxide on viability and morphology of oak pollen. Int Forum Allergy Rhinol. 2016; 6:95–100.

62. Pau BC, Ng DK. Prevalence of otitis media with effusion in children with allergic rhinitis, a cross sectional study. Int J Pediatr Otorhinolaryngol. 2016; 84:156–160.

63. Hwang CY, Hwang YY, Chen YJ, Chen CC, Lin MW, Chen TJ, et al. Atopic diathesis in patients with Kawasaki disease. J Pediatr. 2013; 163:811–815.

64. Chiang MR, Wei CC, Muo CS, Fu LS, Li TC, Kao CH. Association of primary immune thrombocytopenia and common allergic diseases among children. Pediatr Res. 2015; 77:597–601.

65. Wang IC, Tsai JD, Lin CL, Shen TC, Li TC, Wei CC. Allergic rhinitis and associated risk of migraine among children: a nationwide population-based cohort study. Int Forum Allergy Rhinol. 2016; 6:322–327.

66. Lin YT, Chen YC, Gau SS, Yeh TH, Fan HY, Hwang YY, et al. Associations between allergic diseases and attention deficit hyperactivity/oppositional defiant disorders in children. Pediatr Res. 2016; 80:480–485.

67. Cai XH, Xie YP, Li XC, Qu WL, Li T, Wang HX, et al. The prevalence and associated risk factors of sleep disorder-related symptoms in pregnant women in China. Sleep Breath. 2013; 17:951–956.

68. Xi L, Cao F, Zhang Y, Zhang L. Severity of nasal obstruction can predict the anxiety status of patients with allergic rhinitis but not patients with vasomotor rhinitis. Int Forum Allergy Rhinol. 2016; 6:1196–1203.

69. Cheng L, Chen J, Fu Q, He S, Li H, Liu Z, et al. Chinese society of allergy guidelines for diagnosis and treatment of allergic rhinitis. Allergy Asthma Immunol Res. 2018; 10:300–353.

70. Ouyang Y, Li J, Zhang D, Fan E, Li Y, Zhang L. A model to predict the incidence of allergic rhinitis based on meteorological factors. Sci Rep. 2017; 7:10006.