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Rhinitis in 10-year-old children and early life risk factors for its development
S H Arshad1, R J Kurukulaaratchy, M Fenn
1The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport, Isle of Wight, UK. sha@soton.ac.uk
Insights
Childhood rhinitis is common by age 10, strongly linked to allergies and asthma. Genetic factors, like parental rhinitis and atopy, play a significant role in its development.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Epidemiology
Background:
- Childhood rhinitis is a prevalent condition with significant health implications.
- Understanding its characteristics and risk factors is crucial for effective management.
Purpose of the Study:
- To determine the prevalence, clinical features, and risk factors associated with childhood rhinitis.
- To investigate the relationship between rhinitis and allergic conditions, asthma, and bronchial hyperresponsiveness in children.
Main Methods:
- A population-based birth cohort study involving 1,456 children.
- Standardized questionnaires, skin-prick testing, serum IgE screening, and methacholine bronchial challenges were administered at age 10.
Main Results:
- Rhinitis prevalence was 22.6% at age 10, often seasonal and requiring treatment.
- Rhinitis was significantly associated with atopy, wheezing, asthma, and bronchial hyperresponsiveness.
- Key risk factors included childhood atopy, eczema, and parental history of rhinitis or maternal food allergy.
Conclusions:
- Childhood rhinitis is common and strongly associated with atopy, asthma, and airway hyperresponsiveness.
- Genetic predisposition, particularly atopy, appears to be a primary driver in the etiology of childhood rhinitis.
Aim:
To study the prevalence, characteristics of and risk factors for childhood rhinitis.
Methods:
In a whole population birth cohort study (n = 1,456) the prevalence and characteristics of rhinitis among 10-y-old children were examined. At this age 1373 children (94%) completed standardized questionnaires, 1,043 (72%) skin-prick testing, 953 (65%) serum inhalant immunoglobulin E antibody screening and 784 (54%) methacholine bronchial challenges.
Results:
At the age of 10 y the prevalence of hayfever ever was 18.6% and current nasal symptoms (rhinitis) 22.6%. Rhinitis at 10 y was largely seasonal and associated with low morbidity, although 62.7% of cases required pharmacological treatment. Atopy (positive skin test) and other allergic states were associated with rhinitis (p < 0.001). Wheeze or diagnosed asthma was higher with coexistent rhinitis. Among wheezing children physician-diagnosed asthma (p < 0.024) and inhaled corticosteroid use (p < 0.001) were greater with the presence of rhinitis. Significant bronchial hyperresponsiveness (methacholine concentration giving a 20% fall in forced expiratory volume in I s <4.0 mg ml(-1)) was greater if rhinitis was present even when the child did not wheeze (p < 0.001). Risk factor analysis for rhinitis identified the independent significance for atopy (p < 0.001) and eczema (p = 0.009) at the age of 4 y plus paternal rhinitis (p < 0.001), maternal rhinitis (p = 0.033) and maternal food allergy (p = 0.016).
Conclusion:
Rhinitis is common at the age of 10 y, with strong associations with atopy, wheezing, asthma and bronchial hyperresponsiveness. An inherited predisposition towards atopy appears to predominate over environment in the aetiology of this state.