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Rhinoconjunctivitis in 5-year-old children: a population-based birth cohort study
1University of Manchester, Academic Division of Medicine and Surgery, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.
Insights
This study found that family history of allergies and sensitization to allergens are key risk factors for rhinoconjunctivitis in young children. In preschool children, rhinoconjunctivitis does not impact wheeze severity or lung function.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Epidemiology
Background:
- Limited data exists on rhinitis prevalence, risk factors, and natural history in early childhood.
- Rhinitis and rhinoconjunctivitis are common conditions with potential long-term health implications.
Purpose of the Study:
- To investigate the prevalence and risk factors of current rhinoconjunctivitis (CRC) at age 5 years within a whole-population birth cohort.
- To identify associations between CRC and other allergic diseases and respiratory outcomes.
Main Methods:
- Prospective follow-up of a birth cohort to age 5 years, utilizing questionnaires, skin testing, specific immunoglobulin E measurements, lung function tests, and dry air challenges.
- Quantification of endotoxin and allergen exposures from dust samples.
Main Results:
- The prevalence of rhinitis ever, current rhinitis, and CRC was 28.2%, 26.1%, and 12.1%, respectively.
- Maternal asthma, paternal hay fever, and sensitization to grass and cat allergens were significant independent risk factors for CRC.
- CRC coexisted with asthma, wheeze, and eczema, but did not affect wheeze severity or lung function in preschool children.
Conclusions:
- Family history of allergic disease and sensitization to inhalant allergens are significant risk factors for rhinoconjunctivitis in preschool children.
- In this age group, rhinoconjunctivitis is not associated with increased wheeze severity, airway reactivity, or reduced lung function.
Background:
There is a paucity of data on the prevalence, risk factors and natural history of rhinitis in early childhood.
Objective:
Within the context of a whole-population birth cohort we investigated the prevalence of and risk factors for current rhinoconjunctivitis (CRC) at age 5 years.
Methods:
Children were followed prospectively to age 5 years [questionnaires (n = 815), skin testing (n = 717), specific immunoglobulin E (n = 478), lung function (n = 711), dry air challenge (n = 556)]. Endotoxin and allergen exposures were measured in dust samples.
Results:
The prevalence of rhinitis ever, current rhinitis and rhinoconjunctivitis was 28.2%, 26.1%, and 12.1%, respectively. Asthma, wheeze and eczema coexisted with CRC (P < or = 0.01). In a multivariate model, maternal asthma (OR 2.38, 95% CI: 1.30-4.38, P = 0.005), paternal hay fever (1.96, 1.11-3.46, P = 0.02) and sensitization to grass (3.46, 1.86-6.42, P < 0.001) and cat (2.42, 1.14-5.18, P = 0.02) remained significant and independent associates of CRC. Whilst almost half of children with CRC were nonatopic, there was little difference in risk factors between atopic and nonatopic CRC. Amongst children with current wheeze, the presence of concurrent CRC had no effect on either severity or frequency of wheezy episodes. There was no difference in specific airway resistance, forced expiratory volume in 1 second (FEV(1)) or airway reactivity between children with and without CRC after adjustment for the presence of wheeze.
Conclusion:
Family history of allergic disease and sensitization to inhalant allergens are risk factors for rhinoconjunctivitis in preschool children. In this age group, there is no association between the presence of rhinoconjunctivitis and severity of wheeze, increased airway reactivity and reduced lung function.
