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Inter-Relationship between Rhinitis and Conjunctivitis in Allergic Rhinoconjunctivitis and Associated Risk Factors in
Michael R Perkin1, Tara Bader1, Alicja R Rudnicka1
1Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, United Kingdom.
Insights
Children living on farms show reduced risks of allergic conjunctivitis and allergic rhinitis. Exposure to farm environments and animals appears to offer protection against these common childhood allergies.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Epidemiology
- Ophthalmology
Background:
- Allergic conjunctivitis (AC) and allergic rhinitis (AR) are prevalent in children, but their co-occurrence and independent risk factors are not well understood.
- Understanding the relationship between these allergic conditions is crucial for effective management and prevention strategies.
Purpose of the Study:
- To investigate the interrelationship between allergic rhinitis and conjunctivitis in children.
- To identify epidemiological risk factors associated with these conditions in a rural UK population.
Main Methods:
- A cross-sectional study involving rural school children aged 5-11 years.
- Parental questionnaires collected data on allergic outcomes, atopic history, and environmental exposures.
- Statistical analysis (odds ratios) adjusted for potential confounders.
Main Results:
- Prevalence rates: conjunctivitis (17.5%), rhinitis (15.1%), and rhinoconjunctivitis (13.0%).
- Living on a farm significantly reduced the risk of conjunctivitis, rhinitis, and rhinoconjunctivitis.
- Early-life exposure to farm animals, unpasteurized milk, and farm environments (barns/stables) were associated with reduced allergy risk.
Conclusions:
- Parent-reported conjunctivitis was more common than rhinitis in this cohort.
- Most children with AC or AR reported symptoms of the other condition, suggesting a strong link.
- Farm-associated environmental factors, particularly microbial exposures, likely mediate a protective effect against allergic eye and nasal symptoms.
Objective:
Allergic conjunctivitis (AC) is a common condition, especially in childhood. The extent to which it occurs concurrently with or independently from allergic rhinitis (AR) has not been well described.
Aim:
To examine the inter-relationship between rhinitis and conjunctivitis and the epidemiological risk factors for these conditions in a rural UK population.
Methods:
Cross-sectional study of rural school children (aged 5-11 years). Parental questionnaires were used to diagnose allergic outcomes (including conjunctivitis, rhinitis and rhinoconjunctivitis), and to collect data on atopic history, demographic and environmental exposures. Odds ratios of allergic outcome by exposure were examined adjusted for age, sex, breastfeeding, family history of allergy, number of older and younger siblings.
Results:
Prevalence of conjunctivitis was 17.5%, rhinitis 15.1% and rhinoconjunctivitis 13.0%. Seasonality of symptoms varied by condition: 64.7% of those with conjunctivitis had seasonal symptoms (April-Sept only), 46.7% of those with rhinitis and 92.2% of those with rhinoconjunctivitis. Living on a farm consistently reduced the risk of conjunctivitis (odds ratio 0.47, 95%CI 0.29-0.79, p = 0.004), rhinitis (OR 0.57, 95%CI 0.33-1.01, p = 0.05) and rhinoconjunctivitis (OR 0.57, 95%CI 0.32-1.03, p = 0.06). Exposure to farm animals (particularly in early life), current consumption of unpasteurised milk and playing in a barn or stable significantly reduced the risk of all three conditions.
Conclusion:
More children had parent-reported conjunctivitis than rhinitis. The majority of children with either condition also reported symptoms with the other condition. Farmers' children have less eye and/or nasal symptoms. A number of farming variables linked with the farm microbial environment are likely to be mediating the protective effect.
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