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Factors associated with the severity of childhood rhinoconjunctivitis
Koichi Yoshida1, Mari Sasaki1, Yuichi Adachi2
1Division of Allergy, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Insights
High pollen and eczema increase childhood allergic rhinitis severity. Maternal allergies are a risk factor, but early pet exposure may be protective against severe symptoms.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Epidemiology
Background:
- Allergic rhinitis is a prevalent chronic childhood disease impacting quality of life.
- Factors influencing allergic rhinitis severity in children are not well understood.
- This study investigates determinants of rhinoconjunctivitis severity in a general pediatric population.
Purpose of the Study:
- To identify environmental and familial factors associated with severe rhinoconjunctivitis in children.
- To assess the role of comorbidities and early-life exposures in symptom severity.
- To provide insights for managing and preventing severe allergic rhinitis in pediatric populations.
Main Methods:
- A large-scale online survey of parents of children aged 6-12 years was conducted.
- The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was adapted to assess rhinoconjunctivitis and symptom severity.
- Severity was defined by the degree of daily life impairment caused by symptoms.
Main Results:
- Rhinoconjunctivitis affected 19.4% of 26,725 children; 13.3% of these had severe symptoms.
- High cedar/cypress pollen areas and concurrent eczema were linked to increased severity.
- Maternal history of asthma/allergic rhinitis increased risk, while early pet exposure showed a protective effect.
Conclusions:
- Environmental exposures (pollen, pets) significantly influence rhinoconjunctivitis severity.
- Comorbidities like eczema and maternal allergic history are key risk factors.
- Early-life pet exposure may offer protection against severe pediatric allergic rhinitis.
Background:
Allergic rhinitis is one of the most common chronic diseases in children. Although it has a large impact on the patient's quality of life, little is known about the factors associated with its severity. The aim of this study was to assess the factors associated with the severity of rhinoconjunctivitis among children in the general population.
Methods:
A survey was conducted using an online research panel in 2012. Parents were asked to answer an International Study of Asthma and Allergies in Childhood-based questionnaire to identify children with current rhinoconjunctivitis and evaluate factors associated with the severity of its symptoms. Severity was rated according to the degree of impairment caused by the symptoms in the patient's daily life.
Results:
Among 26,725 children aged 6-12 years old, rhinoconjunctivitis was defined in 5175 (19.4%), and of these, 688 children (13.3% of children with current rhinoconjunctivitis) presented severe symptoms. Living in areas with a high cedar and cypress pollen count and having concurrent eczema were associated with severe rhinoconjunctivitis [adjusted OR (95% CI): 1.21 (1.00-1.46) and 1.45 (1.20-1.75), respectively]. Further, a maternal history of asthma and allergic rhinitis was a significant risk factor for severe rhinoconjunctivitis [1.34 (1.04-1.74) and 1.30 (1.10-1.53), respectively]. However, living with fur-bearing animals (pets) before 1 year of age proved to be a protective factor against severe rhinoconjunctivitis [0.70 (0.52-0.94)].
Conclusions:
Environmental factors such as pets and pollen, together with comorbidities and a maternal history of allergic diseases, play an important role in determining the severity of rhinoconjunctivitis.
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