Assessing the cold temperature effect on hospital visit by allergic rhinitis in Seoul, Korea

The association between temperature and health outcome has been studied in worldwide. However, studies for mild diseases such as AR, with high prevalence and considerable economic burden, are lacking compared to other relatively severe respiratory diseases. We aimed to assess the trend of hospital visit by AR and estimate the cold temperature effect on hospital visit by allergic rhinitis in Seoul, Korea, 2003-2011. We fitted generalized additive model with quasi-poisson distribution, controlling for humidity, long-term trend, day of week, national holiday, and influenza epidemic. We estimated the cumulative cold temperature effect (10%, -1.7°C) referent to 7.9°C for the considered lag periods using distributed lag non-linear model: vary from the day of hospital visit to 10days before. Stratified analysis by season was also conducted. To adjust for possible confounding effect of air pollutants, we additionally adjusted for PM₁₀, O₃ and NO₂ respectively. Hospital visit counts and rates per 1,000,000 show increasing trend especially in elderly population (over 65years). Hospital visit rate is higher in children population (age<13years). Statistically significant cold temperature effects were found in the total (1.094(95%CI: 1.037, 1.153)), male (1.100 (95%CI: 1.010, 1.163)), female (1.088 (95%CI: 1.059, 1.170)) and adult (1.113 (95%CI: 1.059, 1.170)) population with consideration of 3-day lag period. In the stratified analysis by the season, the strongest effect was shown in the autumn (Sep-Nov) season. Confounding effects by air pollutants were not found. In this study, we found significant increasing trend of hospital visit by AR. This study provides suggestive evidence of cold temperature effect on hospital visit by AR. To reduce the growing burden of AR, it is important to find possible related environmental risk factors. More studies should be conducted for better understanding of temperature effect on AR.