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Impact of Air Pollution on Allergic Rhinitis and Asthma: Consensus Statement by Indian Academy of Pediatrics
K R Bharath Kumar Reddy1, Neeraj Gupta2, Barnali G Bhattacharya3
1Department of Paediatric Pulmonology and Sleep, Shishuka Children's Hospital, Bangalore, Karnataka. Correspondence to: Dr KR Bharath Kumar Reddy, Shishuka Children's Hospital, Kalyan Nagar, HRBR Layout, Bengalure, Karnataka 560 043. drbharathreddykr@gmail.com.
Insights
Air pollution significantly contributes to pediatric respiratory allergies like asthma. Understanding pollutant effects and implementing community, physician, and individual strategies are crucial for prevention and reducing the allergy burden.
Area of Science:
- Environmental Health
- Pediatric Allergy
- Pulmonology
Background:
- Rising air pollution poses a significant threat to human health, particularly impacting children with respiratory allergies.
- Poor air quality is strongly linked to allergic rhinitis and asthma, with a notable increase in pediatric cases.
- There is a need for a clearer understanding of how common air pollutants affect allergic respiratory diseases.
Purpose of the Study:
- To develop a consensus statement for healthcare professionals on the impact of air pollution on pediatric respiratory allergies.
- To provide guidance on the prevention and management of allergies exacerbated by air pollution.
- To enhance understanding among pediatricians and general practitioners regarding the relationship between air quality and allergic conditions.
Main Methods:
- A panel of pediatric pulmonologists and allergy specialists from India was convened by the Indian Academy of Pediatrics (IAP).
- A consensus statement was formulated through virtual meetings, literature review, and expert discussions.
- The document underwent review and approval by IAP representatives and environmental chapter experts.
Main Results:
- Air pollution is identified as an emerging cause of respiratory allergies through mechanisms like oxidative stress and impaired mucociliary clearance.
- Children are particularly susceptible to both indoor and outdoor air pollution due to physiological factors.
- Understanding pollutant particle size and air quality index aids in assessing airway involvement.
Conclusions:
- A comprehensive approach integrating environmental history with pharmacological treatments is necessary for managing challenging allergic rhinitis and asthma cases.
- Multi-level interventions targeting the community, physicians, and individuals are essential to mitigate the impact of air pollution on respiratory health.
- Improving air quality is vital to reduce the economic and psychological burden associated with respiratory allergies.
Justification:
Rising air pollution is an ever-growing threat to many human diseases. Poor air quality has been directly correlated with respiratory allergies with a disproportionate affection among the pediatric age group. A clear understanding of common air pollutants and their potential contribution in allergic rhinitis and asthma is lacking.
Objective:
To formulate a consensus statement for appropriate understanding among pediatricians and general practitioners about the effects of air pollution on respiratory allergies and their prevention.
Process:
A group of experts (Pediatric pulmonologists and allergy specialists) from across India were appointed by the Indian Academy of Pediatrics (IAP) to formulate a consensus statement on 'Allergy and Air pollution'. A virtual meeting was conducted on 6th April 2020 to discuss in detail regarding various issues related to the subject and a writing committee was formed with broad consensus. After extensive literature review and multiple virtual sessions, the current document was prepared and circulated via email to the representatives from central IAP and IAP environment chapter. All the experts approved the consensus with minor modifications after a detailed discussion on 29th September 2020 on a virtual platform.
Recommendations:
Air pollution is the emerging contributor to respiratory allergies due to various mechanisms including oxidative stress and compromised mucociliary clearance. Children are more vulnerable to both outdoor and indoor pollution, due to their unique physiological characteristics. Knowledge about pollutant particle size and air quality index will help in demarcating level and extent of airway involvement. Relevant environmental history in difficult allergic rhinitis and asthma cases, along with conventional pharmacological measures, is warranted. Multipronged approach, targeted at community, physician and individual levels, needs to be emphasized to improve air quality and reduce economic and psychological burden of respiratory allergies.
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