Air Pollution Exposure Affects Severity and Cellular Endotype of Chronic Rhinosinusitis With Nasal Polyps

Air pollution has emerged as an important environmental risk factor for chronic rhinosinusitis (CRS) progression. This study assessed exposure to five types of air pollution (PM_2.5/10 , SO₂ , NO₂ , CO, O₃ ) and explored their effects on CRS with nasal polyps (CRSwNP) severity and endotype.

Retrospective cohort study.

Air pollution data from monitoring sites in Beijing were obtained to assess individual air pollution exposure. Outcomes of CRSwNP (n = 282) including Lund-Mackay (L-M) score, Lund-Kennedy (L-K) score, visual analogue scale (VAS) score and nasal patency/airflow resistance and so on were measured to analyze correlations with air pollution and compare groups with different exposure types. Multivariable-adjusted binary logistic regression was used to determine potential air pollution risk factors of the endotype of eosinophilic CRSwNP (ECRSwNP).

Short-term exposures to PM_2.5/10 , SO₂ , CO, NO₂ , and O₃ were weak but significantly associated with increased L-M scores. Short-term exposures to PM₁₀ , CO, and NO₂ were correlated with increased VAS headache/facial pain scores. The L-M scores of the group of the highest PM_2.5 (≥150 μg/m³ ) exposure were significantly higher than those of control group. For each increased unit of the average concentration of PM_2.5 , there was a 1.047-fold (95% confidence interval, 1.005-1.091) increased risk of the endotype of ECRSwNP.

Air pollution exposure exacerbated CRSwNP severity and PM_2.5 could be a risk factor for endotype of ECRSwNP, suggesting the role of air pollution in CRSwNP pathogenesis.

4 Laryngoscope, 132:2103-2110, 2022.