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Children With Food Allergy Are at Risk of Lower Lung Function on High-Pollen Days
N Sabrina Idrose1, Don Vicendese2, Rachel L Peters3
1Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia.
Insights
Grass pollen exposure negatively impacts lung function and increases airway responsiveness in children with allergic diseases, particularly those with food allergies. Proactive management is crucial before high pollen days to protect susceptible children.
Area of Science:
- Environmental Health
- Pediatric Allergy
- Respiratory Medicine
Background:
- Childhood asthma hospitalizations are linked to grass pollen exposure.
- Short-term effects of grass pollen on lung function in children with allergies are understudied.
Purpose of the Study:
- To investigate the association between grass pollen concentration and lung function in children.
- To examine if allergic conditions modify this association.
Main Methods:
- Spirometry was performed by 641 children during grass pollen season.
- Grass pollen concentrations were analyzed at various lags (0-3 days) and cumulatively.
- Linear regression assessed associations and interactions with asthma, hay fever, eczema, and food allergy.
Main Results:
- Significant associations were found only in children with allergic diseases (P interaction ≤ 0.1).
- In children with food allergy, increased pollen correlated with lower FEV1/FVC and FEF25%-75%, and increased bronchodilator responsiveness (BDR).
- Children with asthma showed reduced FEF25%-75% and increased BDR; those with hay fever/eczema had increased BDR only.
Conclusions:
- Grass pollen exposure adversely affects lung function and airway responsiveness in children with allergic conditions.
- Children with food allergies are particularly susceptible to the respiratory effects of grass pollen.
- Proactive management strategies are recommended for susceptible children before high pollen days.
Background:
Grass pollen exposure is a risk factor for childhood asthma hospital attendances. However, its short-term influence on lung function, especially among those with other allergic conditions, has been less well-studied.
Objective:
To investigate this association in a population-based sample of children.
Methods:
Within the HealthNuts cohort, 641 children performed spirometry during the grass pollen season. Grass pollen concentration was considered on the day of testing (lag 0), up to 3 days before (lag 1-lag 3), and cumulatively (lag 0-3). We used linear regression to assess the relevant associations and examined potential interactions with current asthma, hay fever or eczema, and food allergy.
Results:
Associations were observed only in children with allergic disease (P value for interaction ≤ 0.1). In children with food allergy, grass pollen concentration was associated with a lower ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) and lower mid-forced expiratory flows (FEF25%-75%) at all lags (eg, at lag 2, FEV1/FVC z-score = -0.50 [95% CI -0.80 to -0.20] and FEF25%--75% z-score = -0.40 [-0.60 to -0.04] per 20 grains/m3 pollen increase), and increased bronchodilator responsiveness (BDR) at lag 2 and lag 3 (eg, at lag 2, BDR = (31 [95% CI -0.005 to 62] mL). In children with current asthma, increasing grass pollen concentration was associated with lower FEF25%-75% and increased BDR, whereas children with current hay fever or eczema had increased BDR only.
Conclusions:
A proactive approach needs to be enforced to manage susceptible children, especially those with food allergy, before high-grass pollen days.
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