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Updated: Jul 9, 2025
Symptom Assessment of Patients with Allergic Rhinitis Using an Allergen Exposure Chamber
Published on: March 3, 2023
Comorbid asthma is associated with rhinitis severity in children exposed to air pollutants
Sai-Wai Ho1,2, Ko-Huang Lue3, Shan-Ming Chen2
1Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC.
Insights
Asthma exacerbates allergic rhinitis (AR) severity in young males exposed to air pollution, increasing discomfort and nasal issues. This link between asthma, rhinitis, and pollutants was specific to males in the study.
Area of Science:
- Environmental Health
- Pediatric Allergy
- Respiratory Medicine
Background:
- The impact of air pollution on allergic rhinitis (AR) severity in children with asthma is not well understood.
- Previous studies have not specifically investigated the combined effects of asthma and air pollutants on rhinitis symptoms in pediatric populations.
Purpose of the Study:
- To investigate the influence of comorbid asthma on the severity of allergic rhinitis in children exposed to various air pollutants.
- To determine if asthma modifies the relationship between air pollutant exposure and rhinitis outcomes in children.
Main Methods:
- Children aged 6-13 with allergic rhinitis (AR), with and without asthma, were recruited from a hospital in Taiwan.
- Correlations were analyzed between quality-of-life scores, nasal peak expiratory flow, clinical visit frequency, and concentrations of PM10, PM2.5, NO2, and NMHC.
- A database of AR patients was used to compare clinical visit times with air pollutant levels.
Main Results:
- In male children with AR and asthma, higher levels of PM10, PM2.5, NO2, and NMHC correlated with increased rhinitis discomfort (quality-of-life scores) and more frequent clinical visits.
- Nasal inflammation and obstruction, indicated by lower nasal peak expiratory flow, were also associated with higher air pollutant concentrations in these male children.
- These correlations were specifically observed in male children and not in female children.
Conclusions:
- Comorbid asthma significantly increases rhinitis severity in male children with AR when exposed to air pollutants.
- Increased nasal obstruction and inflammation due to air pollutant exposure may be the underlying mechanism for this observed association in males.
- The findings highlight a sex-specific vulnerability in pediatric allergic rhinitis patients with asthma exposed to environmental pollutants.
Background:
The impact of asthma on the severity of rhinitis when children with allergic rhinitis (AR) are exposed to air pollutants has not been studied.
Methods:
Children with AR (65 with asthma, 208 without asthma), aged 6-13 years, were recruited from a hospital in Taichung, Taiwan, between 2007 and 2011. Correlations between Pediatric-Rhinoconjunctivitis-Quality-of-Life score, nasal peak expiratory flow, and air pollutants were compared. With the same age, research time, and form the same city, children with AR (660 with asthma, 3174 without asthma) were selected from a database. Correlations between clinical visit times for AR and air pollutants were compared.
Results:
In male children with AR and asthma, both clinical and database studies revealed a correlation between higher rhinitis discomfort (quality-of-life score), higher visit times for AR, and higher PM10, PM2.5, NO2, NMHC concentrations. Correlations between higher nasal inflammation/obstruction (lower expiratory flow) and higher air pollutant concentrations were observed in male children with AR and asthma.
Conclusion:
In children with AR, comorbid asthma was associated with increased rhinitis severity when they were exposed to air pollutants, and the association was only noted in males. Increased nasal obstruction/inflammation from exposure to air pollutants may be the mechanisms underlying this association.
Impact Statement:
The influence of asthma on the severity of rhinitis when children with allergic rhinitis (AR) are exposed to air pollutants has not been studied. In children with AR, the correlation between higher rhinitis discomfort, higher number of clinical visits for AR, and higher PM10, PM2.5, NO2, NMHC concentrations were only noted in those who also had asthma. The correlation was only noted in male. Comorbid asthma was associated with higher rhinitis severity when children with AR are exposed to air pollutants The association was only noted in male.
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