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The relation between physician-diagnosed sinusitis, asthma, and skin test reactivity to allergens in 8-year-old
E Lombardi1, R T Stein, A L Wright
1Respiratory Sciences Center, University of Arizona, Tucson, USA.
Insights
Childhood sinusitis is common, affecting 13.1% of children. Allergic rhinitis and grass pollen are key risk factors. Sinusitis is not linked to asthma or cough when allergies are considered.
Area of Science:
- Pediatric Respiratory Health
- Allergy and Immunology
- Epidemiology
Background:
- Sinusitis is a common pediatric condition.
- The relationship between sinusitis and allergic rhinitis (AR), atopy, asthma, and cough requires further investigation in pediatric populations.
Purpose of the Study:
- To determine the prevalence of sinusitis in a general pediatric sample.
- To examine the association between sinusitis and allergic rhinitis (AR), atopy, asthma, and cough.
Main Methods:
- A cohort of 835 children from the Tucson Children's Respiratory Study was analyzed at a mean age of 8.6 years.
- Parental questionnaires assessed physician-diagnosed sinusitis (MD-Sinusitis), allergic rhinitis (MD-AR), asthma (MD-Asthma), and cough.
- Skin prick testing for aeroallergens was performed on 630 children.
Main Results:
- The prevalence of MD-Sinusitis was 13.1%.
- 78% of children with MD-Sinusitis also had MD-AR.
- Bermuda grass pollen allergy was significantly associated with MD-Sinusitis after controlling for MD-AR (adjusted OR 2.3).
- MD-Sinusitis showed initial associations with MD-Asthma (OR 3.0) and cough (OR 2.5), but these were not significant after controlling for MD-AR and skin test reactivity.
Conclusions:
- Childhood sinusitis is prevalent.
- Independent risk factors for sinusitis in this community include grass pollen allergy and current allergic rhinitis.
- Sinusitis is not independently associated with asthma or cough once allergic rhinitis and skin test reactivity are accounted for.
Abstract:
The purpose of this study was to assess the prevalence of sinusitis in a nonselected sample of children, and the relation of sinusitis to allergic rhinitis (AR), atopy, asthma, and cough in the same population sample. Of 1246 children enrolled at birth in the Tucson Children's Respiratory Study, 835 were studied at a mean age +/-SD of 8.6 +/- 0.7 years. Questionnaires asking about MD-Sinusitis, MD-AR, MD-Asthma, and cough were completed by parents. Skin tests for seven common aeroallergens in the Tucson area had been performed in 630 of the participating children at the mean age +/-SD of 6.3 +/- 0.9 years. Prevalence of MD-Sinusitis was 13.1%; 78% of subjects with MD-Sinusitis also had MD-AR. Detailed analysis of the relation between MD-Sinusitis and individual environmental allergens tested for showed that only a response to Bermuda grass pollen was significantly associated with MD-Sinusitis after controlling for MD-AR [adjusted odds ratio 2.3 (95% CI 1.2-4.3)]. Having MD-Sinusitis was also significantly associated with MD-Asthma and cough [odds ratios 3.0 (95% CI 1.8-5.2)] and 2.5 (95% CI 1.6-3.8), respectively]. However, logistic regression demonstrated that, after controlling for MD-AR and skin test reactivity, MD-Sinusitis was no longer significantly associated with MD-Asthma or cough. We conclude that MD-Sinusitis is a common condition in childhood. The main independent risk factors in our community for MD-Sinusitis were grass pollen and current MD-AR. MD-Sinusitis was not associated with MD-Asthma or with cough after controlling for skin test reactivity and for MD-AR.