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Climate, traffic-related air pollutants and allergic rhinitis prevalence in middle-school children in Taiwan

Depts of ¹ Environmental and Occupational Health, ² Internal Medicine, ³ Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, ⁴ Dept of Public Health, Tzu-Chi University, Hua-lien, ⁵ Dept of Occupational Safety and Health, China Medical College, Taichung, ⁶ Dept of Public Health, Kaohsiung Medical University, Kaohsiung, ⁷ Institute of Environmental Health Sciences, National Yang-Ming University, and ⁸ Institute of Environmental Health, National Taiwan University, Taipei, Taiwan

CORRESPONDENCE: Y. L. Guo, Dept of Environmental and Occupational Health, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan. Fax: 886 62743748. E-mail: leonguo@mail.ncku.edu.tw

Keywords: air pollution, allergic rhinitis, children, climate, factor analysis

Received: October 16, 2002
Accepted January 9, 2003

This study was funded by grant No. 88-EPA-Z006-018 from the Environmental Protection Administration and grant No. NSC-87-2621-P-006-013 from the National Science Council (both Taipei, Taiwan).

The prevalence of allergic rhinitis, a common respiratory disorder, may be rapidly increasing. Epidemiological studies, however, indicate little about its association with climatic factors and air pollution. The relationship between traffic-related air pollutants and allergic rhinitis in middle-school students was therefore investigated.

In a nationwide survey of middle-school students in Taiwan conducted in 1995/1996, the lifetime prevalence of physician-diagnosed allergic rhinitis and typical symptoms of allergic rhinitis were compared with air-monitoring station data on temperature, relative humidity, sulphur dioxide (SO₂), nitrogen oxides (NOx), ozone (O₃), carbon monoxide (CO) and particulate matter with a 50% cut-off aerodynamic diameter of 10 µm (PM₁₀).

A total of 331,686 nonsmoking children attended schools located within 2 km of 55 stations. Mean (range) annual exposures were: CO 853 (381–1,610) parts per billion (ppb), NOx 35.1 (10.2–72.4) ppb, SO₂ 7.57 (0.88–21.2) ppb, PM₁₀ 69.2 (40.1–116.2) µg·m^–3, O₃ 21.3 (12.4–34.1) ppb, temperature 22.9 (19.6–25.1)°C, and relative humidity 76.2 (64.8–86.2)%. The prevalence of physician-diagnosed allergic rhinitis was 28.6 and 19.5% in males and females, respectively, with prevalence of questionnaire-determined allergic rhinitis 42.4 and 34.0%. After adjustment for age, parental education and history of atopic eczema, physician-diagnosed allergic rhinitis was found to be associated with higher nonsummer (September–May) warmth and traffic-related air pollutants, including CO, NOx and O₃. Questionnaire-determined allergic rhinitis correlated only with traffic-related air pollutants.

Nonsummer warmth and traffic-related air pollution, probably mediated through exposure to common allergens such as dust mites, are possible risk factors for allergic rhinitis in middle-school-aged children.

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