Effects of pollen concentration on allergic rhinitis in children: A retrospective study from Beijing, a Chinese megacity

Abstract

With global climate change and rapid urbanization, the prevalence of allergic diseases caused by pollen is rising dramatically worldwide with unprecedented complexity and severity, especially for children in mega-cities. However, because of the lack of long time-series pollen concentrations data, the accurate evaluation of the impact of pollen on allergic rhinitis (AR) was scarce in the Chinese metropolis. A generalized additive model was used to assess the effect of pollen concentration on pediatric AR outpatient visits in Beijing from 2014 to 2019. A stratified analysis of 10 pollen species and age-gender-specific groups was also conducted during the spring and summer-autumn peak pollen periods separately. Positive associations between pollen concentration and pediatric AR varied with the season and pollen species were detected. Although the average daily pollen concentration is higher during the spring tree pollen peak, the influence was stronger at the summer-autumn weed pollen peak with the maximum relative risk 1.010 (95% CI 1.009, 1.011), which was higher than the greatest relative risk, 1.003 (95% CI 1.002, 1.004) in the spring peak. The significant adverse effects can be sustained to lag10 during the study period, and longer in the summer-autumn peak (lag13) than in the spring peak (lag8). There are thresholds for the health effects and they varied between seasons. The significant effect appeared when the pollen concentration was higher than 3.74 × 10⁵ grain·m^-2·d^-1 during the spring tree pollen peaks and 4.70 × 10⁴ grain·m^-2·d^-1 during the summer-autumn weed pollen peaks. The stratified results suggested that the species-specific effects were heterogeneous. It further highlights that enough attention should be paid to the problem of pollen allergy in children, especially school-aged children aged 7-18 years and weed pollen in the summer-autumn peak pollen period. These findings provide a more accurate reference for the rational coordination of medical resources and improvement of public health.

Keywords: Allergic rhinitis; Children's health; Generalized additive model; Pollen concentration.