Prevalence and risk factors of allergic rhinitis in primary schoolchildren in Guangzhou in 2019

Background In the past two decades, allergic rhinitis has shown an increasing prevalence, especially among children.

Objective This study aims to investigate the prevalence of allergic rhinitis in school-age children in Guangzhou, Guangdong Province, China and its relationship with residential environment and living habits, and to provide evidence for the prevention and control of allergic rhinitis.

Methods Data on air pollutants (PM₁₀, PM_2.5, NO₂) were collected in Guangzhou in 2018, and 11 administrative divisions of Guangzhou were divided into high, medium, and low air pollution areas based on the tertile values of the corresponding comprehensive air quality index data. In 2019, Yuexiu District, Panyu District, and Conghua District were selected from the each exposure category, and one elementary school was randomly selected from each district. The basic information, living environment, living habits, with or without allergic rhinitis, and family history of allergies among all students in grades 3 to 5 were surveyed. The prevalence of allergic rhinitis in the population with different characteristics was studied, and the risk factors were analyzed by multiple regression analysis.

Results The annual average daily concentrations of PM₁₀, PM_2.5, and NO₂ in Yuexiu District, Panyu District, and Conghua District were 51, 31, 53 μg·m^-3; 46, 31, 41 μg·m^-3; and 38, 20, 25 μg·m^-3, respectively. A total of 3 100 questionnaires were distributed and 3 013 valid questionnaires were recovered, with a valid recovery rate of 97.2%. The prevalence rate of allergic rhinitis was 23.1% (697/3 013) among selected school-aged children in Guangzhou in 2019. Males had a significantly higher prevalence than females26.8% (439/1 637) vs 18.8% (258/1 376), P < 0.05. The prevalence was different for parents with different educational backgrounds (P < 0.05). The prevalence of allergic rhinitis in students with a family history of allergy (51.7%) was higher than that of students without a family history (21.3%)(P < 0.05). The prevalence of high-exposure area (27.5%) was higher than that of medium-exposure area (20.2%) and low-exposure area (16.3%). The multiple logistic regression analysis results showed that air pollution (OR=1.689, 95% CI: 1.294-2.204), male (OR=1.632, 95% CI: 1.363-1.954), with a family history of allergy (OR=3.576, 95% CI: 2.601-4.916), and use of new furniture in the past year (OR=1.694, 95%CI: 1.270-2.259) were independent risk factors for allergic rhinitis (P < 0.05).

Conclusion The prevalence of allergic rhinitis is higher in high air pollution area than in low air pollution area. Air pollution, male, with a family history of allergy, and use of new furniture within the past year are independent risk factors for allergic rhinitis.