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Short-term exposure to pollen and the risk of allergic and asthmatic manifestations: a systematic review and meta-analysis.

ABSTRACT: BACKGROUND:Several studies have assessed effects of short-term exposure to pollen on allergic and asthmatic manifestations. The evidence is inconclusive, and no meta-analysis has been published. OBJECTIVE:To synthesise the evidence on the relations between short-term pollen exposure and the risk of allergic and asthmatic manifestations. METHODS:We performed a systematic literature search of PubMed and Scopus databases up to the end of August 2018. In addition, we reviewed the reference lists of relevant articles. Two authors independently evaluated the eligible articles and extracted relevant information in a structured form. We calculated summary effect estimates (EE) based on the study-specific ORs and regression coefficients (?) by applying both fixed-effects and random-effects models. RESULTS:26 studies met the a priori eligibility criteria, and 12 of them provided sufficient information for the meta-analysis. The summary EE related to 10 grains per m³ increase in pollen exposure showed an 1% increase (EE 1.01, 95%?CI 1.00 to 1.02) in the risk of lower respiratory symptoms and a 2% increase (EE 1.02, 95%?CI 1.01 to 1.03) in the risk of any allergic or asthmatic symptom. Correspondingly, the risk of upper respiratory symptoms and ocular symptoms increased 7% (EE 1.07, 95%?CI 1.04 to 1.09) and 11% (EE 1.11, 95%?CI 1.05 to 1.17), respectively, in relation to such pollen exposure. Short-term exposure to pollen did not show any significant effect on daily lung function levels. CONCLUSION:Our results provide new evidence that short-term pollen exposure significantly increases the risks of allergic and asthmatic symptoms.

SUBMITTER: Kitinoja MA

PROVIDER: S-EPMC7045159 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Short-term exposure to pollen and the risk of allergic and asthmatic manifestations: a systematic review and meta-analysis.

Kitinoja Milja A MA Hugg Timo T TT Siddika Nazeeba N Rodriguez Yanez Daniel D Jaakkola Maritta S MS Jaakkola Jouni J K JJK

BMJ open 20200110 1

<h4>Background</h4>Several studies have assessed effects of short-term exposure to pollen on allergic and asthmatic manifestations. The evidence is inconclusive, and no meta-analysis has been published.<h4>Objective</h4>To synthesise the evidence on the relations between short-term pollen exposure and the risk of allergic and asthmatic manifestations.<h4>Methods</h4>We performed a systematic literature search of PubMed and Scopus databases up to the end of August 2018. In addition, we reviewed t ...[more]

PMID: 31924628

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Project description:BackgroundWhile year-round exposure to pollen is linked to a large burden of allergic diseases, location-specific risk information on pollen types and allergy outcomes are limited. We characterize the relationship between acute exposure to tree, grass and weed pollen taxa and two allergy outcomes (allergic rhinitis physician visit and prescription allergy medication fill) across 28 metropolitan statistical areas (MSA) in the United States.MethodsWe obtained daily pollen data from National Allergy Bureau (NAB) monitors at these 28 MSAs for 2008-2015. We revised the NAB guidelines to classify taxa-specific pollen severity each day. Daily information on allergic rhinitis and prescribed allergy medications for individuals with employer-based health insurance from the IBM MarketScan Research database for these MSAs. We combined the daily pollen and health data for each MSA into a longitudinal dataset. We conducted a MSA-specific conditional quasi-Poisson regression analysis to assess how different levels of pollen concentration impact the health outcomes, controlling for local air pollution, meteorology and Influenza-like illness (ILI). We used a random effects meta-analysis to produce an overall risk estimate for each pollen type and health outcome.ResultsThe seasonal distribution of pollen taxa and associated health impacts varied across the MSAs. Relative risk of allergic rhinitis visits increased as concentrations increased for all pollen types; relative risk of medication fills increased for tree and weed pollen only. We observed an increase in health risk even on days with moderate levels of pollen concentration. 7-day average concentration of pollen had stronger association with the health outcomes compared to the same-day measure. Controlling for air pollution and ILI had little impact on effect estimates.ConclusionThis analysis expands the catalogue of associations between different pollen taxa and allergy-related outcomes across multiple MSAs. The effect estimates we present can be used to project the burden of allergic disease in specific locations in the future as well inform patients with allergies on impending pollen exposure.

Project description:Background Subcutaneous immunotherapy (SCIT) has been proved to be effective and safe in adult asthma. But it is still controversial in children. Object To evaluate the efficacy and safety of SCIT in asthmatic children with allergy to house dust mite. Method We searched the databases of Cochrane Library, EMBASE and MEDLINE (from 1 January 1990 to 1 December 2022). Two reviewers independently screened studies, extracted data and critically appraised the risk of bias. We used the Revman 5 to synthesize the effect sizes. Results We finally selected 38 eligible studies including 21 randomized controlled trials to evaluate the efficacy and safety of SCIT and 17 observational studies to assess the safety. The results revealed that short-term asthma symptom scores were declined with a standardized mean difference (SMD) of −1.19 (95% CI: −1.87, −0.50) in 12 researches with high heterogeneity. Short-term asthma medication scores were decreased with SMD −1.04 (95% CI: −1.54, −0.54) in 12 heterogeneous researches. One study showed no significant reduction in combined symptom and medication scores without providing details. No studies we reviewed reported long-term efficacy. SCIT resulted in an obviously increased risk of adverse reactions compared with placebo. For secondary outcomes, SCIT improved life quality and reduced the numbers of annual asthma attacks and allergen-specific airway hyperreactivity, but without significant improvement in pulmonary function, asthma control or hospitalization. Conclusions SCIT can reduce the short-term symptom scores and medication scores regardless of different treatment duration or mono/polysensitization, but with an increased incidence of local and systemic adverse effects. Further studies on pediatric asthma are needed to evaluate the long-term efficacy, and clarify the effectiveness of SCIT in specific population using mix allergen extracts or with severe asthma. Overall, it is recommended for children with mild-moderate HDM-driven allergic asthma.

Dataset Information

Short-term exposure to pollen and the risk of allergic and asthmatic manifestations: a systematic review and meta-analysis.

Publications

Short-term exposure to pollen and the risk of allergic and asthmatic manifestations: a systematic review and meta-analysis.

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