Air Pollution and Allergic Rhinitis
Allergic rhinitis (AR) is one of the most common diseases in the modern-day world. It is associated with a drastic impact on the quality of life.[1] AR is likely to increase the incidence of bronchial asthma, rhinitis, sinusitis, nasal polyps, ear infections, and allergic conjunctivitis. In a recent publication, around 77% of the population is exposed to the particulate matter PM 2.5 exceeding the safety threshold values set by the National Air Quality Standards of India Both genetic and environmental factors have been linked to the causation of allergic disorders, especially allergic rhinitis. [2] Ambient particulate matter (particles with an aerodynamic diameter of < 2.5 and (10 μm, PM10, and PM2.5) and nitrogen dioxide (NO2) have been found to play an essential role in the initiation of airway diseases such as bronchial asthma and AR.
The overall concentration and exposure time to air pollution has been linked with the severity of such conditions. Mechanisms, particularly oxidative stress, potentially explain the interaction. In a recent study published in the Journal of Allergy and Clinical Immunology, researchers found a positive correlation between prenatal exposure to air pollution and immune perturbations in children aged 4-7 years.
The exact mode of the onset of allergic reactions to air pollution is yet to be eluded. Still, several researchers have suggested possible mechanisms, namely, (1) skin barrier dysfunction, (2) oxidative damage, and (3) inflammatory dysfunction. [4] Exposure to NO2 leads to a mixed Th2/Th17 adaptive immune response causing the recruitment of immune cells such as Eosinophils and neutrophils. This critical step leads to the onset of a cascade of inflammatory pathways, swelling of nasal linings, an increase of nasal secretions, and a plethora of symptoms that characterize AR.
HOW CAN WE REDUCE THE EXPOSURE AND EFFECTS OF AIR POLLUTION?
We cannot escape the air around us. Rapid urbanization and shrinking green cover around the major cities have forced us to breathe in toxic air. But still, we can limit overall exposure and maintain health by these few measures Reduce Outdoor Air Pollution and Its Effects Face mask: N95 mask is most effective for filtering PM2.5 particles and is recommended whenever the ambient AQI exceeds 200. You may also use a reusable 3-layer cotton cloth mask if not available.
Clean fuels for vehicles: use of newer and lesser polluting fuels, with less exposure to diesel fumes, has now been recognized by governments worldwide with several new strategies [29]. Electric vehicles are one such welcome initiative.
Restrict outdoor activities: keep indoors when AQI is poor, or pollen count is high. Indoor activities and fun board games may keep the children well-stimulated. Home exercise regimes are an excellent replacement for outdoor walks or run.
Reduce Indoor Air Pollution
Reduce moulds, dust, and dust mites concentration: Regular changing of bedsheets & washing using hot water at 54OC helps reduce mite breeding. You may also use commercially available mite-proof bedding.
Wet cleaning instead or dry mopping: Shift to wet cleaning as feather dusters disperse dust and allergens. Vacuum cleaners should be sealed tightly to avoid a dust leak. Avoid cleaning products having a high composition of volatile organic compounds (VOC).
Home ventilation and use of air purifiers: Air purifiers have been shown to reduce asthma rates. Choose an air purifier with a Clear air delivery rate (CADR) of more than 600 and with a Minimum efficiency reporting value (MERV) of the High-efficiency particulate air (HEPA) filter of more than 14. Ensure that filters are changed regularly
Cooking fuels: The use of clean fuels for cooking, like LPG, should be encouraged at home. Avoid angidi or local chulhas
Cessation of smoking (both active and passive): Environmental Tobacco Smoke should be reduced in all forms. Passive smoking and parental smoke have been found to have a detrimental impact on the health of family members of smokers. Indian Government has banned smoking in public places and started several media education campaigns on the benefits of cessation. It is advisable to seek professional help in the cessation of smoking.
Stop using mosquito coils, agarbatti, and dhoop sticks indoors
Avoid pressed wood furniture. These often use bond adhesives which emit high concentrations of VOC, formaldehyde, and carbamide (urea)
Avoid renovation and painting of the house while still living there. Complete such jobs during a holiday break when children can be away from home.
Prefer a house, school, or building carefully so that it is at least 100 meters from the main road
Measure to Build Lung Capacity
Yoga and relaxation therapy: Breathing exercises increase the peak expiratory flow rate in children and adults. Exercise and other physical activities: Regular aerobic activity has the potential to improve lung capacity and reduce bronchial hyperresponsiveness.
Managing Asthma and Allergic Rhinitis in the Presence of Pollution
Regular follow-ups with your specialist and medication in the form of inhalers or nasal sprays are essential to prevent flare-ups of airway reactivity. Do not neglect signs of ill health, especially in children
CONCLUSION:
Air pollution is a modern-day bane that we have to live with. It seriously impacts our health and quality of life and adds a significant health burden on the economy. More research is needed to understand the health impacts and measures to deal with them. At present, our best bet is to reduce exposure to pollutants and boost our health with regular exercise and nutrition. People with allergic rhinitis are more sensitive to the irritant effects of particulate matter, and so, must take extra precautions to protect themselves from air pollution. People with asthma or other respiratory conditions must also take precautions in case of poor weather or an increase in the severity of allergic rhinitis.
References
. Li CH, Sayeau K, Ellis AK. Air Pollution and Allergic Rhinitis: Role in Symptom Exacerbation and Strategies for Management. J Asthma Allergy. 2020 Aug 26;13:285-292. doi: 10.2147/JAA.S237758. PMID: 32922045; PMCID: PMC7457822.
. Krishna MT, Mahesh PA, Vedanthan PK, Mehta V, Moitra S, Christopher DJ. The burden of allergic diseases in the Indian subcontinent: barriers and challenges. Lancet Glob Health. 2020 Apr;8(4):e478-e479. doi: 10.1016/S2214-109X(20)30061-9. PMID: 32199115.
. https://www.news-medical.net/news/20220908/Prenatal-exposure-to-air-pollution-increases-risk-of-childhood-allergic-rhinitis-and-asthma.aspx
Wang H, Li XB, Chu XJ, Cao NW, Wu H, Huang RG, Li BZ, Ye DQ. Ambient air pollutants increase the risk of immunoglobulin E-mediated allergic diseases: a systematic review and meta-analysis. Environ Sci Pollut Res Int. 2022 Jul;29(33):49534-49552. doi: 10.1007/s11356-022-20447-z. Epub 2022 May 20. PMID: 35595897; PMCID: PMC9122555.
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