International variation in prevalence of rhinitis and its relationship with sensitisation to perennial and seasonal allergens
Open accessAbstract
The relative importance of atopy in the aetiology of rhinitis is largely unknown. The present study investigated the geographical variations in rhinitis in relation to atopy. The cross-sectional study involved 54,178 children (aged 8–12 yrs) from 30 study centres in 22 countries worldwide. Symptoms of rhinoconjunctivitis and rhinitis without conjunctivitis in the last 12 months were reported in parental questionnaires and children were skin-prick tested. The prevalence of rhinoconjunctivitis and rhinitis without conjunctivitis varied widely (1.5–24.5% and 1.4–45.2%, respectively). For rhinoconjunctivitis, the population attributable fraction (PAF) varied 0–71% for a positive skin-prick test to one or more seasonal allergens and 0–41% for perennial allergens. The PAF for sensitisation to seasonal and perennial allergens was higher in affluent countries (36 and 25%, respectively) than nonaffluent countries (1.3 and 12.6%, respectively). For rhinitis without conjunctivitis, the PAF for perennial allergens was 8 and 4% for affluent and nonaffluent countries, respectively. No significant PAF was found for seasonal allergens. Overall, atopy explained only a limited proportion of rhinitis symptoms, suggesting that the importance of other environmental factors has been under emphasised, particularly in less affluent countries. Atopy seems to be only marginally relevant for rhinitis without conjunctivitis, which seems mainly to reflect nonatopic rhinitis.
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Major international efforts using standardized methods, ECRHS and ISAAC, show marked geographic variation in hay fever or nasal allergies in adults and in rhinoconjunctivitis symptoms in children.
“There have been major international efforts to compare variations in the national prevalence of AR using standardized methods (ie, ECRHS and ISAAC). These studies show marked geographic variation of “hay fever or nasal allergies” (adults) or “a problem with sneezing, or a runny, or a blocked nose when you DID NOT have a cold or the flu that was accompanied by itchy-watery eyes?” (children).”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [475]
The introduction reports international variation in childhood rhinitis and describes ISAAC Phase Two as a comparison using a common protocol. Materials and Methods gives the standardized questions about nasal symptoms without a cold and accompanying itchy-watery eyes. The paper does not report ECRHS findings or geographic variation in adults’ “hay fever or nasal allergies,” so the adult portion is unsupported. Page numbers are unavailable in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredA higher prevalence of hay fever or nasal allergy responses is seen in English-speaking countries, a lower prevalence in Eastern Europe than Western Europe, and allergic rhinitis diagnosis is more frequent in countries with higher asthma rates and sensitization to seasonal allergens.
“A higher prevalence of these responses is seen in people living in “English-speaking” countries (eg, UK, Australia, New Zealand), a lower prevalence in Eastern Europe than in Western Europe, and a diagnosis of AR is more frequently seen in countries with higher asthma rates and sensitization to seasonal allergens.455,475”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [475]
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- Authors
- Weinmayr, G., Forastiere, F., Weiland, S. K., Rzehak, P., Abramidze, T., Annesi-Maesano, I., Björkstén, B., Brunekreef, B., Büchele, G., Cookson, W. O. C., von Mutius, E., Pistelli, R., & Strachan, D. P.
- Affiliations
- Universität Ulm (DE)
- ORCID
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2008-06-25
- Volume
- 32
- Issue
- 5
- Pages
- 1250-1261
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2148201175
- Cited by
- 79
- References
- 37
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 1 · 2023: 2 · 2021: 6 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 4 · 2015: 5 · 2014: 11 · 2013: 5 · 2012: 10
- FWCI
- 4.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Site cant be reached (submittedVersion)
- Funders
- Vårdalstiftelsen
- Wellcome Trust
- University of Oxford
- European Commission
- Institut National de la Santé et de la Recherche Médicale
- Karolinska Institutet
- Hacettepe Üniversitesi
- Universität Ulm
- Health Research Council of New Zealand
- Topics
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- rhinitis, rhinoconjunctivitis, atopy, allergen sensitization, perennial allergens, seasonal allergens, international variation, population attributable fraction, children, skin prick test, prosperity
- MeSH terms
- Allergens, Child, Conjunctivitis, Cross-Sectional Studies, Female, Rhinitis, Allergic, Seasonal, Humans, Hypersensitivity, Male, Rhinitis, Rhinitis, Allergic, Perennial, Seasons, Skin Tests, Models, Statistical, Prevalence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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