International expert consensus on the management of allergic rhinitis (AR) aggravated by air pollutants
Robert M. Naclerio, Ignacio J. Ansotegui, Jean Bousquet, Giorgio Walter Canonica, Gennaro D’Amato, Nelson Rosario, Ruby Pawankar, David B. Peden, Karl‐Christian Bergmann, Leonard Bielory, Luis Caraballo, Lorenzo Cecchi, S. Alfonso M. Cepeda, Herberto José Chong‐Neto, Carmen Galán, Sandra Nora González Díaz, Samar Idriss, Todor A. Popov, German D. Ramón, Erminia Ridolo, Menachem Rottem, Wisuwat Songnuan, Philip W. Rouadi
Abstract
Allergic rhinitis affects the quality of life of millions of people worldwide. Air pollution not only causes morbidity, but nearly 3 million people per year die from unhealthy indoor air exposure. Furthermore, allergic rhinitis and air pollution interact. This report summarizes the discussion of an International Expert Consensus on the management of allergic rhinitis aggravated by air pollution. The report begins with a review of indoor and outdoor air pollutants followed by epidemiologic evidence showing the impact of air pollution and climate change on the upper airway and allergic rhinitis. Mechanisms, particularly oxidative stress, potentially explaining the interactions between air pollution and allergic rhinitis are discussed. Treatment for the management of allergic rhinitis aggravated by air pollution primarily involves treating allergic rhinitis by guidelines and reducing exposure to pollutants. Fexofenadine a non-sedating oral antihistamine improves AR symptoms aggravated by air pollution. However, more efficacy studies on other pharmacological therapy of coexisting AR and air pollution are currently lacking.