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. 2022 Mar 17;19(6):3586.
doi: 10.3390/ijerph19063586.

The Effect of Outdoor Aeroallergens on Asthma Hospitalizations in Children in North-Western Tuscany, Italy

Maria Di Cicco  1   2 , Ester Del Tufo  1   2 , Salvatore Fasola  3 , Serena Gracci  1   2 , Maria Giovanna Marchi  4 , Luca Fibbi  5   6 , Giovanna Cilluffo  7 , Giuliana Ferrante  8 , Diego G Peroni  1   2 , Stefania La Grutta  3
Affiliations

The Effect of Outdoor Aeroallergens on Asthma Hospitalizations in Children in North-Western Tuscany, Italy

Maria Di Cicco et al. Int J Environ Res Public Health. .

Abstract

Few data are currently available on the effects of aeroallergens in triggering respiratory symptoms in children. To evaluate the potential effects of daily outdoor aeroallergens loads on childhood admissions, in this case-crossover study, we analyzed data from 85 children hospitalized at the University Hospital of Pisa, Italy, for asthma or asthma-like symptoms without respiratory infection, between 2010 and 2019. Data were linked to outdoor allergens, temperature, nitrogen dioxide, and relative humidity observed during the same period. A 10-grains/m3 increase in the total aeroallergen concentration was associated with an increased risk of admission at lag 0 (OR = 1.054, 95% CI: 1.011-1.098), with a smaller effect at lag 1 (OR = 1.037, 95% CI: 1.008-1.067) and lag 2 (OR = 1.021, 95% CI: 1.003-1.039). Trends to larger effects were observed in children with sensitization to one or more aeroallergens (OR = 1.085, 95% CI: 1.004-1.173 at lag 0), in males (OR = 1.069, 95% CI: 1.009-1.132 at lag 0) and in older children (OR = 1.065, 95% CI: 1.007-1.127 at lag 0). Our study shows an association between increased outdoor allergens loads and asthma or asthma-like symptoms in children up to at least two days prior to hospitalization, suggesting that tracking aeroallergen counts may be useful to improve the management of respiratory allergic diseases.

Keywords: Alternaria alternata; allergy; asthma; climate change; pollen; sensitization to outdoor allergens.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Annual means of total outdoor allergen counts and apparent temperatures recorded in the study area; (b) annual means of total outdoor allergen counts and NO2.
Figure 2
Figure 2
Daily total outdoor allergen counts recorded during the study period (points), with bars superimposed to highlight the case days.
Figure 3
Figure 3
Acute effects of outdoor aeroallergen counts on the risk of asthma admissions: odds ratios (OR) per 10-grains/m3 increase and 95% confidence intervals for the conditional logistic regression models with distributed lags, stratified by presence of outdoor sensitization (a), gender (b), and age group (c).
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