IMPACT OF ENVIRONMENTAL AIR POLLUTION ON ALLERGIC RHINITIS SEVERITY AND QUALITY OF LIFE IN ADULTS: A NARRATIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6048Keywords:
Allergic Rhinitis; Air Pollution; Particulate Matter; Oxidative Stress; Quality of Life; Environmental ExposureAbstract
Air pollution is recognized as one of the leading environmental determinants of human health. It has been associated with a growing burden of respiratory diseases worldwide. Allergic rhinitis (AR), a chronic inflammatory disorder of the upper airways, may be susceptible to the effects of environmental pollutants. This narrative review aimed to summarize current evidence regarding the impact of air pollution on allergic rhinitis severity, disease control, and quality of life in adults.
A literature search was conducted using the PubMed database. Relevant publications were identified using combinations of the keywords with priority given to recent systematic reviews, meta-analyses, observational studies, clinical investigations, and international clinical guidelines.
The reviewed evidence consistently demonstrated positive associations between exposure to ambient air pollutants and allergic rhinitis outcomes. Particulate matter (PM2.5 and PM10), nitrogen dioxide (NO₂), ozone (O₃), and sulfur dioxide (SO₂) were most frequently associated with increased symptom severity, poorer disease control, and reduced quality of life. Particulate matter showed the strongest and most consistent relationship with allergic rhinitis burden. Proposed biological mechanisms include oxidative stress, epithelial barrier dysfunction, chronic inflammation, and immune dysregulation.
In conclusion, air pollution represents an important and potentially modifiable determinant of allergic rhinitis severity and quality of life. Improving air quality and reducing individual exposure to environmental pollutants may contribute to better disease control and reduced burden of allergic respiratory diseases, highlighting the importance of both clinical and public health interventions.
References
Li, S., Wu, W., Wang, G., Zhang, X., Guo, Q., Wang, B., Cao, S., Yan, M., Pan, X., Xue, T., Gong, J., & Duan, X. (2022). Association between exposure to air pollution and risk of allergic rhinitis: A systematic review and meta-analysis. Environmental Research, 205, 112472. https://doi.org/10.1016/j.envres.2021.112472
Wise, S. K., Damask, C., Roland, L. T., Ebert, C., Levy, J. M., Lin, S., Luong, A., Rodriguez, K., Sedaghat, A. R., Toskala, E., Villwock, J., Abdullah, B., Akdis, C., Alt, J. A., Ansotegui, I. J., Azar, A., Baroody, F., Benninger, M. S., Bernstein, J., . . . Zhang, L. (2023). International consensus statement on allergy and rhinology: Allergic rhinitis—2023. International Forum of Allergy & Rhinology, 13(4), 293–859. https://doi.org/10.1002/alr.23090
Dykewicz, M. S., Wallace, D. V., Amrol, D. J., Baroody, F. M., Bernstein, J. A., Craig, T. J., Dinakar, C., Ellis, A. K., Finegold, I., Golden, D. B. K., Greenhawt, M. J., Hagan, J. B., Horner, C. C., Khan, D. A., Lang, D. M., Larenas-Linnemann, D. E. S., Lieberman, J. A., Meltzer, E. O., Oppenheimer, J. J., . . . Wang, J. (2020). Rhinitis 2020: A practice parameter update. Journal of Allergy and Clinical Immunology, 146(4), 721–767. https://doi.org/10.1016/j.jaci.2020.07.007
Akhouri, S., & House, S. A. (2023). Allergic rhinitis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538186/
Emeryk, A., Bartkowiak-Emeryk, M., & Kowalska, M. (2012). Definition, classification and epidemiology of allergic rhinitis. Postępy Dermatologii i Alergologii/Advances in Dermatology and Allergology Supplement, 1–5.
de Bont, J., Jaganathan, S., Dahlquist, M., Persson, Å., Stafoggia, M., & Ljungman, P. (2022). Ambient air pollution and cardiovascular diseases: An umbrella review of systematic reviews and meta-analyses. Journal of Internal Medicine, 291(6), 779–800. https://doi.org/10.1111/joim.13467
Hamanaka, R. B., & Mutlu, G. M. (2025). Particulate matter air pollution: Effects on the respiratory system. Journal of Clinical Investigation, 135(17), e194312. https://doi.org/10.1172/JCI194312
Xu, X., Liu, X., Li, J., Deng, X., Dai, T., Ji, Q., Xiong, D., & Xie, H. (2023). Environmental risk factors, protective factors, and biomarkers for allergic rhinitis: A systematic umbrella review of the evidence. Clinical Reviews in Allergy & Immunology, 65(2), 188–205. https://doi.org/10.1007/s12016-023-08964-2
Jia, X., Shen, Z., Liu, R., et al. (2022). Association of fine particulate matter to allergic rhinitis: A systematic review and meta-analysis. European Journal of Inflammation, 20. https://doi.org/10.1177/1721727X221089839
Scussiatto, H. O., Wroblewski, K. E., Pagel, K. L., Schumm, L. P., McClintock, M. K., Ramanathan, M., Jr., Suh, H. H., & Pinto, J. M. (2024). Air pollution exposure is associated with rhinitis in older US adults via specific immune mechanisms. International Forum of Allergy & Rhinology, 14(1), 68–77. https://doi.org/10.1002/alr.23225
Tagliaferro, S., Pirona, F., Fasola, S., Stanisci, I., Sarno, G., Baldacci, S., Gariazzo, C., Licitra, G., Moro, A., Silibello, C., Stafoggia, M., Viegi, G., & Maio, S. (2024). Effects of traffic-related air and noise pollution exposure on allergic diseases in the elderly: An observational study. Annals of Medicine, 56(1), 2398193. https://doi.org/10.1080/07853890.2024.2398193
Park, K. H., Sim, D. W., Lee, S. C., Moon, S., Choe, E., Shin, H., Kim, S. R., Lee, J. H., Park, H. H., Huh, D., & Park, J. W. (2020). Effects of air purifiers on patients with allergic rhinitis: A multicenter, randomized, double-blind, and placebo-controlled study. Yonsei Medical Journal, 61(8), 689–697. https://doi.org/10.3349/ymj.2020.61.8.689
Cavalier, A., Dick, A. I., Johnson, V., II, Cramer, E., Eldeirawi, K., Pinto, J., Nyenhuis, S. M., & Lee, V. S. (2025). Assessing the impact of home environmental exposures on allergic rhinitis using real-time air quality monitoring and symptom assessment: Observational feasibility study. JMIR Formative Research, 9, e73215. https://doi.org/10.2196/73215
Massey, C. J., Tullis, B., Johnson, C., Oakley, G., Orlandi, R., Alt, J., Pulsipher, A., Gill, A., Horel, J., & Smith, K. (2025). Characterizing air pollution exposure methodologies in rhinology: A scoping review. International Journal of Environmental Health Research, 35(11), 3588–3603. https://doi.org/10.1080/09603123.2025.2477585
Gharbi, D., Neumann, F. H., Staats, J., McDonald, M., Linde, J. H., Mmatladi, T., Podile, K., Piketh, S., Burger, R., Garland, R. M., Bester, P., Lebre, P. H., & Ricci, C. (2025). Prevalence of aeroallergen sensitization in a polluted and industrialized area: A pilot study in South Africa’s Vaal Triangle. Environmental Monitoring and Assessment, 197(3), 287. https://doi.org/10.1007/s10661-025-13718-y
Li, J., Feng, C., Ma, X., & Wu, D. (2025). Impact of the urban atmospheric environment on otolaryngologic disease outpatient visits in Lanzhou, China. Scientific Reports, 15(1), 21556. https://doi.org/10.1038/s41598-025-07352-4
Abramson, M. J., Wigmann, C., Altug, H., & Schikowski, T. (2020). Ambient air pollution is associated with airway inflammation in older women: A nested cross-sectional analysis. BMJ Open Respiratory Research, 7(1), e000549. https://doi.org/10.1136/bmjresp-2019-000549
Zhang, Z.-Q., Li, J.-Y., Guo, Q., et al. (2025). Association between air pollution and allergic upper respiratory diseases: A meta-analysis. European Respiratory Review, 34, 240266. https://doi.org/10.1183/16000617.0266-2024
Nagino, K., Inomata, T., Ebihara, N., Midorikawa-Inomata, A., Fujio, K., Kobayashi, H., & Nakao, S. (2026). Association between yellow dust, PM2.5, and hay fever: A large-scale crowdsourced observational study using the AllerSearch smartphone application. Allergology International, 75(2), 294–306. https://doi.org/10.1016/j.alit.2025.11.008
Kim, J. Y., Lee, D. S., Woo, H. J., Kim, H. G., Son, B. S., Park, M. K., & Hong, S. N. (2021). Impact of particulate matter on the clinical characteristics of rhinitis. The Laryngoscope, 131(6), E1753–E1759. https://doi.org/10.1002/lary.29185
Rosario, C. S., Urrutia-Pereira, M., Murrieta-Aguttes, M., D’Amato, G., Chong-Silva, D. C., Godoi, R. H. M., & Rosario Filho, N. A. (2024). Air pollution and rhinitis. Frontiers in Allergy, 5, 1387525. https://doi.org/10.3389/falgy.2024.1387525
Li, J., Wu, H., Xing, W., Li, X., Han, Z., Ji, R., Deng, Z., Jung, M., Sun, S., Chung, B. I., Cardenas, A., & Langston, M. E. (2024). Air pollution mixture associated with oxidative stress exacerbation and symptoms deterioration in allergic rhinitis patients: Evidence from a panel study. Science of the Total Environment, 930, 172688. https://doi.org/10.1016/j.scitotenv.2024.172688
Pisithkul, T., Pisithkul, T., & Lao-Araya, M. (2024). Impact of air pollution and allergic status on health-related quality of life among university students in Northern Thailand. International Journal of Environmental Research and Public Health, 21(4), 452. https://doi.org/10.3390/ijerph21040452
European Forum for Research and Education in Allergy and Airways Diseases. (2020). Allergic rhinitis in adults. https://www.euforea.org/news/allergic-rhinitis-pocket-guide/
World Health Organization. (2021). WHO global air quality guidelines: Particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. https://www.who.int/publications/i/item/9789240034228
World Health Organization. (2025). Health risks of air pollution in Europe: HRAPIE-2 project: Updated guidance on concentration–response functions for health risk assessment of air pollution in the WHO European Region. https://www.who.int/publications/i/item/9789289062633
Wang, G. F., Zhang, Y. Z., Yang, H. Y., Yang, Y., Dong, L., Zhang, P., Liu, J., Chen, X. D., & Gong, Y. (2024). Impact of air pollutants on lung function and inflammatory response in asthma in Shanghai. Biomedical and Environmental Sciences, 37(8), 811–822. https://doi.org/10.3967/bes2024.125
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Copyright (c) 2026 Adela Dzwonkowska, Jakub Dzwonkowski, Alicja Kozłowska, Karolina Przybysz, Jarosław Rachoń, Luiza Stadnik, Nicol Szerenos, Daria Trocka, Natalia Woroniecka, Natalia Zienkiewicz

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