title: Impairment in quality of life is directly related to the level of allergen exposure and allergic airway inflammation.
abstract: BACKGROUND
  Allergic disease has been shown to impair health-related quality of life (HRQL). The relationship between HRQL and either allergen exposure or allergic inflammation has not been previously assessed.
  
  
  OBJECTIVE
  To assess the relationship between HRQL and both grass pollen exposure and airway inflammation using the Paediatric Allergic Disease Quality of Life Questionnaire (PADQLQ). This is a novel questionnaire previously developed to assess the multi-system aspects of allergic disease.
  
  
  METHODS
  Eighty-four subjects, aged 6-17 years, with seasonal allergic rhinoconjunctivitis, asthma and/or cutaneous manifestations were assessed before and during the grass pollen season. They were assessed with the PADQLQ, a visual analogue scale (VAS) to assess quality of life, symptom diary and exhaled nitric oxide (FENO).
  
  
  RESULTS
  HRQL, as measured by the PADQLQ, significantly correlated with the average pollen count in the previous week (regression coefficient 0.038, 95% confidence interval (CI) 0.027-0.049, P<0.001). The PADQLQ score was also found to be significantly associated with airway inflammation as measured by FENO (regression coefficient 0.410, 95% CI 0.175-0.646, P=0.001). Additionally, PADQLQ showed a high degree of correlation with symptom scores and quality of life as measured by a VAS, good within-subject reliability and a small minimal important difference (0.20, 95% CI -0.09 to 0.49 on a seven-point scale).
  
  
  CONCLUSIONS
  HRQL is related to both allergen load and allergic inflammation and the PADQLQ has excellent cross-sectional and longitudinal validity with respect to quality of life and symptoms.
authors.affiliation: Academic Child Health, University of Southampton, Southampton, UK. g.c.roberts@soton.ac.uk
authors.forename: G
authors.initials: G
authors.lastname: Roberts
authors.forename: M
authors.initials: M
authors.lastname: Mylonopoulou
authors.forename: C
authors.initials: C
authors.lastname: Hurley
authors.forename: G
authors.initials: G
authors.lastname: Lack
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000009:adverse effects* / Q000032:analysis; D001249:Asthma / Q000209:etiology / Q000534:rehabilitation; D002648:Child; D003233:Conjunctivitis, Allergic / Q000209:etiology / Q000534:rehabilitation; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000032:analysis; D006109:Poaceae; D011058:Pollen / Q000009:adverse effects; D011594:Psychometrics; D011788:Quality of Life; D012130:Respiratory Hypersensitivity / Q000209:etiology / Q000534:rehabilitation*; D006255:Rhinitis, Allergic, Seasonal / Q000209:etiology / Q000534:rehabilitation; D011795:Surveys and Questionnaires
chemical_list: D000485:Allergens; D009569:Nitric Oxide