title: Environmental pollutants and allergic rhinitis.
abstract: OBJECTIVE
  To review the current knowledge of the pathophysiology, epidemiology, and management of environmental pollutants and allergic rhinitis.
  
  
  RESULTS
  Both active cigarette smoking and passive exposure to cigarette smoke are associated with chronic rhinitis and sinusitis. Matrix metalloproteinase 9, which is thought to contribute to the pathophysiology of allergy, is elevated in children with passive cigarette smoke exposure compared with controls. Ground-level ozone and particulate matter exposure is associated with an allergic-type response and may increase sensitization to other allergens. Certain occupational exposures can cause nasal irritation and local cytotoxic effects. Evidence suggests that rhinitis symptomatology may often precede the development of occupational asthma.
  
  
  CONCLUSIONS
  Environmental factors have been noted to induce sinonasal mucosal irritation and often contribute to the multifactorial cause of chronic rhinitis and allergic rhinitis. Cigarette smoke is a common irritant that impacts the innate immune function of the sinonasal epithelial cells, and creates local irritation and cytotoxic effects. Both active smoking and exposure to second-hand smoke increase the risk of chronic rhinitis. Many other environmental pollutants are associated with chronic rhinitis, including ozone, particulate matter, and occupational irritants. The management of chronic rhinitis associated with environmental exposures is similar to the management of other types of chronic rhinitis. Although often not feasible, avoidance is probably the most effective course.
authors.affiliation: The Johns Hopkins Sinus Center, Department of Otolaryngology and Head & Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Higgins
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Reh
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects; D059366:Asthma, Occupational / Q000453:epidemiology / Q000209:etiology; D015984:Causality; D004785:Environmental Pollutants / Q000009:adverse effects*; D005858:Germany; D006801:Humans; D016273:Occupational Exposure / Q000009:adverse effects; D010126:Ozone / Q000009:adverse effects; D052638:Particulate Matter / Q000009:adverse effects; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D000393:Air Pollutants; D004785:Environmental Pollutants; D052638:Particulate Matter; D014028:Tobacco Smoke Pollution; D010126:Ozone