title: Inter-Relationship between Rhinitis and Conjunctivitis in Allergic Rhinoconjunctivitis and Associated Risk Factors in Rural UK Children.
abstract: OBJECTIVE
  Allergic conjunctivitis (AC) is a common condition, especially in childhood. The extent to which it occurs concurrently with or independently from allergic rhinitis (AR) has not been well described.
  
  
  OBJECTIVE
  To examine the inter-relationship between rhinitis and conjunctivitis and the epidemiological risk factors for these conditions in a rural UK population.
  
  
  METHODS
  Cross-sectional study of rural school children (aged 5-11 years). Parental questionnaires were used to diagnose allergic outcomes (including conjunctivitis, rhinitis and rhinoconjunctivitis), and to collect data on atopic history, demographic and environmental exposures. Odds ratios of allergic outcome by exposure were examined adjusted for age, sex, breastfeeding, family history of allergy, number of older and younger siblings.
  
  
  RESULTS
  Prevalence of conjunctivitis was 17.5%, rhinitis 15.1% and rhinoconjunctivitis 13.0%. Seasonality of symptoms varied by condition: 64.7% of those with conjunctivitis had seasonal symptoms (April-Sept only), 46.7% of those with rhinitis and 92.2% of those with rhinoconjunctivitis. Living on a farm consistently reduced the risk of conjunctivitis (odds ratio 0.47, 95%CI 0.29-0.79, p = 0.004), rhinitis (OR 0.57, 95%CI 0.33-1.01, p = 0.05) and rhinoconjunctivitis (OR 0.57, 95%CI 0.32-1.03, p = 0.06). Exposure to farm animals (particularly in early life), current consumption of unpasteurised milk and playing in a barn or stable significantly reduced the risk of all three conditions.
  
  
  CONCLUSIONS
  More children had parent-reported conjunctivitis than rhinitis. The majority of children with either condition also reported symptoms with the other condition. Farmers' children have less eye and/or nasal symptoms. A number of farming variables linked with the farm microbial environment are likely to be mediating the protective effect.
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, United Kingdom.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Perkin
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, United Kingdom.
authors.forename: Tara
authors.initials: T
authors.lastname: Bader
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, United Kingdom.
authors.forename: Alicja R
authors.initials: AR
authors.lastname: Rudnicka
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, United Kingdom.
authors.forename: David P
authors.initials: DP
authors.lastname: Strachan
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, United Kingdom.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Owen
mesh_terms: D003231:Conjunctivitis / Q000453:epidemiology; D003233:Conjunctivitis, Allergic / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012220:Rhinitis / Q000453:epidemiology*; D006255:Rhinitis, Allergic, Seasonal / Q000453:epidemiology; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology