title: Occupational and environmental risk factors for chronic rhinosinusitis in China: a multicentre cross-sectional study.
abstract: Chronic rhinosinusitis (CRS) is defined as a condition of inflammation in the paranasal sinus mucosa persisting for more than 12 weeks. We previously reported that the prevalence of CRS was about 8 % in China. Here, we aim to investigate the occupational and environmental risk factors associated with CRS.
  
  
  
  Data were collected from seven Chinese cities: Urumqi, Changchun, Beijing, Wuhan, Chengdu, Huaian and Guangzhou. CRS was diagnosed according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EP(3)OS) document. Participants were asked to complete a standardized questionnaire, which was developed by the Global Allergy and Asthma European Network (GA(2)LEN) project and covered sociodemographic characteristics, CRS-related symptoms and occupational and environmental exposures. We evaluated the association between CRS and various occupational and environmental factors using odds ratios (ORs) and 95 % confidence intervals (95 % CIs).
  
  
  
  The total study population consisted of 10,633 subjects, 850 (7.99 %) of whom were defined as having CRS according to the EP(3)OS criteria. We found that there were significant associations between occupational and environmental factors and CRS. Specifically, having a clearance-related job, occupational exposure to dust, occupational exposure to poisonous gas, a pet at home or carpet at home or at the workplace were risk factors for CRS. Additionally, the method used to keep warm in winter, the duration of time spent using air conditioning in summer and the frequency of exposure to mouldy or damp environments were significantly different in subjects with and without CRS.
  
  
  
  Our data showed that some occupational and environmental exposures are strongly associated with CRS, which aids in understanding the epidemiology of CRS.
authors.affiliation: Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, Guangdong, 510080, China.
authors.forename: Wen-Xiang
authors.initials: WX
authors.lastname: Gao
authors.affiliation: State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Chun-Quan
authors.initials: CQ
authors.lastname: Ou
authors.affiliation: Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, Guangdong, 510080, China.
authors.forename: Shu-Bin
authors.initials: SB
authors.lastname: Fang
authors.affiliation: Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, Guangdong, 510080, China.
authors.forename: Yue-Qi
authors.initials: YQ
authors.lastname: Sun
authors.affiliation: Department of Otorhinolaryngology, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Cheng
authors.affiliation: Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Yan-Jun
authors.initials: YJ
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology Head and Neck, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China.
authors.forename: Dong-Dong
authors.initials: DD
authors.lastname: Zhu
authors.affiliation: Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Lv
authors.affiliation: Department of Otorhinolaryngology, West China Hospital of Medicine, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Shi-Xi
authors.initials: SX
authors.lastname: Liu
authors.affiliation: Department of Otorhinolaryngology, Affiliated Huai'an First People's Hospital, Nanjing Medical University, Huaian, Jiangsu, China.
authors.forename: P Z
authors.initials: PZ
authors.lastname: Li
authors.affiliation: Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, Guangdong, 510080, China.
authors.forename: Geng
authors.initials: G
authors.lastname: Xu
authors.affiliation: Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, Guangdong, 510080, China. tsjbent@163.com.
authors.forename: Jianbo
authors.initials: J
authors.lastname: Shi
authors.affiliation: Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, Guangdong, 510080, China. fuqingl@mail.sysu.edu.cn.
authors.forename: Qing-Ling
authors.initials: QL
authors.lastname: Fu
mesh_terms: D000293:Adolescent; D000328:Adult; D016902:Air Pollution, Indoor; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019570:Inhalation Exposure / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009298:Nasal Polyps / Q000175:diagnosis / Q000453:epidemiology*; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D016272:Occupational Health; D016017:Odds Ratio; D015995:Prevalence; D012220:Rhinitis / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D012852:Sinusitis / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: China; Chronic rhinosinusitis; Occupational and environmental risk factors; Prevalence