Pollen exposure linked to worse quality of life for chronic sinus infection sufferers

The results of a pilot study suggest long term exposure to higher pollen levels leads to worse symptoms and quality of life for patients with chronic rhinosinusitis.

For the 103 patients studied, levels of ragweed pollen exposure over a five-year interval were correlated with worse Sino-Nasal Outcome Test (SNOT-22) scores. (SNOT-22 is a questionnaire used to measure quality of life for patients with chronic rhinosinusitis.)

Although allergy is often discussed in the context of chronic rhinosinusitis, it is unclear how it might impact disease outcomes.

Prior studies have attempted to clarify the complex relationship between CRS and allergic rhinitis. However, after reviewing the relevant literature to date, the authors determined that the association of systematic allergy and CRS remained inconclusive.

“The goal of the present pilot study was to address that knowledge gap,” said Amarbir Singh Gill, M.D., assistant professor of otolaryngology at the University of Michigan Medical School and senior author on the paper.

“Although preliminary, our data indicate that certain pollen types, including ragweed, may negatively affect sinonasal quality of life.”

Chronic rhinosinusitis is an inflammation of the nose and sinuses that lasts more than 12 weeks.

Resulting symptoms can include congestion, facial pain and a reduced sense of smell.

Previous research has shown the impact of environmental factors such as air pollution on chronic rhinosinusitis.

No previous studies, however, have examined the relationship between patient-reported outcomes and pollen exposure.

This study enrolled patients at four centers and analyzed data from the National Allergy Bureau from counties in those four states (Oregon, South Carolina, Colorado, and Utah).

Higher five-year exposure to both ragweed and other weed pollen correlated with worse SNOT-22 scores. (Higher ragweed pollen exposure also correlated with another measure—Medical Outcomes Study Questionnaire Short-Form 6-D—while weed pollen did not.)

These results conform with a prior study, which found that tree and weed pollen led to more prescriptions filled for allergic rhinitis, an inflammatory condition of the nasal cavity that presents with sneezing, runny nose, and nasal blockage. However, allergic rhinitis doesn’t typically exhibit other sinonasal symptoms common in CRS, such as facial pressure/pain, discolored drainage.

Although many patients with CRS also have allergic rhinitis, not all patients with CRS have allergies.

Researchers believe larger studies are needed to further investigate this potential link between pollen exposure and quality of life in patients with chronic rhinosinusitis.

“It is important to remember that our study has limitations, including its retrospective nature, self-reported allergy status, and limited number of counties with a pollen measurement station,” Gill said.

“It was also not possible to confirm that participants resided continuously in their zip code for the five-year period used to determine their exposure level. Future studies ideally would incorporate larger numbers, objective allergy testing, be prospective in nature and utilize wearable devices that detect absolute exposure for participants.”

Additional authors: Benton Tullis, M.D., Jess C. Mace, M.P.H, Conner Massey, M.D., Stuart Batterman, Ph.D., Vijay R. Ramakrishnan, M.D., Daniel M. Beswick, M.D., Zachary M. Soler M.D., M.Sc., Timothy L. Smith, M.D., M.P.H, Jeremiah A. Alt, M.D. M.P.H.

Funding/disclosures: National Institute on Deafness and Other Communication Disorders R01 DC005805

Paper cited: “Pollen Exposure and Chronic Rhinosinusitis Quality of Life Disease Severity,” Laryngoscope Investigative Otolaryngology. DOI: 10.1002/lio2.70309