K R Bharath Kumar Reddy1, Neeraj Gupta2, Barnali G Bhattacharya3, Nayan Mani Deka4, Parmarth Chandane5, Rashmi Kapoor6, Sarika Gupta7, Sowmya A Nagarajan8, G V Basavaraja9, Bakul Jayant Parekh10. 1. Department of Paediatric Pulmonology and Sleep, Shishuka Children's Hospital, Bangalore, Karnataka. Correspondence to: Dr KR Bharath Kumar Reddy, Shishuka Children's Hospital, Kalyan Nagar, HRBR Layout, Bengalure, Karnataka 560 043. drbharathreddykr@gmail.com. 2. Department of Pediatrics, Sir Ganga Ram Hospital, Delhi. 3. Sir Ganga Ram Hospital, Delhi. 4. Asthma and allergy Centre, Pratiksha Hospital, Guwahati, Assam. 5. Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra. 6. Regency Hospital, Kanpur, Uttar Pradesh. 7. King George Medical University, Lucknow, Uttar Pradesh. 8. Sanjeevini Allergy and Immunology Centre and Kangaroo Care Hospitals, Bengaluru, Karnataka. 9. Indira Gandhi Institute of Child Health, Bengalure, Karnataka. 10. President 2020, Indian Academy of Pediatrics.
Abstract
JUSTIFICATION: Rising air pollution is an ever-growing threat to many human diseases. Poor air quality has been directly correlated with respiratory allergies with a disproportionate affection among the pediatric age group. A clear understanding of common air pollutants and their potential contribution in allergic rhinitis and asthma is lacking. OBJECTIVE: To formulate a consensus statement for appropriate understanding among pediatricians and general practitioners about the effects of air pollution on respiratory allergies and their prevention. PROCESS: A group of experts (Pediatric pulmonologists and allergy specialists) from across India were appointed by the Indian Academy of Pediatrics (IAP) to formulate a consensus statement on 'Allergy and Air pollution'. A virtual meeting was conducted on 6th April 2020 to discuss in detail regarding various issues related to the subject and a writing committee was formed with broad consensus. After extensive literature review and multiple virtual sessions, the current document was prepared and circulated via email to the representatives from central IAP and IAP environment chapter. All the experts approved the consensus with minor modifications after a detailed discussion on 29th September 2020 on a virtual platform. RECOMMENDATIONS: Air pollution is the emerging contributor to respiratory allergies due to various mechanisms including oxidative stress and compromised mucociliary clearance. Children are more vulnerable to both outdoor and indoor pollution, due to their unique physiological characteristics. Knowledge about pollutant particle size and air quality index will help in demarcating level and extent of airway involvement. Relevant environmental history in difficult allergic rhinitis and asthma cases, along with conventional pharmacological measures, is warranted. Multipronged approach, targeted at community, physician and individual levels, needs to be emphasized to improve air quality and reduce economic and psychological burden of respiratory allergies.
JUSTIFICATION: Rising air pollution is an ever-growing threat to many human diseases. Poor air quality has been directly correlated with respiratory allergies with a disproportionate affection among the pediatric age group. A clear understanding of common air pollutants and their potential contribution in allergic rhinitis and asthma is lacking. OBJECTIVE: To formulate a consensus statement for appropriate understanding among pediatricians and general practitioners about the effects of air pollution on respiratory allergies and their prevention. PROCESS: A group of experts (Pediatric pulmonologists and allergy specialists) from across India were appointed by the Indian Academy of Pediatrics (IAP) to formulate a consensus statement on 'Allergy and Air pollution'. A virtual meeting was conducted on 6th April 2020 to discuss in detail regarding various issues related to the subject and a writing committee was formed with broad consensus. After extensive literature review and multiple virtual sessions, the current document was prepared and circulated via email to the representatives from central IAP and IAP environment chapter. All the experts approved the consensus with minor modifications after a detailed discussion on 29th September 2020 on a virtual platform. RECOMMENDATIONS: Air pollution is the emerging contributor to respiratory allergies due to various mechanisms including oxidative stress and compromised mucociliary clearance. Children are more vulnerable to both outdoor and indoor pollution, due to their unique physiological characteristics. Knowledge about pollutant particle size and air quality index will help in demarcating level and extent of airway involvement. Relevant environmental history in difficult allergic rhinitis and asthma cases, along with conventional pharmacological measures, is warranted. Multipronged approach, targeted at community, physician and individual levels, needs to be emphasized to improve air quality and reduce economic and psychological burden of respiratory allergies.