Short-time risk of exacerbation of allergic rhinitis due to exposure air pollutants in 3 largest urban agglomerations in Poland

<bold>Objective:</bold> Ca. 10% of the world population is affected by allergic rhinitis (AR). Increased prevalence is observed in regions with substantial air pollution, but the short-term association between air pollutants exposure and risk of AR exacerbations is unclear. We focused on Poland, due to high level of pollution (e.g. the highest PM_2.5 concentrations in the EU). <bold>Materials and Methods</bold>: We used distributed lag linear-nonlinear models (DLNM) to analyze the risk of AR admission (ICD-10 J30 code) up to day 7 from exposure to PM₁₀, PM_2.5, NO₂, SO₂ and O₃ in 3 largest urban agglomerations in Poland: Warsaw, Cracow and the Tricity in 2012-2018. Long-term trends and seasonality was also analyzed. <bold>Results:</bold> 55.4% of total AR admissions were identified in cold season (53.8%-57.0% depending on city). They were associated with the exposure to NO₂ and O₃. Cumulative RR per 10 mg/m³ of NO₂ and O₃ was 1.252 (1.122-1.398) and 1.112 (1.011-1.244) respectively. 52.7% (31.2%-65.4%) and 8.14% (3.04%-12.6%) of admissions were attributable to NO₂ and O₃ respectively. The association with PM₁₀, PM_2.5 and SO₂ was insignificant. In the warm season, the admission risk due to J30 increased significantly after exposure to PM₁₀ and O₃. Cumulative relative risk (RR) per 10 mg/m³ of PM₁₀ and O₃ was 1.202 (95%CI: 1.044-1.384) and 1.112 (1.011-1.244) respectively. 8.79% (2.70%-14.9%) and 17.8% (3.44%-30.2%) of admissions were attributable to PM₁₀ and O₃ respectively. The admission risk did not change significantly after the exposure to PM_2.5, NO₂ and SO₂. <bold>Conclusions:</bold> AR admissions were associated with exposure to PM₁₀ and O₃ in the warm season and NO₂ and O₃ exposure in the heating season.