Impact of temperature exposure on nasal symptoms in temperature-sensitive chronic rhinitis patients

Background: Chronic rhinitis, including allergic rhinitis (AR) and nonallergic rhinitis (NAR), is frequently influenced by environmental factors such as temperature. This study aimed to investigate the characteristics of temperature-sensitive rhinitis patients and to explore the effects of temperature on nasal symptoms. Methods: A cross-sectional study was conducted from February 2023 to February 2024 at Beijing Tongren Hospital, enrolling 5,595 adult outpatients with chronic rhinitis. Patients were diagnosed with AR or NAR, with AR further classified into seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR). Standardized questionnaires and serum-specific immunoglobulin E testing were performed. Nasal symptoms (congestion, itching, sneezing, and rhinorrhea) were assessed using a visual analogue scale. A generalized linear model with cubic spline functions was used to examine nonlinear associations between ambient temperature and nasal symptoms, adjusting for potential confounders. Associations between temperature sensitivity, symptom severity, and environmental exposures were analyzed. Results: A total of 83.6% of patients with AR and 84.5% of those with NAR reported temperature sensitivity. Patients sensitive to temperature changes had significantly higher nasal symptom scores than those insensitive to temperature changes ( P < 0.001). The proportion of temperature-sensitive individuals increased with the severity of chronic rhinitis symptoms. In SAR, symptoms exhibited an inverted U -shaped relationship with temperature, peaking around 20°C, which corresponded to the pollen peak. In PAR, low-temperature environments (<20°C) aggravated nasal congestion and were the main factor affecting quality of life. Conclusions: Temperature-sensitive rhinitis patients experience more severe nasal symptoms. Low-temperature environments have the greatest impact on patients with PAR, particularly exacerbating symptoms of nasal congestion. Temperature indirectly affects the nasal symptoms in SAR patients by influencing pollen exposure.