Original Article

The Prevalence of Allergic Rhinitis in Southwestern Iran and Its Association with Chronic Rhinosinusitis: A GA2LEN Study

The Prevalence of Allergic Rhinitis in Adults


Allergic rhinitis (AR) is a prevalent disease affecting the quality of life of patients throughout the world. This study aimed to assess the prevalence of AR and its association with chronic rhinosinusitis (CRS) in the adult population living in Bushehr, southwestern part of Iran.
In this population-based study, a total of 5420  individuals aged 15-65 years were selected through a multi-stage, cluster, random sampling method from which 5201 of them completed the Global Allergy and Asthma Network of Excellence (GA2LEN) questionnaire (Response rate=96.1%). The prevalence of AR, based on Allergic Rhinitis and Its Impact on Asthma (ARIA) classification (mild or moderate; intermittent or persistent) was calculated and the association of AR and CRS was evaluated using a multiple logistic regression model.
The overall prevalence of AR was 28.8%, and for the intermittent and persistent AR were 25.9% (out of which 81.34% were moderate to severe) and 74.1% respectively. Moreover, the prevalence of AR was significantly higher in health workers and smokers (p=0.002 and p<0.001, respectively). Furthermore, an association was found between AR and CRS (p<0.001, aOR: 4.68, 95%CI: 4.07-5.39), and also, between the persistent AR and CRS as compared with the intermittent (p<0.001, aOR: 4.21, 95%CI: 3.40-5.22).
The present study showed that the prevalence of AR in Bushehr (Southwestern part of Iran) was significantly high. In addition, the results indicated a strong association between AR and CRS, especially in individuals with moderate to severe persistent AR. 

1. Min Y-G. The pathophysiology, diagnosis and treatment of allergic rhinitis. Allergy Asthma Immunol Res. 2010;2(2):65-76.
2. Meltzer EO, Bukstein DA. The economic impact of allergic rhinitis and current guidelines for treatment. Ann Allergy Asthma Immunol. 2011;106(2):S12-S6.
3. Skoner DP Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol. 2001;108(1):S2-8.
4. Vázquez D, Medina I, Logusso G, Arias S, Gattolin G, Parisi C. Cross-sectional survey about the prevalence of allergic rhinitis in Argentina: Study PARA Encuesta transversal sobre la prevalencia de rinitis alérgica en Argentina: el estudio PARA. Rev Alerg Mex. 2019;66(1):55-64.
5. Bédard A, Basagaña X, Anto JM, Garcia-Aymerich J, Devillier P, Arnavielhe S, et al. Mobile technology offers novel insights into the control and treatment of allergic rhinitis: The MASK study.J Allergy Clin Immunol. 2019;134(10;135-43.
6. Shakhova N, Kamaltynova E, Lobanov Y, Ardatova T, Nikolaeva K. The prevalence and risk factors of allergic rhinitis among the children of the preschool age. Vestn Otorinolaringol. 2017;82(6):47-51.
7. Bousquet J, Schunemann H, Fonseca J, Samolinski B, Bachert C, Canonica G, et al. MACVIA‐ARIA Sentinel NetworK for allergic rhinitis (MASK‐rhinitis): the new generation guideline implementation. Allergy. 2015;70(11):1372-92.
8. Bousquet J, Schünemann HJ, Samolinski B, Demoly P, Baena-Cagnani CE, Bachert C, et al. Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs. J Allergy Clin Immunol.2012;130(5):1049-62.
9. Pawankar R, Bunnag C, Chen Y, Fukuda T, You-Young K, Le LTT, et al. Allergic rhinitis and its impact on asthma update (ARIA 2008)-western and Asian-Pacific perspective. Asian Pac J Allergy Immunol. 2009;27(4):237.
10. Fazlollahi MR, Souzanchi G, Nourizadeh M, Sabetkish N, Tazesh B, Entezari A, et al. The prevalence of allergic rhinitis and it's relationship with second-hand tobacco smoke among adults in Iran. Acta Med Iran. 2017;7(2):712-7.
11. Scadding G, Durham S, Mirakian R, Jones N, Drake‐Lee A, Ryan D, et al. BSACI guidelines for the management of rhinosinusitis and nasal polyposis. Clin Exp Allergy. 2008;38(2):260-75.
12. Van Zele T, Claeys S, Gevaert P, Van Maele G, Holtappels G, Van Cauwenberge P, et al. Differentiation of chronic sinus diseases by measurement of inflammatory mediators. Allergy. 2006;61(11):1280-9.
13. Krause HF. Allergy and chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2003;128(1):14-6.
14. Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European position paper on rhinosinusitis and nasal polyps 2020. 2020;29(1):1-464.
15. Hoffmans R, Wagemakers A, van Drunen C, Hellings P, Fokkens W. Acute and chronic rhinosinusitis and allergic rhinitis in relation to comorbidity, ethnicity and environment. PloS one. 2018;13(2):e0192330.
16. Hastan D, Fokkens W, Bachert C, Newson R, Bislimovska J, Bockelbrink A, et al. Chronic rhinosinusitis in Europe–an underestimated disease. A GA2LEN study. Allergy. 2011;66(9):1216-23.
17. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens W, Togias A, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008. Allergy. 2008;63:8-160.
18. Weiler JM, Layton T, Hunt M. Asthma in United States Olympic athletes who participated in the 1996 Summer Games. J Allergy Clin Immunol. 1998;102(5):722-6.
19. Dykewicz MS, Hamilos DL. Rhinitis and sinusitis.J Allergy Clin Immunol. 2010;125(2):S103-S15.
20. Ozdoganoglu T, Songu M. The burden of allergic rhinitis and asthma. Ther Adv Respir Dis. 2012;6(1):11-23.
21. Varasteh AR, Fereidouni M, Shakeri MT, Vahedi F, Abolhasani A, Afsharian MS, et al. Prevalence of allergic disorders among the population in the city of Mashhad, Northeast Iran. J Public Health. 2009;17(2):107-12.
22. Zhang L, Han D, Huang D, Wu Y, Dong Z, Xu G, et al. Prevalence of self-reported allergic rhinitis in eleven major cities in china. Int Arch Allergy Immunol. 2009;149(1):47-57.
23. Peden D, Reed CE. Environmental and occupational allergies. J Allergy Clin Immunol. 2010;125(2):S150-S60.
24. Iranpour D, Farrokhi S, Gheybi MK, Movahed A, Tahmasebi R, Fatemi A, et al. Common aeroallergens in patients with asthma and allergic rhinitis living in southwestern part of Iran: based on skin prick test reactivity. Iran J Allergy Asthma Immunol. 2015;14(2):3-14.
25. Gheybi MK, Movahed AM, Dehdari R, Amiri S, Khazaei HA, Gooya M, et al. Dusty Air Pollution is Associated with an Increased Risk of Allergic Diseases in Southwestern Part of Iran. Iran J Allergy Asthma Immunol. 2014;1296):404-11.
26. Bilge U, Unluoglu I, Son N, Keskin A, Korkut Y, Unalacak M. Occupational allergic diseases in kitchen and health care workers: an underestimated health issue. Biomed Res Int. 2013;2013.
27. Feng CH, Miller MD, Simon RA. The united allergic airway: connections between allergic rhinitis, asthma, and chronic sinusitis. Am J Rhinol Allergy. 2012;26(3):187-90.
28. Hoover GE, Newman LJ, Platts-Mills TA, Phillips CD, Gross CW, Wheatley LM. Chronic sinusitis: risk factors for extensive disease.J Allergy Clin Immunol. 1997;100(2):185-91.
29. Newman LJ, Platts-Mills TA, Phillips CD, Hazen KC, Gross CW. Chronic sinusitis: relationship of computed tomographic findings to allergy, asthma, and eosinophilia. Jama. 1994;271(5):363-7.
30. Min J-Y, Tan BK. Risk factors for chronic rhinosinusitis. Curr Opin Allergy Clin Immunol. 2015;15(1):1-12.
31. Berrettini S, Carabelli A, Sellari‐Franceschini S, Bruschini L, Quartieri F, Sconosciuto F, et al. Perennial allergic rhinitis and chronic sinusitis: correlation with rhinologic risk factors. Allergy. 1999;54(3):242-8.
32. Hamilos DL, Leung DY, Wood R, Cunninghama L, Bean DK, Yasruelb Z, et al. Evidence for distinct cytokine expression in allergic versus nonallergic chronic sinusitis. J Allergy Clin Immunol. 1995;96(4):537-44.
33. Ghaffar O, Small P, Frenkiel S, Hamid Q. IL-4 and IL-13 expression in chronic sinusitis: relationship with cellular infiltrate and effect of topical corticosteroid treatment. J Otolaryngol. 1997;26(3):160-6.
IssueVol 20 No 3 (2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijaai.v20i3.6342
Allergic rhinitis Asthma Nasal polyps Prevalence Sinusitis

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How to Cite
Ostovar A, Pordel S, Movahed A, Kaboodkhani R, Akhlaghi A, Darabi A, Ghaderi F, Farrokhi S. The Prevalence of Allergic Rhinitis in Southwestern Iran and Its Association with Chronic Rhinosinusitis: A GA2LEN Study. Iran J Allergy Asthma Immunol. 20(3):263-270.