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      POLLAR: Impact of air POLLution on Asthma and Rhinitis; a European Institute of Innovation and Technology Health (EIT Health) project

      review-article
      1 , 2 , 3 , 4 , 5 , 6 , , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 13 , 17 , 18 , 7 , 17 , 19 , 20 , 13 , 21 , 22 , 7 , 14 , 15 , 21 , 13 , 21 , 21 , 23 , 24 , 25 , 14 , 15 , 26 , 27 , 28 , 29 , 30 , 31 , 31 , 32 , 33
      Clinical and Translational Allergy
      BioMed Central
      Asthma, Pollen, Pollution, Rhinitis, mHealth, Climate change

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          Abstract

          Allergic rhinitis (AR) is impacted by allergens and air pollution but interactions between air pollution, sleep and allergic diseases are insufficiently understood. POLLAR (Impact of air POLLution on sleep, Asthma and Rhinitis) is a project of the European Institute of Innovation and Technology (EIT Health). It will use a freely-existing application for AR monitoring that has been tested in 23 countries (the Allergy Diary, iOS and Android, 17,000 users, TLR8). The Allergy Diary will be combined with a new tool allowing queries on allergen, pollen (TLR2), sleep quality and disorders (TRL2) as well as existing longitudinal and geolocalized pollution data. Machine learning will be used to assess the relationship between air pollution, sleep and AR comparing polluted and non-polluted areas in 6 EU countries. Data generated in 2018 will be confirmed in 2019 and extended by the individual prospective assessment of pollution (portable sensor, TLR7) in AR. Sleep apnea patients will be used as a demonstrator of sleep disorder that can be modulated in terms of symptoms and severity by air pollution and AR. The geographic information system GIS will map the results. Consequences on quality of life (EQ-5D), asthma, school, work and sleep will be monitored and disseminated towards the population. The impacts of POLLAR will be (1) to propose novel care pathways integrating pollution, sleep and patients’ literacy, (2) to study sleep consequences of pollution and its impact on frequent chronic diseases, (3) to improve work productivity, (4) to propose the basis for a sentinel network at the EU level for pollution and allergy, (5) to assess the societal implications of the interaction. MASK paper N°32.

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          Most cited references64

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            Effect of outdoor air pollution on asthma exacerbations in children and adults: Systematic review and multilevel meta-analysis

            Background Several observational studies have suggested that outdoor air pollution may induce or aggravate asthma. However, epidemiological results are inconclusive due to the presence of numerous moderators which influence this association. The goal of this study was to assess the relationship between outdoor air pollutants and moderate or severe asthma exacerbations in children and adults through a systematic review and multilevel meta-analysis. Material and methods We searched studies published in English on PubMed, Scopus, and Google Scholar between January 2000 and October 2016. Studies following a case-crossover design with records of emergency departments and/or hospital admissions as a surrogate of moderate or severe asthma exacerbations were selected. A multilevel meta-analysis was employed, taking into account the potential clustering effects within studies examining more than one lag. Odds ratios (ORs) and 95% confidence intervals were estimated. A subgroup analysis in children aged 0 to 18 years and a sensitivity analysis based on the quality of the included studies as defined in the Newcastle-Ottawa Scale were performed. Publication bias was evaluated through visual inspection of funnel plots and by a complementary search of grey literature. (Prospero Registration number CRD42015032323). Results Database searches retrieved 208 records, and finally 22 studies were selected for quantitative analysis. All pollutants except SO2 and PM10 showed a significant association with asthma exacerbations (NO2: 1.024; 95% CI: 1.005,1.043, SO2: 1.039; 95% CI: 0.988,1.094), PM10: 1.024; 95% CI: 0.995,1.053, PM2.5: 1.028; 95% CI: 1.009,1.047, CO: 1.045; 95% CI: 1.005,1.086, O3: 1.032; 95% CI: 1.005,1.060. In children, the association was significant for NO2, SO2 and PM2.5. Conclusion This meta-analysis provides evidence of the association between selected air pollutants and asthma exacerbations for different lags.
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              Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care

              Backround Visual analogue scales (VAS) are psychometric measuring instruments designed to document the characteristics of disease-related symptom severity in individual patients and use this to achieve a rapid (statistically measurable and reproducible) classification of symptom severity and disease control. VAS can also be used in routine patient history taking and to monitor the course of a chronic disease such as allergic rhinitis (AR). More specifically, the VAS has been used to assess effectiveness of AR therapy in real life, both in intermittent and persistent disease. Methods This position paper takes a detailed look at the historical development of VAS and its method-specific principles. Particular focus is put on aspects of practical application in daily routine and on a critical discussion of the advantages and disadvantages of the individual methods. Results VAS are well validated for the measurement of AR symptoms and correlate well with the ARIA (allergic rhinitis and its impact on asthma) severity classification and also correlated well with rTNSS and RQLQ. Moreover, several treatment studies on AR have used VAS as an evaluation parameter. Thanks to the use of new (real-life and real-time) communication technologies, such as smartphone apps, Discussion: VAS can be used relatively simply and highly effectively to assess disease control. The VAS lends itself very well to digitization and has now been incorporated into a smartphone app (called Allergy Diary) to assess AR control and direct treatment decisions as part of an AR clinical decision support system (CDSS). MASK Rhinitis has developed this app, which is currently available in 15 different languages.
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                Author and article information

                Contributors
                +33 611 42 88 47 , jean.bousquet@orange.fr
                Journal
                Clin Transl Allergy
                Clin Transl Allergy
                Clinical and Translational Allergy
                BioMed Central (London )
                2045-7022
                17 September 2018
                17 September 2018
                2018
                : 8
                : 36
                Affiliations
                [1 ]MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
                [2 ]ISNI 0000000121866389, GRID grid.7429.8, INSERM U 1168, VIMA : Ageing and Chronic Diseases Epidemiological and Public Health Approaches, ; Villejuif, France
                [3 ]Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
                [4 ]Euforea, Brussels, Belgium
                [5 ]ISNI 0000 0001 2218 4662, GRID grid.6363.0, Charité, ; Berlin, Germany
                [6 ]ISNI 0000 0000 9961 060X, GRID grid.157868.5, CHU Montpellier, ; 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
                [7 ]ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
                [8 ]ISNI 0000 0004 1767 8811, GRID grid.411142.3, IMIM (Hospital del Mar Research Institute), ; Barcelona, Spain
                [9 ]ISNI 0000 0001 2172 2676, GRID grid.5612.0, Universitat Pompeu Fabra (UPF), ; Barcelona, Spain
                [10 ]ISNI 0000 0000 9314 1427, GRID grid.413448.e, CIBER Epidemiología y Salud Pública (CIBERESP), ; Barcelona, Spain
                [11 ]ISNI 0000 0001 2308 1657, GRID grid.462844.8, Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, , INSERM and UPMC Sorbonne Universités, Medical School Saint Antoine, ; Paris, France
                [12 ]ISNI 0000 0001 0671 0327, GRID grid.413521.0, AQuAS, ; Barcelona, Spain
                [13 ]Kyomed INNOV, Montpellier, France
                [14 ]Université Grenoble Alpes, Laboratoire HP2, INSERM, U1042 Grenoble, France
                [15 ]ISNI 0000 0001 0792 4829, GRID grid.410529.b, CHU de Grenoble, ; Grenoble, France
                [16 ]ISNI 0000 0004 0452 3378, GRID grid.423754.3, Bull SAS, ; Échirolles, France
                [17 ]ISNI 0000 0001 0011 8533, GRID grid.413802.c, National Center of Expertise in Cognitive Stimulation (CEN STIMCO), Broca Hospital, ; Paris, France
                [18 ]ISNI 0000 0001 2188 0914, GRID grid.10992.33, Memory and Cognition Laboratory, Institute of Psychology, , Paris Descartes University, Sorbonne Paris Cité, ; Boulogne Billancourt, France
                [19 ]ISNI 0000 0001 2097 6957, GRID grid.58140.38, Mines ParisTech CRI - PSL Research University, ; Fontainebleau, France
                [20 ]GRID grid.450307.5, Direction de la Recherche, Innovation et Valorisation, Université Grenoble Alpes, ; Grenoble, France
                [21 ]Neogia, Paris, France
                [22 ]Centre National de Référence Narcolepsie Hypersomnies, Département de Neurologie, Hôpital Gui-de-Chauliac Inserm U1061, Unité des Troubles du Sommeil, Montpellier, France
                [23 ]LIP6 SU, Place Jussieu, Paris, France
                [24 ]Conseil Général de l’Economie Ministère de l’Economie, de l’Industrie et du Numérique, Paris, France
                [25 ]ISNI 0000 0000 9601 989X, GRID grid.425902.8, Climate and Health Program and ISGlobal and ICREA, ; Barcelona, Spain
                [26 ]iQ4U Consultants Ltd, London, UK
                [27 ]Joensuu, Finland
                [28 ]Medical Consulting Czarlewski, Levallois, France
                [29 ]ISNI 0000 0001 1503 7226, GRID grid.5808.5, Center for Health Technology and Services Research- CINTESIS, Faculdade de Medicina, , Universidade do Porto, ; Porto, Portugal
                [30 ]MEDIDA, Lda, Porto, Portugal
                [31 ]Center for Rhinology and Allergology, Wiesbaden, Germany
                [32 ]Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
                [33 ]Managing Director, EIT Health France, Paris, France
                Author information
                http://orcid.org/0000-0001-9226-7762
                Article
                221
                10.1186/s13601-018-0221-z
                6139902
                30237869
                3a8069c6-10c3-4559-8d65-ab77ddc265dc
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 16 May 2018
                : 12 August 2018
                Categories
                Review
                Custom metadata
                © The Author(s) 2018

                Immunology
                asthma,pollen,pollution,rhinitis,mhealth,climate change
                Immunology
                asthma, pollen, pollution, rhinitis, mhealth, climate change

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