Abstract
BACKGROUND: Environmental factors, such as air irritants, may play an important role in chronic rhinosinusitis (CRS); however, no studies to date have examined the role of pollen in CRS disease severity. Here, we analyze the effects of pollen exposure on disease-specific and general quality-of-life (QOL) reports. METHODS: Patients were enrolled prospectively across four academic medical centers and completed the 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) surveys at enrollment. Mean annual pollen exposure over a 5-year period before enrollment was obtained from the National Allergy Bureau using residence zip codes. Unadjusted Spearman's correlation coefficients (r (s) ) and 95% confidence intervals (CI) were calculated. RESULTS: One hundred and three patients were included and 55% had a history of allergy. Higher 5-year mean ragweed pollen exposure correlated with worse presenting SNOT-22 (r (s) = 0.24; 95% CI: 0.033, 0.42; p = 0.019) and SF-6D scores (r (s) = -0.21; 95% CI: -0.40, -0.0054; p = 0.039). Higher 5-year weed pollen exposure correlated with worse SNOT-22 scores (r (s) = 0.20; 95% CI: 0.00054, 0.38; p = 0.043). CONCLUSION: This multi-institutional pilot study suggests that weed and ragweed pollen may negatively impact the QOL of patients with CRS, but further studies are needed to confirm these findings. LEVEL OF EVIDENCE: 3. TRIAL REGISTRATION: Clinical trial registration ID: NCT02720653 (www.clinicaltrials.gov).