Abstract
To investigate the association of long-term exposure to ambient air pollution with the risk of allergic rhinitis (AR), we performed a longitudinal analysis of 379,488 participants (47.4% women) free of AR at baseline in the UK Biobank. The annual average concentrations of PM2.5, PMcoarse, PM10, NO2, and NOx were estimated by land use regression models. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). A weighted polygenic risk score was constructed. During a median follow-up period of 12.5 years, 3095 AR cases were identified. We observed significant associations between the risk of AR and PM2.5 (HR: 1.51, 95% CI: 1.27-1.79, per 5 μg/m3), PMcoarse (HR: 1.28, 95% CI: 1.06-1.55, per 5 μg/m3), PM10 (HR: 1.45, 95% CI: 1.20-1.74, per 10 μg/m3), NO2 (HR: 1.14, 95% CI: 1.09-1.19, per 10 μg/m3), and NOx (HR: 1.10, 95% CI: 1.05-1.15, per 20 μg/m3). Moreover, participants with high air pollution combined with high genetic risk showed the highest risk of AR, although no multiplicative or additive interaction was observed. In conclusion, long-term exposure to air pollutants was associated with an elevated risk of AR, particularly in high-genetic-risk populations, emphasizing the urgent need to improve air quality.