The impact of air pollution and aeroallergens levels on upper airway acute diseases at urban scale.

Air pollution (AP) represents one of the main environmental threats to public health and exposure to AP has been connected to upper airway (UA) disease. We evaluated the relationships between the ENT urgent referrals recorded at the Hospital of Padua and the daily levels of particulate matter (PM) as well as other environmental factors in a single year. Patients with UA disorders were included in the study group while those referred for facial trauma or foreign body inhalation formed the control group. Daily PM concentrations, meteorological data and the concentrations of the commonest aeroallergens were obtained. 6368 patients formed the study group and 910 the control one. The concentration of compositae allergens showed a positive effect on the total number of admissions (p = 0.001). PM 10 did not demonstrate an effect on the total number of admissions or either the study or control groups admissions (p = 0.25). Alternaria positively influenced admissions of patients in the study group (p = 0.005). Significant relationships were found between the following: PM 10 measured on the seventh day before A&E admission and rhinosinusitis (p = 0.007), PM 10 on the fifth day and laryngitis (p = 0.01), PM 10 on the second day and otitis media (p = 0.03), PM 10 on the admission day and epistaxis (p = 0.0198). Our study confirms the causal relationship between aeroallergen concentration and ENT admissions. The levels of PM 10 at specific days preceding A&E admission correlated with certain UA disorders. This study strongly points towards the harmful effects of pollution and climate change on UA disease

Development and validation of the Drug Hypersensitivity Quality of Life Questionnaire

Background The impact of drug hypersensitivity has never been considered from the patient's perspective, and no questionnaire is currently available for this purpose. Objective To develop and validate a questionnaire specifically designed for the assessment of quality of life in patients with drug hypersensitivity entitled the Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q). Methods During the development procedure, an initial questionnaire of 34 items was generated and administered to 70 patients; the 20 most important items were detected and converted into questions evaluated with a 5-point Likert scale. This provisional questionnaire then underwent a validation procedure to assess its psychometric properties. The DrHy-Q and the Psychological General Well-Being Index (PGWBI) were completed by 365 patients (67.5% female; mean [SD] age, 40 [15] years). Results Statistical analysis revealed a 1-dimensional structure for the DrHy-Q that explained up to 50.7% of the total variance and showed good levels of internal consistency for the extracted factor (Cronbach α = 0.928). The correlations between the DrHy-Q and the PGWBI scores were low. However, the DrHy-Q scores of patients who experienced anaphylactic shock were significantly higher than the scores from patients with other reactions (analysis of variance; F = 5.991; df = 4; P < .001). The test-retest associations were good (R = 0.995; P < .001). Conclusions DrHy-Q met the standards for construct validity, internal consistency, and reliability, indicating that it is appropriate for use alone or in combination with other patient-reported outcome questionnaires to explore the subjective experiences of patients with drug hypersensitivity