Relative contributions of environmental pollen exposure and host susceptibility to Artemisia-related sensitisation and allergy in a high-exposure region of Northern China: a population-based cross-sectional study.

内容摘要

Artemisia pollen is a major airborne allergen in northern China; however, the relative contributions of environmental pollen exposure and host susceptibility to allergic disease remain unclear in high-exposure regions. A population-based cross-sectional study was conducted in Yulin City, China, involving 12,345 participants recruited through multistage stratified cluster sampling. Serum Artemisia-specific IgE was measured in 3,130 participants. Disease status was classified into healthy, sensitized, allergic rhinitis, and acute asthma exacerbation groups. Regional pollen exposure was categorized into low, medium, and high levels based on monitoring data. Inverse probability weighting was applied to reduce selection bias. Multivariable logistic regression models were used to assess associations. The IPW-adjusted prevalence of Artemisia sensitization, allergic rhinitis, and acute asthma exacerbations was 13.0%, 10.7%, and 1.9%, respectively. Regional pollen concentration was not significantly associated with sensitization or disease outcomes in adjusted models (all P > 0.05). In contrast, host-related factors, including family history of allergy and Artemisia-specific IgE levels, showed consistent associations across disease stages. Family history of allergy was strongly associated with sensitization (OR = 4.57, 95% CI: 3.01-6.95). Increasing Artemisia-specific IgE levels were associated with higher odds of progression from sensitization to clinical disease and from rhinitis to acute asthma exacerbation. In this high-exposure population, host susceptibility factors demonstrated stronger and more consistent statistical associations with Artemisia-related allergic disease than regional pollen concentration. These findings suggest that host heterogeneity may contribute importantly to disease variability in high-exposure environments; however, causal inference is limited by the cross-sectional design and exposure measurement constraints.