Rhinitis and chronic rhinosinusitis in Melbourne, Australia

Introduction: Previous prevalence studies of nasal allergies in Australian adults have not included non-allergic rhinitis or chronic rhinosinusitis (CRS). Aims: To investigate the prevalence of rhinitis and CRS and their association with potential risk factors including atopy in participants of the European Community Respiratory Health Survey III in Melbourne, Australia. Methods: This analysis included 313 participants with complete data. Current rhinitis was defined as sneezing, runny or blocked nose without a cold/flu in the past year. Skin prick tests with 12 aeroallergens assessed atopy in 272 subjects. CRS was defined by symptoms (two or more symptoms one of which should be nasal blockage or nasal discharge in addition to facial pain/pressure or reduced smell >12 weeks in the past year) or as self-reported doctor-diagnosed CRS ever. Multivariate logistic models were fitted with rhinitis or CRS as the outcome adjusting for age, gender, atopy and smoking status. Results: Mean (SD) age was 55.3(6.2) years, 53.4% were females, 8.9% current smokers, 38% ex-smokers and 53.1% never smokers. Current rhinitis was reported by 47% of subjects (52.1% in females and 41.1% in males, p=0.05) and 70.7% of rhinitis cases were atopic. Rhinitis was independently associated with atopy (OR 3.8, 95%CI 2.3, 6.3). CRS was present in 2.6% of all subjects, but 10.9% had a doctor diagnosis of CRS. Agreement between symptom-based and doctor-diagnosed CRS was poor (κ=0.16). CRS was not associated with age, gender, atopy or smoking. Conclusions: Rhinitis remains very prevalent in Australia, but symptom-based CRS has a low prevalence. CRS may be over-diagnosed by doctors or CRS symptoms may have remitted in some subjects. Funding: NHMRC.