Pollen-induced allergic rhinitis in the central region of Inner Mongolia, China: prevalence, risk factors, and regional characteristics

Background Pollen-induced allergic rhinitis (PIAR) is a major public health burden in high-pollen regions of northern China (e.g., Ordos, southern Inner Mongolia Plateau). However, regional variations in PIAR across ecological zones (urban, agropastoral, desert, and mining zones), dominant allergens, and key risk factors remain understudied due to prior small-sample or narrow-scope research. Objective This study aimed to investigate the prevalence, major risk factors, and current treatment patterns for PIAR in Ordos. Methods From March to July 2023, a multicenter, randomized, stratified cross-sectional survey was conducted across nine areas in Ordos. Participants were recruited to complete in-person questionnaires and undergo skin prick tests (SPTs) for 16 common allergens. Pollen was collected and counted to monitor exposure levels. Results Among the 4,303 participants, the prevalence rates of self-reported allergic rhinitis (SRAR), physician-diagnosed allergic rhinitis (PDAR), and PIAR were 52.89% (2,276/4,303), 34.70% (1,493/4,303), and 31.51% (1,356/4,303), respectively. The prevalence rates of PIAR in urban, agropastoral, desert, and mining areas were 30.46%, 39.55%, 29.09%, and 19.72%, respectively. Among patients with PIAR, the incidence of symptom onset was highest among urban residents and lowest among mining area residents. Poplar pollen allergen dominated in spring, whereas in autumn, Artemisia pollen was predominant. Clinical symptoms were greatest in July, preceding the autumn pollen peak in September. Conclusion PIAR is highly prevalent in northern China's grasslands, with marked zone-specific variations. Artemisia pollen exposure is the main sensitization driver, supporting targeted PIAR prevention/control.