Impact of Environmental AIr Pollution on Allergic Rhinitis Severity and Quality of Life in Adults: A Narrative Review

Air pollution is recognized as one of the leading environmental determinants of human health. It has been associated with a growing burden of respiratory diseases worldwide. Allergic rhinitis (AR), a chronic inflammatory disorder of the upper airways, may be susceptible to the effects of environmental pollutants. This narrative review aimed to summarize current evidence regarding the impact of air pollution on allergic rhinitis severity, disease control, and quality of life in adults. A literature search was conducted using the PubMed database. Relevant publications were identified using combinations of the keywords with priority given to recent systematic reviews, meta-analyses, observational studies, clinical investigations, and international clinical guidelines. The reviewed evidence consistently demonstrated positive associations between exposure to ambient air pollutants and allergic rhinitis outcomes. Particulate matter (PM2.5 and PM10), nitrogen dioxide (NO₂), ozone (O₃), and sulfur dioxide (SO₂) were most frequently associated with increased symptom severity, poorer disease control, and reduced quality of life. Particulate matter showed the strongest and most consistent relationship with allergic rhinitis burden. Proposed biological mechanisms include oxidative stress, epithelial barrier dysfunction, chronic inflammation, and immune dysregulation. In conclusion, air pollution represents an important and potentially modifiable determinant of allergic rhinitis severity and quality of life. Improving air quality and reducing individual exposure to environmental pollutants may contribute to better disease control and reduced burden of allergic respiratory diseases, highlighting the importance of both clinical and public health interventions.