Allergic rhinitis: the joint burden of indoor and outdoor environmental exposures

Allergic Rhinitis (AR) is a highly prevalent global upper‑respiratory chronic disease that seriously impairs patients' quality of life and brings heavy public‑health burdens. Its rising prevalence cannot be fully explained by stable genetic factors, implying environmental factors play a critical role. Nevertheless, most existing studies focus on single‑factor effects, while evidence regarding combined and interactive impacts of multi‑source environmental exposures remains insufficient. This narrative review synthesize indoor, outdoor and social-living environmental risk factors for allergic rhinitis, covering indoor biological allergens, indoor chemical pollutants, micro-environmental conditions, air pollution, pollen allergens, climate factors and factors related to social life. It concludes that the increased incidence of AR arises from synergistic interactions among multiple environmental risk factors. Limitations include the lack of original empirical data. Further multi-factor studies and targeted environmental interventions are required for AR prevention and control.