Pollen levels linked to chronic pelvic pain syndrome flares

High pollen levels may cause flare-ups in urologic chronic pelvic pain syndrome, according to research published in The Journal of Urology.

“If the association with pollen levels is confirmed through future studies, it may help us to understand how flares occur in individuals with urologic chronic pelvic pain, as well as how to prevent or treat these otherwise unpredictable attacks,” Siobhan Sutcliffe, PhD, ScM, MHS, a professor and epidemiologist at the Washington University School of Medicine, St Louis, said in a press release.

Sutcliffe and colleagues evaluated urologic chronic pelvic pain syndrome flares every 2 weeks over 1 year in participants enrolled in a case-crossover study, the Multidisciplinary Approach to the study of Chronic Pelvic Pain (MAPP) study. In the study, participants underwent three in-person biweekly visits in which they answered online questionnaires. Participants who indicated that they were experiencing a flare-up were then asked about any flaring symptoms, the date these flare-ups started, and exposures 3 days before the flare-up. The researchers also asked these questions at three random times when participants were not experiencing a flare-up.

The researchers linked daily pollen counts from local air quality monitoring data by the dates participants were questioned and the first three digits of their ZIP codes. They compared pollen counts in the 3 days leading up to a flare-up and pollen levels beyond set thresholds with levels on days without symptom flare-ups.

A total of 290 participants were included in the case-crossover analysis. There were 791 non-flare observations and 574 flare observations among them. In the longitudinal analysis, the researchers evaluated 409 patients with 5,387 non-flare observations and 966 flare observations.

Among participants, approximately two-thirds reported having a history of allergies, with drug allergies and allergic rhinitis the most reported.

Overall, the researchers found no associations between daily pollen count and symptom flare ups. However, Sutcliffe and colleagues determined that pollen level increases above medium or high thresholds were associated with flare-ups 1 to 2 days later among all participants in the case-crossover sample (OR = 1.22; 95% CI, 0.99-1.50) and in those with allergies or respiratory tract disorders (OR = 1.31; 95% CI, 1.04-1.66).

Additionally, Sutcliffe and colleagues found that initial pollen count increases past medium or high thresholds were associated with an increase in flare-ups over 3 weeks among all participants in the full longitudinal sample (relative rate = 1.14; 95% CI: 0.98-1.33) and in those with allergies or respiratory tract disorders (relative rate = 1.23; 95% CI, 1.03-1.46).

“If pollen does indeed trigger flares for some patients with urologic chronic pelvic pain, that might have implications for further research and patient care,” Sutcliffe said in the release. “For example, patients may benefit from taking antihistamines on days with high pollen levels, or from allergy testing and immunotherapy.”

References:

Newswise. Pollen levels might trigger flares of urologic chronic pelvic pain. https://www.newswise.com/articles/pollen-levels-might-trigger-flares-of-urologic-chronic-pelvic-pain. Accessed January 11, 2021.

Javed I, et al. J Urol. 2021;doi:10.1097/JU.0000000000001482.