Outdoor Environmental Risk Factors for Paediatric Ragweed Sensitisation: A Formal Model Comparison

Background/Objectives: Ragweed (Ambrosia artemisiifolia) is a major aeroallergen in Central and Eastern Europe. Croatian children in regions with twofold difference in pollen exposure show near-identical sensitisation prevalence (the “Zagreb paradox”), and an earlier analysis found regional pollen and rural residence to be the only associated environmental factors. We re-examined whether air pollution, surrounding landscape and indoor environment contribute to it.

Methods

This cross-sectional analysis used 3520 of the 4016 children recruited to the EU FP7 ATOPICA study, who had their complete data re-analysed within the EU Horizon Europe EDIAQI project. Sensitisation was defined as a skin prick test wheal of at least 2 mm. Environmental predictors (particulate matter, PM10; nitrogen dioxide, NO2; regional pollen; CORINE land cover within 5 km; rural residence; and indoor exposures) were compared using the Akaike Information Criterion (AIC) in logistic regression models, which were adjusted for age and parental atopy.