Walker Samantha, Khan-Wasti Saba, Fletcher Monica, Cullinan Paul, Harris Jessica, Sheikh Aziz
Education for Health, Warwick, United Kingdom.
J Allergy Clin Immunol. 2007 Aug;120(2):381-7. doi: 10.1016/j.jaci.2007.03.034. Epub 2007 Jun 8.
Seasonal allergic rhinitis is common globally, and symptoms have been shown to impair learning ability in children in laboratory conditions. Critical examinations in children are often held in the summer during the peak grass pollen season.
To investigate whether seasonal allergic rhinitis adversely impacts examination performance in United Kingdom teenagers.
Case-control analysis of 1,834 students (age 15-17 years; 50% girls) sitting for national examinations. Cases were those who dropped 1 or more grades in any of 3 core subjects (mathematics, English, and science) between practice (winter) and final (summer) examinations; controls were those whose grades were either unchanged or improved. Associations between allergic rhinitis symptoms, clinician-diagnosed allergic rhinitis, and allergic rhinitis-related medication use, recorded on examination days immediately before the examination, were assessed using multilevel regression models.
Between 38% and 43% of students reported symptoms of seasonal allergic rhinitis on any 1 of the examination days. There were 662 cases (36% of students) and 1,172 controls. After adjustment, cases were significantly more likely than controls to have had allergic rhinitis symptoms during the examination period (odds ratio [OR], 1.4; 95% CI, 1.1-1.8; P = .002), to have taken any allergic rhinitis medication (OR, 1.4; 95% CI, 1.1-1.7; P = .01), or to have taken sedating antihistamines (OR, 1.7; 95% CI, 1.1-2.8; P = .03).
Current symptomatic allergic rhinitis and rhinitis medication use are associated with a significantly increased risk of unexpectedly dropping a grade in summer examinations.
This is the first time the relationship between symptomatic allergic rhinitis and poor examination performance has been demonstrated, which has significant implications for clinical practice.
季节性过敏性鼻炎在全球范围内都很常见，并且在实验室条件下已表明其症状会损害儿童的学习能力。儿童的重要考试通常在夏季草花粉季节高峰期举行。
调查季节性过敏性鼻炎是否会对英国青少年的考试成绩产生不利影响。
对1834名参加全国考试的学生（年龄15 - 17岁；50%为女生）进行病例对照分析。病例为在模拟考试（冬季）和期末考试（夏季）之间，在3门核心科目（数学、英语和科学）中的任何一门成绩下降1分或更多分的学生；对照为成绩未变或提高的学生。在考试前立即记录的考试当天的过敏性鼻炎症状、临床诊断的过敏性鼻炎以及与过敏性鼻炎相关的药物使用情况之间的关联，使用多水平回归模型进行评估。
在任何一天的考试中，38%至43%的学生报告有季节性过敏性鼻炎症状。有662例病例（占学生的36%）和1172名对照。调整后，病例在考试期间出现过敏性鼻炎症状的可能性显著高于对照（比值比[OR]，1.4；95%置信区间[CI]，1.1 - 1.8；P = 0.002），服用任何过敏性鼻炎药物的可能性（OR，1.4；95% CI，1.1 - 1.7；P = 0.01），或服用镇静性抗组胺药的可能性（OR，1.7；95% CI，1.1 - 2.8；P = 0.03）。
当前有症状的过敏性鼻炎和鼻炎药物使用与夏季考试成绩意外下降的风险显著增加有关。
这是首次证明有症状的过敏性鼻炎与考试成绩不佳之间的关系，这对临床实践具有重要意义。
