The prevalence of asthma and allergies among children has become an increasing problem in the last few decades. Data on the population of children and adolescents, especially living in polluted cities, are limited and based on studies carried out in small groups. In our study, we analyzed the incidence of asthma and allergic rhinitis between 2014 and 2018. We analyzed data collected from nearly 30,000 children aged seven to eight and adolescents aged 16–17, which allowed us to assess the frequency of allergic diseases in the population of children and youth in Krakow. More than 40% of respondents reported allergic symptoms, and nearly 50% of them were not diagnosed and treated. In the group of seven- and eight-year-olds with a positive history of allergies, 52% had allergic rhinitis and 9.1% had asthma. In the group of 16–17-year-olds, allergic rhinitis was diagnosed in 35.8%, while asthma was found in 4.9% of cases. The results obtained over the course of 10 years has shown the reduction in the frequency of asthma (from 22% in the case of asthma in both age groups) and allergic rhinitis cases (from 63.9% in adolescents). In our opinion, this can be considered a positive effect of the preventive measures taken in Kraków after 2010. Although there is still a higher incidence of allergic diseases among children and young people living in urban areas compared to rural areas, the trend apparently has reversed for some diseases.

Until now, the simultaneous influence of air pollution assessed by measuring the objective marker of exposition (1-hydroxypirene, 1-OHP) and atopy on the development of allergic airway diseases has not been studied. The aim of this study was to determine the pathomechanism of the allergic response to PM2.5 in atopic and non-atopic patients. We investigated the changes in peripheral blood basophil activity of patients after stimulation with the birch pollen allergen alone, the allergen combined with PM2.5 (BP), PM2.5 alone, a concentration of 1-OHP in urine, and a distance of residence from the main road in 30 persons. Activation by dust alone was positive for all concentrations in 83% of atopic and 75% of non-atopic assays. In the group of people with atopy, the simultaneous activation of BP gave a higher percentage of active basophils compared to the sum of activation with dust and birch pollen alone (B + P) for all concentrations. The difference between BP and B + P was 117.5 (p = 0.02) at a PM concentration of 100 μg. Such a relationship was not observed in the control group. The correlation coefficient between the distance of residence from major roads and urinary 1-OHP was 0.62. A Pearson correlation analysis of quantitative variables was performed, and positive correlation results were obtained in the atopy group between BP and 1-OH-P. Exposure to birch pollen and PM2.5 has a synergistic effect in sensitized individuals. The higher the exposure to pollutants, the higher the synergistic basophil response to the allergen and PM in atopic patients.

Atopic dermatitis (AD) prevalence in Poland is more frequent in individuals who live in a city. There are more studies demonstrating that long-term exposure to air pollutants is an independent risk factor for developing AD. The aim of the study was to assess the epidemiology of AD and food allergy (FA) in school children and adolescents living in Krakow, and to find a potential relationship between the incidence of atopic dermatitis with exposure to polluted air. In this paper, we presented the incidence of AD and FA between 2014 and 2018. We analyzed data collected from nearly 30,000 children aged 7–8 and adolescents aged 16–17 from the population of children and youth in Krakow. We correlated it with annual mean concentrations of PM10 and PM2.5, which indicated a gradual improvement in the air quality in Krakow. As our research results show that the prevalence of atopic dermatitis decreased with food allergy prevalence depending on the age group. We can suspect that this is the result of children growing out of a food allergy. It may be also influenced by more consequential eating habits in a group of adolescents and the elimination of allergenic foods from the diet. The decreasing incidence of atopic dermatitis appears to be also related to improvement in air quality.

The diagnosis of drug-induced anaphylaxis (DIA) is a serious health problem. The Basophil activation test (BAT) is considered a specific in vitro provocation, and compared to in vivo provocation, it is more convenient, cheaper, and safer for the patient. This study aimed to evaluate the usefulness of the BAT in the diagnosis of DIA. This study included 150 patients referred to a reference allergy clinic with suspected drug allergies. All patients underwent a detailed clinical evaluation supplemented with the BAT. Positive BAT results were obtained in two out of 21 patients who were to receive the COVID-19 vaccine. The sensitivity and specificity of the BAT were 40% and 75% for the COVID-19 vaccine, 67% and 58% for DMG PEG 2000, and 100% and 75% for PEG 4000, respectively. Nine out of 34 patients with suspected antibiotic allergies had positive BAT results with 14 different antibiotics. Positive BAT results were also obtained with NSAIDs in two patients and with local anesthetics in three patients. The confirmation of allergy by the BAT improves the safety profile of the diagnostic work-up as it may defer the need for drug provocation, preventing potential anaphylactic reactions.

Allergic diseases have been increasing in prevalence over the last years. In a polluted environment, this problem can worsen and become more complex. Long-term exposure to air pollution can lead to the aggravation of allergic rhinitis (AR) and even to the development of seasonal asthma. Climate changes can accelerate and extend the pollination season. Research indicates that air pollution may modify the properties of pollen, making it more aggressive. Asymptomatic allergic people disclose their allergies in a polluted environment. A polluted environment complicates the diagnosis of seasonal allergies. The treatment might be more challenging as standard allergy medications may not be enough to control symptoms. The causal treatment of allergic rhinitis is specific allergen immunotherapy (AIT), which may prove less effective in people living in a polluted environment. The problem may lie in the proper evaluation for AIT as well as the assessment of its effectiveness. To date, the best way to confirm an allergy and qualify a patient for AIT seems to be molecular diagnostics. The question arises whether patients exposed to air pollution, which could potentially reduce the effectiveness of AIT, are still eligible for AIT. It is also debatable whether molecular diagnostics remain effective in such cases. Advancing precision medicine alongside environmental management represents a critical pathway toward reducing the growing global burden of allergic diseases.