Study of the Interrelations of the Concentrations of Six Tree Pollen Types and Six Atmospheric Pollutants with Rhinitis and Allergic Conjunctivitis in the Community of Madrid
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsThe paper investigates the interrelation between concentrations of six tree pollen types, six atmospheric pollutants, and allergic pathologies in the Community of Madrid. It analyzes how these factors influence episodes of rhinitis and allergic conjunctivitis, using descriptive multiple linear regression models. The study finds significant correlations between pollen types, pollutants, and allergic conditions, with insightful implications for public health and urban planning. However, this manuscript needs to address the following concerns before it gets published:
Formatting:
1. Are the commas in the numbers in tables A1-A4 and B1-B4 meant to be decimal points? If so, please change it to a decimal point, otherwise it will be ambiguous.
Content:
1. The paper is too lengthy in introducing the data analysis method (Section 3), and the text-only presentation makes it difficult for readers to quickly understand the data analysis process. It is recommended that the authors add a flowchart to this section to visualize the multiple linear regression used in the study and the corresponding adjustment process.
2. In terms of implications for clinical practice or policy development, the authors are suggested to highlight the response options summarized in Lines 576 through 579 in the Conclusions section as well, which would reinforce the actual implications of this study for clinical practice or policy development.
3. In response to the discussion that the interaction between pollen and air pollutants causes pollen to be more likely to trigger allergic symptoms in humans, could the authors draw the appropriate conclusions from the results of the analysis available so far? The current paper mainly discusses the correlation between pollen and air pollutants and two allergic conditions in isolation.
Comments on the Quality of English LanguageThe authors need to polish the English writing of this manuscript because there are some grammar errors.
Author Response
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Author Response File: 
Author Response.docx
Reviewer 2 Report
Comments and Suggestions for AuthorsThe relationships between all variables considered are important and highlight the role of air pollution in pathology of allergy. The authors considered in particular conjunctivitis and allergic rhinitis in relationships to number of primary care episodes.
In the conclusions the authors present statistically significant relationships on two pathologies with the two variables.
In my opinion, the studies regarding the role of environmental variables on pathologies of allergies need to be deepen. I suggest, in the future, studies on other pathologies as asthma.
Author Response
The relationships between all variables considered are important and highlight the role of air pollution in pathology of allergy. The authors considered in particular conjunctivitis and allergic rhinitis in relationships to number of primary care episodes.
In the conclusions the authors present statistically significant relationships on two pathologies with the two variables.
Thank you very much for your time spent with to review.
In my opinion, the studies regarding the role of environmental variables on pathologies of allergies need to be deepen. I suggest, in the future, studies on other pathologies as asthma.
-Thank you so much. The authors are preparing manuscripts showcasing their research on both topics.
Reviewer 3 Report
Comments and Suggestions for Authorsinstead of y put and, put footnotes bellow the table and add reference or webpage for the network. see pdf attached
Comments for author File: 
Comments.pdf
Author Response
Thank you very much for your time spent with an extensive review. He has enriched the manuscript with his comments and considered his suggestions.
-All suggestions have been corrected
Please see the attachment
Author Response File: Author Response.pdf
Reviewer 4 Report
Comments and Suggestions for AuthorsJavier Chico-Fernandez, and Esperanza Ayuga-Téllez in this manuscript determine the influence of certain atmospheric pollutants and pollen types on the cases of rhinitis and allergic conjunctivitis detected in the Community of Madrid.
I am positive about the work done and its impact on the interplay between pollen and atmospheric pollutants, and the citations it will receive in the future. However, I have some minor recommendations to improve the manuscript.
1 Authors are encouraged to read the manuscript thoroughly for inconsistencies, use of abbreviations for the first appearance. Also, structure it in a more didactic way.
2 As a suggestion to the authors, the introduction could be shortened.
3. describe how the agents (pollutants and allergens) were measured.
4. in the discussion contrast your findings with the background, do not assume that the reader remembers everything described in the results.
Author Response
Please see the attachment.
Author Response File: Author Response.docx
Reviewer 5 Report
Comments and Suggestions for AuthorsThe manuscript represents an examination of the correlation between specific allergenic airborne pollen levels and potentiation of the allergenic response by elevated urban concentrations of specific atmospheric pollutants. The authors examine correlations between allergic response and O3, PM2.5 and PM10 particles, NO2, CO, and SO2. I have only minor recommendations for revision.
1. Lines 343-351: The authors described the statistical procedures used to determine correlations, but they should also state the name and source of any software used to perform the calculations.
2. Line 18: "y" en castellano debe ser "and" en ingles.
3. Lines 222-288 and lines 300-308 read in a way that the information should have been included either in the Introduction or the Discussion rather than in Materials and Methods. The authors should revise this section and place the descriptive narrative more appropriately in the Introduction or Discussion where it would be a better fit.
4. Line 399: "p=0" implies a perfecto correlation, which is highly unlikely. It appears that the authors have simply not performed the calculations with a sufficient number of significant figures or decimal places. Therefore, the p value calculations need to be repeated and expressed as p < 0.01 or p < 0.001, etc.
5. Nielsen et al. (G. D. Nielsen, O. Olsen, S. T. Larsen, M. Løvik, L. K. Poulsen, C. Glue, N. P. Brandorff and P. J. Nielsen, Toxicology, 2005, 216, 87–105) reported that cigarette smoke has an adjuvant effect enhancing sensitization. There is a large population of people who smoke in Spain. Did the authors consider this variable on increasing atopic responses?
6. Lines 18, 545-553, 603, 605: The authors describe certain pollutant gases (O3, SO2, NO, NO2) that are pulmonary and ocular irritants. They also mention CO, which is a toxic environmental pollutant, but not an irritant. It is likely that CO is measured together with SO2 and nitrogen oxides but it is not likely that CO is involved along with sulfur and nitrogen oxides in sensitization or as an irritant. Perhaps CO should be deleted.
7. Lines 18, 31, 331, 522, 534-549: The authors briefly mentioned PM2.5 and PM10 particulate pollutants.
8. Lines 18, 31, 331, 522, 534-549: See A. L. Lambert, W. Dong, M. J. K. Selgrade and M. I. Gilmour, Toxicol. Appl. Pharmacol., 2000, 165, 84–93. These authors reported that intratracheal exposure of rats to either high transition metal-containing environmental oil fly ash particulate or its major constituent metals alone (nickel or vanadium) caused significant pulmonary inflammation and that the predominantly metals-containing particulate exhibited an adjuvant effect on sensitization to dust mite with IgE production. Did the authors consider a possible role of metals in environmental particulate as possibly related to the increase in atopic disease in CAM?
Author Response
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Author Response File: Author Response.docx
