The effect of local anthropogenic pollution of a metropolis on refractory chronic rhinosinusitis

Introduction. An important task in the prevention and treatment of chronic rhinosinusitis in patients living in megacities and exposed to anthropogenic pollution is to identify trigger factors, analyze key aspects that increase the risks of refractory course formation and timely take corrective measures. In this context, an in-depth analysis of the epidemiological indicators of chronic rhinosinusitis and its clinical course in patients, with an emphasis on the length of stay (accommodation, work, study, etc.) in various areas of the metropolis with a large number of heavy industry enterprises is of key importance. Aim. To increase the effectiveness of prevention and treatment of chronic rhinosinusitis based on the study of the influence of local anthropogenic pollution of the metropolis on the refractory course of chronic rhinosinusitis. Materials and methods. A retrospective analysis of the frequency of registration of chronic rhinosinusitis in patients who spend most of the day in places with increased anthropogenic pollution of the city was carried out. In total, the study involved more than 20 thousand residents living in different districts of the city of Chelyabinsk, discussed by medical organizations, according to annual report form No. 12 (from 2020 to 2024). The results were analyzed using data from literary sources in specialized libraries and high-tech databases Web of Science, Medline, Scopus. Results and discussion. In the structure of treatment of patients with chronic rhinosinusitis for 2020‑2023, women prevailed (from 59 to 67 % of all cases), in 2024 the ratio of men to women was 1:1. The peak of treatment of patients in all areas of the industrial metropolis was recorded in spring and summer. The highest incidence of chronic rhinosinusitis, out of the total number of referrals, was observed in young patients (39,7‑73 %). In the studied years, residents of an industrial metropolis aged 45 to 59 years accounted for an average of 22,7 % of visits to an otorhinolaryngologist with this diagnosis. The maximum indicators and the highest growth rates were observed in the areas adjacent to industrial enterprises. Conclusion. The results obtained are of great scientific and practical importance for improving the diagnosis of chronic rhinosinusitis and patient routing.