• Olivier Vandenplas, Denis Vinnikov, BlancPaul DPDDivision of Occupational and Environmental Medicine, Department of Medicine, University of California San Francisco, San Francisco, Calif., Ioana Agache, Claus Bachert, Michael Bewick, Lars-Olaf Cardell, Paul Cullinan, Pascal Demoly, Alexis Descatha, Joao Fonseca, Tari Haahtela, Peter W Hellings, Jacques Jamart, Juha Jantunen, Ömer Kalayci, David Price, Boleslaw Samolinski, Joaquin Sastre, Longxiu Tian, Antonio L Valero, Xinyi Zhang, and Jean Bousquet.
• Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium. Electronic address: olivier.vandenplas@uclouvain.be.
• J Allergy Clin Immunol Pract. 2018 Jul 1; 6 (4): 1274-1286.e9.

BackgroundAllergic rhinitis (AR) is increasingly acknowledged as having a substantial socioeconomic impact associated with impaired work productivity, although available information remains fragmented.ObjectiveThis systematic review summarizes recently available information to provide a quantitative estimate of the burden of AR on work productivity including lost work time (ie, absenteeism) and reduced performance while working (ie, presenteeism).MethodsA Medline search retrieved original studies from 2005 to 2015 pertaining to the impact of AR on work productivity. A pooled analysis of results was carried out with studies reporting data collected through the validated Work Productivity and Activity Impairment (WPAI) questionnaire.ResultsThe search identified 19 observational surveys and 9 interventional studies. Six studies reported economic evaluations. Pooled analysis of WPAI-based studies found an estimated 3.6% (95% confidence interval [CI], 2.4; 4.8%) missed work time and 35.9% (95% CI, 29.7; 42.1%) had impairment in at-work performance due to AR. Economic evaluations indicated that indirect costs associated with lost work productivity are the principal contributor to the total AR costs and result mainly from impaired presenteeism. The severity of AR symptoms was the most consistent disease-related factor associated with a greater impact of AR on work productivity, although ocular symptoms and sleep disturbances may independently affect work productivity. Overall, the pharmacologic treatment of AR showed a beneficial effect on work productivity.ConclusionsThis systematic review provides summary estimates of the magnitude of work productivity impairment due to AR and identifies its main determinant factors. This information may help guide both clinicians and health policy makers.Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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