The “Five in One” integrated precise prevention and control system for pollen allergic diseases in Northern China: A narrative review with global perspective

Allergic diseases driven by airborne pollen are a growing public health burden in Northern China, where spring tree pollens and summer–autumn weed pollens are major triggers of allergic rhinitis, asthma, conjunctivitis, atopic dermatitis, and anaphylaxis. Internationally, management frameworks concentrate on 4 pillars—allergen avoidance, pharmacotherapy, allergen immunotherapy, and patient education—as codified in the Allergic Rhinitis and its Impact on Asthma guidelines and endorsed by the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology. To address gaps in prevention, specialist availability, and public awareness, the Five-in-One integrated precise prevention and control system was established in Northern China. This multidisciplinary framework combines pollen monitoring, vegetation survey, epidemiological investigation, standardized primary-care training, and public science education. Over more than 16 years, the system has been implemented across 8 provinces, autonomous regions, and municipalities, covering 174 medical institutions and supporting measurable reductions in disease prevalence and severity. This review summarizes the rationale, structure, implementation, and outcomes of each component, compares the system with international pollen-allergy management frameworks, and discusses its implications for regional and global prevention strategies under worsening climate change.