Environmental Pollutants and Food Allergy: From Traditional Triggers to Emerging Hazards.

Food allergy (FA) is a serious public health concern characterized by a rising global prevalence. This rapid increase, observed largely within a single generation, coincides with escalating environmental pollution driven by industrialization and urbanization. While genetic factors play an important role in FA development, the rapid rise in prevalence cannot be attributed to genetic changes alone. Consequently, environmental factors, particularly environmental pollutants (EPs), are increasingly recognized as critical drivers in the development and progression of FA. The ubiquity of traditional EPs-such as traffic-related air pollutants, environmental tobacco smoke, endocrine-disrupting chemicals, heavy metals, pesticides, and antimicrobials-alongside emerging EPs (including nano-/micro-plastics, engineered nanomaterials, and novel chemical analogues) parallels trends in urban expansion. Although these EPs pose considerable health risks and are linked to allergic diseases, their specific roles in FA remain poorly understood. This review synthesizes current epidemiological evidence regarding the relationship between EPs exposure and FA. The findings reveal that while several EPs are associated with food sensitization, there is no clear evidence of a correlation between EPs and FA, as some studies find effects and some find no effects. At the molecular level, EPs appear to induce immune dysregulation, including Th2 polarization and oxidative stress, which collectively promote allergic inflammation. However, considerable heterogeneity across studies underscores the need for further research into investigating the correlation between both single- and multi-EPs exposures and FA outcome. Overall, this review provides an integrated overview of how EPs may influence FA risk, offering insights to support the development of preventive strategies.