1.     Knoxville, Tenn.
2.     McAllen, Tex.
3.     Louisville, Ky.
4.     Jackson, Miss.
5.     Wichita, Kans.
6.     Oklahoma City, Okla.
7.     Chattanooga, Tenn.
8.     Memphis, Tenn.
9.     San Antonio, Tex.
10.   Dayton, Ohio

Three times is not a charm at all for Knoxville, Tennessee. For the third time in as many years, this East Tennessee city has earned the dubious distinction of being America’s No. 1 spring allergy capital, according to rankings from the Asthma and Allergy Foundation of America (AAFA). McAllen, Texas was the runner-up while Louisville, Kentucky took third place.

In Knoxville, the problem starts with the stately oak, maple and elm trees that abound around this city of some 179,000 residents. They contribute to the lush beauty of the region but pollen scores from male trees are “way ahead of the rest of the country,” and are a main ingredient in the “perfect storm” of spring allergies, says Angel Waldron, a spokesperson for AAFA.

Easing the Pain

Lack of ready access to treatment makes the situation worse. In the spring, there’s often a long wait to see an allergy specialist in Knoxville, adding to the misery of local residents. There’s also mounting use of allergy medications at this time of year.

Local allergists like Dr. Robert Overholt have developed initiatives to ease the suffering. They provide daily pollen counts to news outlets, hold health fairs and frequently comment in the media on the best ways to treat allergies. Overholt says these include: avoiding exposure to pollen as much as possible, using prescription sprays or over-the-counter antihistamines and, for some people, getting allergy shots.

Planning for the spring allergy season is important, agrees Waldron. “If residents are prepared, there’s no reason why they should live in a lovely city and not be able to get out and enjoy it.”

Weather an Allergy Factor

The news that Knoxville is the worst city for spring allergies comes on the heels of another dismal year weatherwise. In 2011, a violent February storm that triggered flash floods across the region was followed by more than 20 tornados in the spring. And then Knoxville was also ranked the top U.S. city for fall allergies, typically triggered by ragweed.

Being the top spring allergy capital again should garner public attention – and this might not be a bad thing. “It isn’t a good title to have, but it encourages people to get educated about their environment and learn what they can do,”  says Waldron.

Knoxville isn’t the only allergen breeding ground in Tennessee. Chattanooga (No. 7) and Memphis (No. 8) also made this year’s Top 10. Several cities came from behind to make the list: San Antonio, Texas went from No. 42 last year to claim the No. 9 this year; and Oklahoma City jumped from 22 to 6.

This is the ninth year for the AAFA’s spring allergy rating. Data for the scores come from the Centers for Disease Control and Prevention, the American Board of Medical Specialties’ database and SDI, a health-care analytics company that collects pollen data.

For the complete list of spring allergy capitals, visit www.allergycapitals.com.

* Rankings information is supplied courtesy of the Asthma and Allergy Foundation of America (AAFA).

Autos

Let’s start with your vehicle. If you’re driving an SUV, it burns one-half to two-thirds more fuel than a regular car. As for cars, newer models can vary con­siderably on environmental and energy efficiency, so compare both fuel effi­ciency and emission controls before buying or leasing.

Technology can only help so much, though. We need to reduce the number of vehicles and the time they spend on the road. One way is to hike the price of gas. As the David Suzuki Foundation points out, in Europe, fuel costs two to three times more than it does here, and European consumption is one-third less.

This is also an urban planning issue, since the growth of suburbs has extend­ed commuting times. So we need to halt sprawl and encourage people to live downtown or close to where they work. This means greater density, with more condo high-rises along subway and bus routes. To get people out of cars, you also need better public transit, as well as more bike lanes. Businesses need to be encouraged to provide secure bicycle racks, plus showering areas.

But in the shorter term, what can you do this summer?

- Carpool, use public transportation, walk or bike (if it’s not a smoggy day). One car commuter uses as much energy as a transit rider uses in 10 years. Viewed another way, if you take public transit instead of a vehicle for a year, you can save nearly a tonne of pollutants, including carbon dioxide.

- Avoid idling. Ontario stats show 3 per cent of fuel is wasted by idling.

- Tune up your car. If we all did it on a regular basis, we could reduce Nitrogen oxides by 12 per cent and volatile organic compounds (VOCs), a key part of smog, by 30 per cent.

- Keep tires properly inflated. Each 5 per cent of under inflation in a tire translates into a 1 per cent increase in fuel consumption.

- Fill your gas tank in the evening, as this a major source of VOCs. If they combine with other gases in the sun, they create smog.

- Consider fuel efficiency when you buy a car. See www.fueleconomy.gov to check gas consumption and emissions.

- Buy a hybrid. Enjoy the sound of silence as you push the button that starts the electric-powered motor. You might qualify for Ottawa’s new rebate for hybrids – up to $2,000. They’re expensive, but what’s the price for breathable air?

- Retire the energy-guzzling clunker. A program called Car Heaven offers a free car tow and eco-friendly recycling.

Next Page: At Home

• America’s Trees of Allergies - Allergic Living‘s field guide to U.S. tree pollen allergies.
• The Trees of Sneeze - Allergic Living‘s field guide to Canadian pollen allergies.
• Hay Fever Handbook - Everything you’ll need to know about managing Spring allergies.
• All About Eye Allergies – Weeping, itching and rubbing. How do you find relief?
• Gardening with Allergies – Great tips; plants to look for.
• Gardening with Allergies - Plants to avoid.
• Oral Allergy Syndrome – Science of tree pollen cross-reactions with food.
• Tree pollen, fruits, vegetables, nuts, spices – What can react with what.
• A Life with Fruit Allergies – What you can and can’t eat with Oral Allergy Syndrome.
• Spring’s Hidden Toll – “hay fever” is more insidious than it sounds.
• Beat the Pollen - Allergic Living‘s 10 ways to beat pollen.

Summer

• Grass Allergy - All about symptoms, coping and medications.
• Grass Pollen cross-reactions.
• Oral Allergy Syndrome - Science of tree and grass pollen cross-reactions with food.
• A Life with Fruit Allergies – What you can and can’t eat with Oral Allergy Syndrome.
• First Person: Summertime, and the Eating Ain’t Easy
• Gardening with Allergies - Includes plants to look for.
• Gardening with Allergies – Plants to avoid.
• Beat the Pollen - Allergic Living‘s 10 ways to beat pollen.
• Stinging Insect Allergies - The troublemakers and when to worry about a reaction.

Fall

• Ragweed Allergy – How to get a grip on it and prevent fall misery.
• Ragweed Allergy – Why the dastardly allergen is so potent and widespread.
• Ragweed Cross-Reactions – To vegetables and fruits.
• Editor’s Blog “Ode to Ragweed”.
• Guide to Fall Allergies - The season’s biggest offenders; tips to gain control.
• All About Eye Allergies – Weeping, itching and rubbing. How do you find relief?
• Stinging Insect Allergies - The troublemakers; how to spot a serious reaction.
• Oral Allergy Syndrome - Pollen and fruit cross-reactions.
• Mold- and Pollen-proofing

See Also:

• Allergy-Proofing Your House.
• Pet Allergies.

What is immunotherapy?

Immunotherapy is a form of treatment, commonly known as allergy shots, in which a patient with allergic rhinitis gets controlled exposure to allergens through injections. It will not be the first course of treatment. In immunotherapy, a doctor raises the allergen dose in your shots over a number of months and years – the intent is that as the dose rises, you become less sensitive to allergens.

Who should get allergy shots?

First, your allergist will take a history, do an examination including skin-prick tests to determine what you are allergic to, and then will prescribe medications. If you’re still suffering even with medication, allergy shots may be the next step. Candidates for this treatment are usually people who are no longer helped by allergy medications and those who have serious rhinitis symptoms for prolonged periods of time.

If you haven’t had allergies for long, you are more likely to be responsive and experience longer-lasting benefits. Children, however, should have had seasonal symptoms for at least two years before being considered candidates, says Dr. Eric Leith, an allergist based in Oakville, Ontario, and chair of the Canadian Allergy, Asthma and Immunology Foundation. The child should be old enough to understand what’s going on, he says, “and if a reaction occurs, they must be able to express that.”

Allergist Dr. Harold Kim says about 5 to 10 per cent of patients receiving immunotherapy have skin, breathing or gastrointestinal reactions. Only about 1 to 3 per cent have more severe reactions. While anaphylaxis is rare, “immunotherapy can be life-threatening,” cautions Leith. “You should be waiting in the doctor’s office for half an hour [after the treatment] to make sure you are not reacting.” If you have asthma, Leith stresses that it must be under control or the shots “may accentuate the asthma.”

How long does immunotherapy treatment last?

Immunotherapy can take years to carry out. Patients receive one to two shots a week of minimal amounts of their allergen for about six months, until they reach their “maintenance dose,” which means symptoms have improved. Then, a monthly dose is required to keep the allergies under control. Treatment can take up to five years, but the benefit of immunotherapy is that it may have a lasting effect even after the shots have stopped. Leith says there have been cases in which patients have seen their symptoms disappear completely.

Related:
• The Hay Fever Handbook
• 10 Ways to Beat the Pollen
• America’s Top 10 Spring Allergy Capitals

From the Spring 2006 issue of Allergic Living magazine.
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