One thing May-Treanor is adamant about this time, is that her nasal allergies won’t get in the way. They came close to doing so at the Beijing Games in 2008: “It started with the smog. It was hard to breathe,” May-Treanor told Allergic Living in a phone interview. She felt that the city’s air pollution was combining with her pollen allergies to bring on a sinus infection.

This is common for the Californian: her allergies kickstart symptoms that just get worse. In Beijing, they moved down into her chest. She and Walsh took the gold, “but it was unfortunate. Nobody wants to be sick when they’re competing in the Olympics,” she says.

When Teva Respiratory approached May-Treanor this year about taking part in a campaign called Ditch the Drip – which aims to raise awareness of the health impact of allergic rhinitis – May-Treanor was all for it.

“Too often people just say: ‘It’s just sneezing and itchy eyes, I can handle it,’” she says. “But I’ve had sneezing attacks where it’s 20 sneezes in a row and your eyes feel all itchy. It gets in the way.”

May-Treanor liked that the campaign, which is also sponsored by the Asthma and Allergy Foundation of America (AAFA), emphasizes that people should not take the condition for granted, “but instead get checked out by a doctor.”

The campaign points out that under 20 percent of nasal allergy sufferers think their seasonal allergies are under control. This can lead  to sleep disturbances and impaired productivity.

“The key thing is being prepared” to handle your rhinitis, advises May-Treanor. Today, she takes her medications, is aware of the climate (and pollen count) going into a foreign country and meets with her trainers and allergist to make sure she’s receiving proper medications for her condition.

Next: Olympic Ready

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).

A quality of life survey conducted by Decima Research for Reactine gives lie to the popular notion that these 40 sufferers are not, well, suffering. Of the 40 employees with hay fever, the survey shows that 23 feel irritable, 22 experience reduced productivity, 17 find their social interactions to be hindered, 10 report reduced libido and five feel “unattractive or unbearable.” Sniffing and sneezing aside, the data suggest that many of them suffer in silence, and not only physically but socially, psychologically and professionally.

What’s in a Name?

Medical professionals say the very name “hay fever” conveys a merely irksome affliction that should be toughed out. Among non-sufferers, there are contradictory perceptions of this condition. In the Decima survey, 83 per cent of staff in an organization’s human resources department – the gatekeepers of employee performance evaluations – say seasonal allergies affect productivity at work. But only 66 per cent of those HR workers consider allergies to be a valid reason to take time off.

Toronto family doctor Dr. Alan Kaplan, chair of the Family Physician Airways Group of Canada, calls hay fever a misnomer, as it has little to do with hay and no fever results from an attack. He much prefers the medical term “seasonal allergic rhinitis,” which captures the congestion, mucous overproduction and sneezing symptoms of the season. The itchy, watery eyes that are usually part of the package are properly referred to as allergic conjunctivitis.

Dr. Jeremy Beach, an associate professor of medicine at the University of Alberta, says the term hay fever trivializes the condition, making people wrongly think “you shouldn’t really worry about it.” In fact, especially in concert with non-seasonal triggers, allergic rhinitis can have a significant effect. Beach, who has a particular interest in work-related asthma and allergies, believes that academics and scientists have “under-researched” this insidious affliction because “it is not seen as life-threatening whereas other types of allergy can be.”

Part of allergic rhinitis’s profile problem is that Canada has no broad national strategy to bring it into the spotlight, says Dr. Harold Kim, an allergist in Kitchener, Ontario, who holds academic appointments at McMaster University and the University of Western Ontario. He says family doctors search for symptoms of breast cancer, cardiac disease, high blood pressure and cholesterol, but most physicians, except for allergists, do not commonly ask about allergy symptoms. “In my experience, patients must be proactive and request an allergy assessment,” he says.

Kim is hopeful this could change with the publication in the Canadian Journal of Otolaryngology in April 2007 of “excellent guidelines” for doctors to diagnose and treat allergic rhinitis. Getting the guidelines put into practice, however, has gone slower than expected: “The problems of implementing revolve around issues of how to change human behaviour,” he explains. “It is not easy.” Having helped to produce the protocols, Kim’s priorities are to have them modified for patients, and to get the word out to doctors and patients alike.

At Work, But Not All There

It has been workplace and classroom productivity research that is gradually shining a light in this dim corner. Our society’s obsession with efficiency and productivity has clashed with the millions of people with rhinitis who just can’t keep up. The result is what management gurus and occupational health specialists call “presenteeism,” or lost productivity while at work.

Last year the Journal of Management Studies reported that increasingly “employees were substituting presenteeism for absenteeism”: they showed up while ill or injured more often than they stayed home. An article in Current Medical Research and Opinion singled out allergic rhinitis as the top reason for presenteeism and lost productivity at 47 workplaces studied in the United States. Calculations revealed that allergic rhinitis sufferers were absent only 3.6 days per year, but were unproductive on average for 2.3 hours per workday. The study determined allergic rhinitis cost the companies $593 per employee per year. That’s ahead of high stress ($518) and more than twice the amount for other conditions including migraines ($277), arthritis ($269), and respiratory infections ($181).

Vancouver allergist Dr. Donald Stark explains that “allergies are a type of chronic inflammation, so the body dealing with inflammation is tiring in itself. Even if [people with allergies] fall asleep, some don’t get into the deeper stages of sleep because their airways get obstructed, and they start to toss and turn to get to breath again.” Stark adds that allergy sufferers don’t even have to feel consciously tired to function poorly. “There are studies that show some adverse effect on performance at school or work – there is some amount of impairment.”

Robin Bayley of Victoria knows about lost productivity. Working from home as a privacy and policy consultant, she says the strong antihistamines she takes for rhinitis “blow (her) schedule out of the water.” She dreads the spring pollen season when her eyes water so much that the skin around them gets chapped. “I once went on vacation in Arizona, and my eyes were so watery and swollen I could barely see the Grand Canyon.” When his allergic rhinitis peaks, Gary Blaney, an Ottawa lawyer, says he gets so tired that he has to limit client meetings to the morning. “The air conditioning in my office helps keep me clear in the morning, but the aching and fatigue begin to take their toll after lunch,” he says. “By the time I get home, I feel miserable and wiped out.”

Suffer the Children

While many adults struggle with the discomfort of rhinitis by modifying routines, using over-the-counter meds or by simply toughing it out, the effect of allergic rhinitis on children is even more severe because their condition can remain undiagnosed ….

Excerpted from the Spring 2008 issue of Allergic Living magazine.
To order that issue or to subscribe, click here.

Related Reading

• Outdoor Allergies Resource Hub – a compilation of our best.
• Sneeze-free Garden – create the perfect low-allergen garden.
• Hay Fever Handbook – all you’ll need to cope.
• Trees that Make You Sneeze
• Ragweed’s Rule – investigating the worst of the allergenic weeds.
• Stinging Insect Allergies – when is it a serious reaction?

© Copyright AGW Publishing Inc.