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Spring is in the air
Sarah Schell
If you are one of the 35 million Americans who suffer from seasonal allergies and you’re fed up with your stuffy nose, itchy and runny eyes, and wheezing, take these words to heart: there is hope. In the spring, you should not have to endure these aggravating and sometimes debilitating symptoms when others can enjoy the season with the sweet smell of early flowers or long walks through grassy fields. Thankfully, you can take steps to help lessen and possibly even eliminate your seasonal symptoms.
Seasonal allergies affect roughly 12% of the general population. Allergies affect the way people sleep, work, perform in school, and how they go about their daily routines. According to the Allergy Report by the American Academy of Allergy, Asthma and Immunology, allergic rhinitis sufferers miss 3.8 million days of work and school every year and make an estimated 8 million visits to doctors’ offices as a result of these allergies. Perhaps you are not sure whether you are experiencing allergic rhinitis (the most common symptom of seasonal allergies, also known as hay fever) or whether you have a common cold. One way to distinguish between the two is that allergies tend to last much longer than a cold. Allergies become worse in the mornings and on windy days. Your eyes may water more often and you may sneeze more persistently with allergies than with a cold. Visiting a boardcertified allergist is the first step toward identifying and coping with allergies. A simple 15-minute test will not only confirm an allergy but also determine which allergens may be the source of your symptoms. What Causes Spring Allergies?
Unlike perennial allergies that occur throughout the year—usually a reaction to such indoor allergens as animal dander, dust mites, or mold spores— seasonal allergies come and go at particular times of year. They typically are caused by pollen, tiny spores released into the air by plants. These allergies vary in timing and intensity depending on the pollens to which you’re sensi20
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ASTHMA MAGAZINE
March/April 2002
tive and the pollen levels in the air during a particular season. Pollen from trees, grasses, and weeds (eg, ragweed) instigate seasonal allergies. An allergic reaction to such substances is a result of your immune system interpreting airborne pollen released by these plants as being harmful. Your immune system defends itself by releasing protective chemicals in the body, such as histamine, which in turn causes sneezing, congestion, and other negative reactions. The springtime brings the birth of new plant life, and with this new life comes new allergens. For plants to reproduce, they must spread their pollen from plant to plant. In some plants (typically those with bright, beautiful flowers), pollination is done by flying insects that transport
the sticky, heavy pollen. However, in many plant species, it is done by the wind carrying their very small, lightweight pollen spores. The wind spreads the pollen particles of certain deciduous trees, grasses, and weeds into the air, where they can be breathed in by people who are sensitive to them, causing allergic reactions. Other factors can exacerbate allergy symptoms, such as changes in weather and certain atmospheric pressure conditions, which can increase airborne concentrations of these allergens. Spring allergies may begin as early as March (when tree pollination begins). Some of the worst culprits are hardwood deciduous trees, such as elm, birch, oak, maple, ash, alder, olive, acacia, and hazel. After trees, grasses are the next to release pollen (in spring and early summer). Most weeds pollinate in the late summer and early fall. According to one study, trees are responsible for 10% of allergies in the United States, grasses account for 30%, and weeds 60%. Allergy seasons can vary from one year to the next. Also, the severity of one season may affect the pollen levels during the next. For example, a mild winter will yield an abundant spring pollen season. Likewise, if the spring is particularly wet and warm, grass will grow earlier, potentially leading to a more uncomfortable spring and summer for allergy sufferers. Treatment Options
Avoidance of the offending substance is the best method of treatment for any allergy. However, because they are everywhere outdoors, the airborne pollens that cause spring allergies can be tricky to avoid. “Seasonal allergies are difficult to avoid because the allergens are mostly airborne pollens,” explains Javed Sheikh, MD, an allergist at the Beth Israel Deaconess Medical Center in Boston, Massachusetts, “so [to avoid them] you are limited to trying to minimize your outdoor time.”
Avoid mowing or spending time around freshly cut grass because mowing stirs up pollen and makes it airborne again.
If you suffer from spring allergies, you can take some steps that may help you control your symptoms and be more comfortable. It is wise to check the weather forecast for pollen counts; if the counts are high, stay indoors during the morning hours because this period tends to be the time airborne pollens are at their peak. Pollen counts above 90 are considered high. See the box below for more allergen avoidence measures.
The amount of pollen released and the duration of the pollination process vary with the season and region. For example, in the southern part of the country, the allergy season starts earlier. “Although the allergy season starts earlier and lasts longer in warmer climates,” Sheikh explains, “it also tends to be less severe than in more northern areas.” If you are looking for a place to seek refuge from your allergies,
Reducing Pollen Exposure The American Academy of Allergy, Asthma and Immunology suggests the following steps to reduce your exposure to pollen during allergy seasons. • Do not hang sheets or clothing out to dry; pollen may collect on these items. • Do not mow lawns or spend time around freshly cut grass; mowing stirs up pollen. • Keep windows closed at night. Keep car windows closed when driving. • Minimize morning activities outdoors, a time when pollen counts are usually at their highest. • Stay indoors as much as possible when pollen counts or humidity is high and on windy days when pollen tends to remain in the air longer. • Use air conditioning when possible. Many air conditioners have filters that trap the pollen spores. • Use a HEPA room air filter to remove pollens from the indoor air you breathe.
ASTHMA MAGAZINE
to subscribe call 1.800.654.2452
|
21
Taking steps to control your allergies can greatly improve your quality of life.
Sheikh recommends “remote desert areas or high altitude areas, particularly if you get above the deciduous tree line. In Colorado, for example, you might escape your allergies completely and perhaps on some of the southern islands and along the coast of Florida.” Although taking steps to avoid allergens can help, they may not be enough for many allergy sufferers. These people may need to turn to medications to control symptoms, either over-the-counter remedies or medicines prescribed by their doctor. The following are some of the options. Antihistamines are an effective means to treat an array of seasonal allergy symptoms. Antihistamines work by blocking the effects of the chemical, histamine, which is released in the body during an allergic reaction. These medications can be used in advance of exposure to prevent symptoms, or they can be used once a reaction has begun to treat the symptoms. One side effect of some antihistamines is they cause 22
|
ASTHMA MAGAZINE
drowsiness. However, the newer, second generation antihistamines are much less likely to make users sleepy. Nonsteroid nasal spray helps prevent nasal symptoms associated with seasonal and perennial allergies. Sold over the counter under the brand name Nasalcrom, the medication is safe and effective when used daily. Doctors recommend using the nasal spray for 1 week before contact with allergens and during contact. If you are just starting treatment, do not expect to see results for 1 to 2 weeks. Possible side effects include increased sneezing, flushing, and irritation inside the nose. Steroid nasal sprays are available only by prescription. They work by reducing the inflammation in the nose caused by nasal allergies and are highly effective in reducing symptoms. These nasal sprays may cause adverse reactions, such as sneezing, nosebleeds, stomach pain, or irritation in the nose. Decongestants work to treat nasal allergies by decreasing swollen nasal tissue. Decongestants are available
March/April 2002
over the counter and by prescription in the form of nasal sprays and oral medications. It is important to note that nasal decongestants actually can increase congestion (known as a rebound reaction) if used for longer periods than directed. Oral decongestants do not cause the rebound reaction, but they may take longer to take effect. Immunotherapy (allergy shots) is an option often used by those who do not find relief from avoidance methods or the various medicines available to treat allergic symptoms. With immunotherapy, the patient receives a series of regular injections that contain tiny amounts of the allergens to which that person is sensitive. Most treatments last for 3 to 5 years, and the sufferer actually may be cured at the end of the period. Although not effective for everyone, studies show allergy shots given to patients with seasonal allergic rhinitis have a 90% success rate; for those with perennial allergic rhinitis, the success rate is 70% to 80%. Take Control!
If you have been a passive allergy sufferer, this spring may be your chance to step up and make a change. You can greatly improve your quality of life when you take steps to control your allergies. If your allergies make you miserable or disrupt your life in some way, you can turn that pattern around. Instead of dreading this spring, see it as a challenge you are fully prepared to face. This spring, enjoy those long walks in the fields! Sarah Schell is a freelance writer in Somerville, Massachusetts, who focuses on the arts and human interest stories. She grew up with a mother who suffers asthma, so she has a particular interest in this subject. Reprint orders: Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318; phone (314) 453-4350; reprint no. 78/1/123557 doi:10.1067/mas.2002.123557
If you are one of the 35 million Americans who suffer from seasonal allergies and you’re fed up with your stuffy nose, itchy and runny eyes, and wheezing, take these words to heart: there is hope. In the spring, you should not have to endure these aggravating and sometimes debilitating symptoms when others can enjoy the season with the sweet smell of early flowers or long walks through grassy fields. Thankfully, you can take steps to help lessen and possibly even eliminate your seasonal symptoms.
Seasonal allergies affect roughly 12% of the general population. Allergies affect the way people sleep, work, perform in school, and how they go about their daily routines. According to the Allergy Report by the American Academy of Allergy, Asthma and Immunology, allergic rhinitis sufferers miss 3.8 million days of work and school every year and make an estimated 8 million visits to doctors’ offices as a result of these allergies. Perhaps you are not sure whether you are experiencing allergic rhinitis (the most common symptom of seasonal allergies, also known as hay fever) or whether you have a common cold. One way to distinguish between the two is that allergies tend to last much longer than a cold. Allergies become worse in the mornings and on windy days. Your eyes may water more often and you may sneeze more persistently with allergies than with a cold. Visiting a boardcertified allergist is the first step toward identifying and coping with allergies. A simple 15-minute test will not only confirm an allergy but also determine which allergens may be the source of your symptoms. What Causes Spring Allergies?
Unlike perennial allergies that occur throughout the year—usually a reaction to such indoor allergens as animal dander, dust mites, or mold spores— seasonal allergies come and go at particular times of year. They typically are caused by pollen, tiny spores released into the air by plants. These allergies vary in timing and intensity depending on the pollens to which you’re sensi20
|
ASTHMA MAGAZINE
March/April 2002
tive and the pollen levels in the air during a particular season. Pollen from trees, grasses, and weeds (eg, ragweed) instigate seasonal allergies. An allergic reaction to such substances is a result of your immune system interpreting airborne pollen released by these plants as being harmful. Your immune system defends itself by releasing protective chemicals in the body, such as histamine, which in turn causes sneezing, congestion, and other negative reactions. The springtime brings the birth of new plant life, and with this new life comes new allergens. For plants to reproduce, they must spread their pollen from plant to plant. In some plants (typically those with bright, beautiful flowers), pollination is done by flying insects that transport
the sticky, heavy pollen. However, in many plant species, it is done by the wind carrying their very small, lightweight pollen spores. The wind spreads the pollen particles of certain deciduous trees, grasses, and weeds into the air, where they can be breathed in by people who are sensitive to them, causing allergic reactions. Other factors can exacerbate allergy symptoms, such as changes in weather and certain atmospheric pressure conditions, which can increase airborne concentrations of these allergens. Spring allergies may begin as early as March (when tree pollination begins). Some of the worst culprits are hardwood deciduous trees, such as elm, birch, oak, maple, ash, alder, olive, acacia, and hazel. After trees, grasses are the next to release pollen (in spring and early summer). Most weeds pollinate in the late summer and early fall. According to one study, trees are responsible for 10% of allergies in the United States, grasses account for 30%, and weeds 60%. Allergy seasons can vary from one year to the next. Also, the severity of one season may affect the pollen levels during the next. For example, a mild winter will yield an abundant spring pollen season. Likewise, if the spring is particularly wet and warm, grass will grow earlier, potentially leading to a more uncomfortable spring and summer for allergy sufferers. Treatment Options
Avoidance of the offending substance is the best method of treatment for any allergy. However, because they are everywhere outdoors, the airborne pollens that cause spring allergies can be tricky to avoid. “Seasonal allergies are difficult to avoid because the allergens are mostly airborne pollens,” explains Javed Sheikh, MD, an allergist at the Beth Israel Deaconess Medical Center in Boston, Massachusetts, “so [to avoid them] you are limited to trying to minimize your outdoor time.”
Avoid mowing or spending time around freshly cut grass because mowing stirs up pollen and makes it airborne again.
If you suffer from spring allergies, you can take some steps that may help you control your symptoms and be more comfortable. It is wise to check the weather forecast for pollen counts; if the counts are high, stay indoors during the morning hours because this period tends to be the time airborne pollens are at their peak. Pollen counts above 90 are considered high. See the box below for more allergen avoidence measures.
The amount of pollen released and the duration of the pollination process vary with the season and region. For example, in the southern part of the country, the allergy season starts earlier. “Although the allergy season starts earlier and lasts longer in warmer climates,” Sheikh explains, “it also tends to be less severe than in more northern areas.” If you are looking for a place to seek refuge from your allergies,
Reducing Pollen Exposure The American Academy of Allergy, Asthma and Immunology suggests the following steps to reduce your exposure to pollen during allergy seasons. • Do not hang sheets or clothing out to dry; pollen may collect on these items. • Do not mow lawns or spend time around freshly cut grass; mowing stirs up pollen. • Keep windows closed at night. Keep car windows closed when driving. • Minimize morning activities outdoors, a time when pollen counts are usually at their highest. • Stay indoors as much as possible when pollen counts or humidity is high and on windy days when pollen tends to remain in the air longer. • Use air conditioning when possible. Many air conditioners have filters that trap the pollen spores. • Use a HEPA room air filter to remove pollens from the indoor air you breathe.
ASTHMA MAGAZINE
to subscribe call 1.800.654.2452
|
21
Taking steps to control your allergies can greatly improve your quality of life.
Sheikh recommends “remote desert areas or high altitude areas, particularly if you get above the deciduous tree line. In Colorado, for example, you might escape your allergies completely and perhaps on some of the southern islands and along the coast of Florida.” Although taking steps to avoid allergens can help, they may not be enough for many allergy sufferers. These people may need to turn to medications to control symptoms, either over-the-counter remedies or medicines prescribed by their doctor. The following are some of the options. Antihistamines are an effective means to treat an array of seasonal allergy symptoms. Antihistamines work by blocking the effects of the chemical, histamine, which is released in the body during an allergic reaction. These medications can be used in advance of exposure to prevent symptoms, or they can be used once a reaction has begun to treat the symptoms. One side effect of some antihistamines is they cause 22
|
ASTHMA MAGAZINE
drowsiness. However, the newer, second generation antihistamines are much less likely to make users sleepy. Nonsteroid nasal spray helps prevent nasal symptoms associated with seasonal and perennial allergies. Sold over the counter under the brand name Nasalcrom, the medication is safe and effective when used daily. Doctors recommend using the nasal spray for 1 week before contact with allergens and during contact. If you are just starting treatment, do not expect to see results for 1 to 2 weeks. Possible side effects include increased sneezing, flushing, and irritation inside the nose. Steroid nasal sprays are available only by prescription. They work by reducing the inflammation in the nose caused by nasal allergies and are highly effective in reducing symptoms. These nasal sprays may cause adverse reactions, such as sneezing, nosebleeds, stomach pain, or irritation in the nose. Decongestants work to treat nasal allergies by decreasing swollen nasal tissue. Decongestants are available
March/April 2002
over the counter and by prescription in the form of nasal sprays and oral medications. It is important to note that nasal decongestants actually can increase congestion (known as a rebound reaction) if used for longer periods than directed. Oral decongestants do not cause the rebound reaction, but they may take longer to take effect. Immunotherapy (allergy shots) is an option often used by those who do not find relief from avoidance methods or the various medicines available to treat allergic symptoms. With immunotherapy, the patient receives a series of regular injections that contain tiny amounts of the allergens to which that person is sensitive. Most treatments last for 3 to 5 years, and the sufferer actually may be cured at the end of the period. Although not effective for everyone, studies show allergy shots given to patients with seasonal allergic rhinitis have a 90% success rate; for those with perennial allergic rhinitis, the success rate is 70% to 80%. Take Control!
If you have been a passive allergy sufferer, this spring may be your chance to step up and make a change. You can greatly improve your quality of life when you take steps to control your allergies. If your allergies make you miserable or disrupt your life in some way, you can turn that pattern around. Instead of dreading this spring, see it as a challenge you are fully prepared to face. This spring, enjoy those long walks in the fields! Sarah Schell is a freelance writer in Somerville, Massachusetts, who focuses on the arts and human interest stories. She grew up with a mother who suffers asthma, so she has a particular interest in this subject. Reprint orders: Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318; phone (314) 453-4350; reprint no. 78/1/123557 doi:10.1067/mas.2002.123557