Don’t Let Pollen Allergies Spoil Your Spring

Spring is in the air, and so is pollen. Learn why these plant particles make you sniffle and sneeze, how to avoid airborne allergens, and the best ways to treat symptoms… Sneezing isn’t always the symptom of a cold. Sometimes it’s an allergic reaction to something in the air. Health experts estimate that 35 million Americans suffer from upper respiratory-tract symptoms caused by allergic reactions to airborne allergens. Asthma symptoms, which affect approximately 11 million Americans, are also often provoked by airborne particles. And pollen allergy, commonly called hay fever, is one of the most common chronic diseases in the United States. Why Pollen Allergens Plague Us Each spring, summer and fall, tiny pollen grains are released from trees, weeds and grasses. Although their mission is to fertilize parts of other plants, many enter human noses and throats instead. Pollen is one of the most common allergy triggers. Many others – such as foods, medicines, animals or even household dust – can often be avoided. But short of staying indoors with the windows closed when pollen count is high (and even that may not help), there’s no easy way to avoid airborne pollen. The types of pollen that most commonly cause allergic reactions are produced by plain-looking plants without showy flowers. They make small, light, dry pollen grains custom-made for wind transport. In fact, scientists have collected samples of ragweed pollen 400 miles out at sea and 2 miles high in the air. So, because airborne pollen can drift for many miles, it does little good to get rid of an offending plant. Among North American plants, weeds are the most prolific producers of allergenic pollen. Ragweed is the major culprit – a single plant can generate a million grains of pollen a day – but other important sources are sagebrush, redroot pigweed, lamb’s quarters, Russian thistle (tumbleweed) and English plantain. Grasses and trees are also important sources. But while more than 1,000 species of grass grow in North America, only a few produce highly allergenic pollen. It’s common to hear people say they’re allergic to colorful or scented flowers like roses. In fact, only florists, gardeners and others who have prolonged, close contact with flowers are likely to be sensitive to pollen from these plants. Most people have little contact with the large, heavy, waxy pollen grains of such flowering plants, because this type of pollen isn’t carried by wind but by insects such as butterflies and bees. When Will Pollen Strike? One of the most obvious features of pollen allergy is its seasonal nature – people have symptoms only when the pollen grains to which they’re allergic are in the air. Each plant has a pollinating period that’s more or less the same from year to year. But exactly when a plant starts to pollinate seems to depend on the relative length of night and day – and therefore on geographical location – rather than on the weather. On the other hand, weather conditions during pollination can affect the amount of pollen produced and distributed in a specific year. That’s why, in the Northern Hemisphere, the farther north you go, the later the start of the pollinating period and allergy season. The pollen count you hear about on local weather reports is a measure of how much pollen is in the air. This count represents the concentration of all pollen (or one particular type, like ragweed) in a certain area at a specific time. It’s expressed as the grains of pollen per square meter of air collected over 24 hours. Pollen counts tend to be highest early in the morning on warm, dry, breezy days and lowest during chilly, wet periods. Although pollen count is an approximate measure that changes, it’s useful as a general guide for when it may be wise to stay indoors. How to Avoid Pollen Allergies Complete avoidance of allergenic pollen means moving to a place where the offending substance doesn’t grow and isn’t present in the air. But even this extreme solution may offer only temporary relief, because a person sensitive to a specific pollen may develop allergies to new ones after repeated exposure. For example, people allergic to ragweed may leave their ragweed-ridden communities and relocate to areas where ragweed doesn’t grow, only to develop allergies to other weeds, or even to grasses or trees, in their new surroundings. Because relocating isn’t a reliable solution, allergy specialists don’t encourage this approach. There are other ways to reduce exposure to offending pollens: Remain indoors with the windows closed when outdoor pollen levels are highest – in the morning, for example. Sunny, windy days can be especially troublesome. If you must be outdoors, wear a face mask designed to filter pollen out of the air and keep it from reaching nasal passages. Take your vacation at the height of the expected pollinating period and choose a location where such exposure would be minimal. Vacationing at the seashore or on a cruise, for example, may be effective for avoiding pollen allergies. When possible, use air conditioners inside your home or car to help prevent pollen and mold allergens from entering. Various types of air-filtering devices made with fiberglass or electrically charged plates may help reduce allergens produced in the home. You can add these to your present heating and cooling system. Portable devices for use in individual rooms are also helpful. An allergist can suggest which kind of filter is best for your home. Before buying a filtering device, rent one and use it in a closed room (such as the bedroom) for a month or two to see whether your allergy symptoms diminish. The airflow should be sufficient to exchange the air in the room five or six times per hour. Therefore, the size and efficiency of the filtering device should be determined in part by room size. Be wary of exaggerated claims for appliances – very small air cleaners can’t remove dust and pollen, for example. Before buying an electrostatic precipitator, compare the machine’s ozone output with federal standards. Ozone can irritate the noses and airways of people with allergies, especially those with asthma, and can increase their allergy symptoms. Other kinds, such as HEPA (high efficiency particulate air) filters, don’t release ozone into the air. But they require machinery with adequate air flow to force air through them. Treating Pollen Allergies When you can’t adequately avoid airborne allergens, your symptoms can often be controlled by over-the-counter remedies. But if they don’t give you relief or cause unwanted side effects such as sleepiness, your health care provider can prescribe antihistamines or topical nasal steroids. Antihistamines These counter the effects of histamine, which contributes to your allergy symptoms. For many years, antihistamines have proven useful in relieving itching and sneezing, and in reducing nasal swelling and drainage. Many people who take antihistamines have some distressing side effects such as drowsiness and loss of alertness and coordination. Antihistamines that cause fewer of these side effects are available over-the-counter or by prescription. These non-sedating antihistamines are as effective as others in preventing symptoms. Topical Nasal Steroids Don’t confuse these with anabolic steroids, which athletes sometimes use to enlarge muscle mass. Nasal steroids are anti-inflammatory medicines that stop an allergic reaction. In addition to other helpful actions, they reduce mucus secretion and nasal swelling. The combination of antihistamines and nasal steroids is an effective way to treat allergic rhinitis, especially if it’s moderate or severe. Although topical nasal steroids can have side effects, they’re safe when used at recommended doses. Cromolyn Sodium When used as a nasal spray, this can safely stop the release of chemicals like histamine, and in some people it helps prevent allergic rhinitis from starting. It has few side effects when used as directed and significantly helps some people manage allergies. Decongestants Sometimes, helping the nasal passages drain away mucus will relieve symptoms such as congestion, swelling, excess secretions and discomfort in the sinus areas caused by nasal allergies. Your doctor may recommend oral or nasal decongestants to reduce congestion along with an antihistamine to control allergic symptoms. You shouldn’t use over-the-counter or prescription decongestant nose drops and sprays for more than a few days. When used for longer periods, they can lead to even more congestion and swelling of the nasal passages. Immunotherapy This is the only available treatment that can reduce allergy symptoms over a longer period of time. It involves receiving injections of increasing concentrations of the allergen(s) to which you’re sensitive. About 85% of people with allergic rhinitis will see hay fever symptoms and need for medicines drop significantly within 12 months of starting immunotherapy. Those who benefit from allergy shots may continue it for three years and then consider stopping. While many are able to stop the injections with good results lasting for several years, others get worse after shots are stopped. To learn more, visit our Allergy Health Center. Excerpted from Airborne Allergens: Something in the Air by the National Institute of Allergy and Infectious Diseases, a division of the National Institutes of Health.