Pollen Allergies: Questions and Answers

About Pollen Allergy

Q: What is hay fever?
A: Hay fever is a commonly used term for pollen allergy, a type of seasonal allergic rhinitis (runny nose).

Q: Do pollen allergies occur only in the spring?
A: No. Pollen grains can be dispersed into the air in the spring, summer and fall, depending on the type of tree, grass or weed. For example, ragweed is a common cause of pollen allergy reactions in the fall. In mild climates, some plants pollinate in the winter as well.

Q: Why are some people allergic to pollen while others are not?
A: People inherit a tendency to be allergic, meaning an increased likelihood of being allergic to one or more allergens (such as pollen), although they probably do not inherit a tendency to be allergic to any specific allergens. Children are much more likely to develop allergies if their parents have allergies, even if only one parent is allergic. Exposure to allergens at certain times when the body's defenses are lowered or weakened, such as after a viral infection or during pregnancy, also seems to contribute to the development of allergies.

Q: Which trees and grasses produce the most allergens?
A: Plain-looking trees, grasses and weeds, which do not have showy flowers, produce the types of pollen that most commonly cause allergic reactions. These plants manufacture small, light, dry pollen granules that are custom-made for wind transport. Although most allergenic pollen comes from plants that produce it in huge quantities, it's the chemical maekup of the pollen that determines whether it is likely to cause hay fever.

Local Conditions

Q: Where can I get information on the pollen count where I live?
A: The National Allergy Bureau monitors pollen counts in many locations throughout the United States. Their phone number for pollen counts is 1-800-9-POLLEN.

Q: What time of day and weather conditions are worst for people with pollen allergy?
A: Generally, pollen is most abundant in the early morning, especially between 5:00 a.m. and 10:00 a.m. Other considerations, however, also determine exposure, such as wind velocity. Also, rain can wash pollen out of the air for a time, and some plants may not pollinate in damp weather.

Testing, Treatment, and Management

Q: How can I get tested to find out if I have pollen allergy?
A: A doctor can use a skin test to see if you will react to specific pollen allergens. A diluted extract is injected under the patient's skin or is applied to a tiny scratch or puncture made on the arm or back. Skin testing is the most common method used to test for allergic reactions. Blood tests are also available to determine if you have a pollen allergy.

Q: As an allergic person, is there anything I can do in my environment and activities to minimize my reaction to pollen?
A: Avoiding exposure to pollen is the best way to decrease allergic symptoms.

• Remain indoors in the morning when outdoor pollen levels are highest.
• Wear face masks designed to filter out pollen if you must be outdoors.
• Keep windows closed and use the air conditioner if possible in the house and car.
• Do not dry clothes outdoors.
• Avoid unnecessary exposure to other environmental irritants such as insect sprays, tobacco smoke, air pollution, and fresh tar or paint.
• Avoid mowing the grass or doing other yard work, if possible.

Q: What are the best treatments for pollen allergy?
A: The best treatment for pollen allergy is to avoid coming into contact with pollen. Because that is usually not possible, certain medications can control allergic reactions in most people. Several oral antihistamine medications are available over-the-counter or by a doctor's prescription. Topical nasal steroid sprays are anti-inflammatory drugs that stop the allergic rhinitis. Using a combination of antihistamines and nasal steroids can effectively treat allergic symptoms, especially in people with moderate or severe allergic symptoms.

Cromolyn sodium, a nasal spray, helps prevent allergic reactions from starting. It significantly helps some people with allergies.

Oral and nasal decongestants reduce congestion sometimes caused by the allergic reaction. Doctors sometimes recommend their use along with an antihistamine which controls the allergic symptoms. Nose drops and sprays, however, should not be used for more than a few days at a time because they can lead to even more congestion and swelling of the nasal passages.

Q: Allergy drugs make me sleepy. Is there anything I can take that won't do that?
A: There are several non-sedating antihistamines on the market that are available with a doctor's prescription.

Q: Can I take shots to get rid of my pollen allergy?
A: Immunotherapy, or a series of allergy shots, is the only available treatment that has a chance of reducing allergy symptoms over the long term. About 80 percent of people with hay fever will have a significant reduction in their symptoms and in their need for medication within 12 months of starting allergy shots.

Q: Do air filters help?
A: Various types of air-filtering devices made with fiberglass or electrically charged plates may help reduce pollen allergens. An allergy specialist can suggest which kind of filter is best for your home.

Q: Should I consider moving to another geographic area where I would have less exposure to the trees, grasses, etc., that I am allergic to?
A: Most people who relocate to get away from the pollens that cause their allergic symptoms find that they eventually develop allergies to the plant pollens in the new area. In addition, other airborne allergens, such as dust or mold, in the new area also might cause allergic rhinitis in a person. Therefore, doctors usually do not recommmend that their patients move.

Research

Q: What new treatments and vaccines are being studied?
A: New treatments under investigation include anti-IgE, a compound designed to block IgE antibodies, which are produced in massive quantities by allergic individuals. Researchers also are exploring the use of agents designed to antagonize other molecules that participate in allergic reactions. An exciting area of vaccine research involves the use of DNA encoding allergy-inducing substances. Other researchers are developing allergy vaccines composed of molecularly modified allergens.

Q: Has the number of individuals with allergies been increasing in recent years?
A: There are very little data available on this issue. Some researchers hypothesize that environmental pollutants can stimulate the immune system in such a way as to make people more vulnerable to allergies. Still, there is insufficient evidence at this time to say that allergies have truly increased within the population. This question requires additional study. Any increase in new commercial products, anecdotal stories, etc., does not necessarily mean that there is a scientifically proven increase in the rate of allergies.

Source: National Institute of Allergy and Infectious Diseases, National Institutes of Health, February 2000