Record-high 'full-body assault'-like symptoms wreak havoc—docs, what's our next move?
Key Takeaways
Industry Buzz
"We know that climate change is leading to greater amounts of pollen in the atmosphere. It's changing the seasonality of the pollen. It's changing the types of pollen that we're exposed to." — Paul Beggs, environmental health scientist and professor at Macquarie University in Sydney, Australia
"We have more pollen grains that are also more allergenic than they have ever been, as temperatures have been steadily rising over the last several decades." — Zachary Rubin, MD, pediatric allergist and clinical immunologist
If your patients are reporting more intense allergy symptoms earlier in the year, they're not alone.
Recent studies confirm that pollen seasons are starting earlier, lasting longer, and and only intensifying. This trend is largely driven by climate change and urban landscaping practices.[][]
It’s not just bad for those with classic seasonal allergic rhinitis—it’s now affecting people who don’t typically suffer from allergies. Why? Because the sheer volume and duration of exposure is enough to trigger sensitization or create non-allergic rhinitis symptoms.
Your patients might not test positive on skin prick or IgE tests—but they’re still reacting to the inflammatory effects of prolonged pollen exposure in already irritated or sensitive airways. In short, even your "non-allergic" patients are caught in the crossfire.
Wind-pollinated trees: The culprits behind airborne allergens
First off, let’s talk about what may be the primary culprit: Many of the trees in our neighborhoods rely on wind, not insects, to spread their pollen. Unlike insect-pollinated plants, which produce heavier, stickier pollen, wind-pollinated trees release vast quantities of lightweight pollen into the air to increase the chances of successful fertilization.
This pollen can travel long distances and easily enters human respiratory systems, triggering allergic reactions. Common culprits include oaks, birches, and maples.[]
Combine all of this with increasing spring winds in many regions (thanks to shifting weather patterns), and you’ve got the perfect mechanism to spread allergens farther and faster.
Related: 8 common myths about allergiesClimate change and 'botanical sexism'
Research indicates that climate change is a significant factor in the worsening of pollen allergies.
Warmer temperatures and higher carbon dioxide levels have led to longer growing seasons (data shows certain cities have experienced an average increase of 20 freeze-free days since 1970, allowing plants more time to release pollen[]) and elevated CO₂ levels (which stimulate plant growth, resulting in more pollen; from 1990 to 2018, for example, research has shown that pollen seasons have expanded by an average of 20 days, with pollen concentrations increasing by 21%[]).
Urban planning practices have inadvertently contributed to higher pollen levels. The preference for planting male trees—due to their lack of fruit and seeds—has led to an overabundance of pollen-producing plants in cities. []
This phenomenon, termed "botanical sexism," exacerbates allergy symptoms among urban residents.
Clinical implications and management strategies
As healthcare providers, it's crucial to recognize the evolving nature of allergy seasons and adjust management plans accordingly:
Early intervention: Advise patients to begin antihistamine therapy before the onset of symptoms, especially in regions with early pollen seasons.
Environmental controls: Recommend keeping windows closed during high pollen days, using HEPA filters, and showering before bedtime to remove pollen from the skin and hair.
Patient education: Inform patients about the impact of climate change on allergies and the importance of monitoring pollen forecasts.[]
Understanding the interplay between environmental changes and allergic responses is essential for effective patient care.
By staying informed and proactive, clinicians can help patients navigate the challenges of worsening pollen allergies.
Related: Food allergies on the rise in your patients—here’s why