Tuesday, September 28, 2021

Longer growing season, more pollen and worse allergies

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Dr. Neelu Tummala, Opinion contributor
Published 5:00 a.m. ET March 2, 2021

My patients feel the burden of global warming and longer growing seasons. We could see year-round pollen if we don’t improve our climate policies.

“Why are my allergies lasting longer than they used to?” The first time a patient asked this, I researched potential reasons. The second time, I was prepared with the answer.  And now, knowing what is coming, I preempt the question. The growing season, the period when trees, grass and weeds grow and produce pollen, has lengthened by about 17 days in Washington, D.C., as compared to 1970. In Detroit and Portland, Oregon, the season has lengthened by almost a month.

A recent study published in PNAS, the Proceedings of the National Academy of Sciences, reinforces what my patients are experiencing. Looking back approximately three decades, pollen seasons now last on average 20 extra days in North America, and pollen concentrations have increased about 21% over the years. The data shows that these changes in pollen allergy season are in part driven by anthropogenic global warming.

Quality of life is suffering

This study and others before it cement what health care providers who treat allergic rhinitis, or allergic inflammation of the nasal cavity, are seeing in their clinics. Climate change affects health. In this case, the roughly 20% of Americans who suffer from environmental allergies feel the burden of global warming through exacerbated pollen allergy symptoms, including increased nasal congestion, sneezing and post-nasal drainage.

Allergy symptoms have a tremendous impact on quality of life. It is not surprising that nasal congestion, a common symptom of allergic rhinitis, affects sleep quality. This translates into daytime fatigue and disruption of emotional health, including feeling irate or depressed.  Also, children who suffer from allergies risk poorer school performance, an unwelcome consequence for students whose learning is already challenged in the COVID-19 era. 

Woman sneezing [Via MerlinFTP Drop] (Photo: IvanMikhaylov, Getty Images/iStockphoto)

Often, patients use a prior year’s patterns to predict when to start their allergy medications. Some of the therapies directed at addressing nasal allergy symptoms are started before the onset of symptoms. Intranasal steroids, for example, are highly effective at controlling nasal inflammation, but the maximal efficacy of the spray may take days to occur. Unfortunately, climate change-induced variations in pollen seasons may make the determination of timing more challenging. When patients are caught off guard by an early pollen season, they end up suffering through poorly controlled allergy symptoms by not starting their allergy medications. 

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Dr. Anjeni Keswani, the Director of the Allergy and Sinus Center at The George Washington Medical Faculty Associates, describes how her practice management has changed in recognizing the shift in ragweed pollen symptoms in her patients, with symptoms both starting earlier in the year and lasting longer. Because of these seasonal variations, she has found it necessary to adjust recommendations regarding starting and stopping allergy medications. 

More medication, higher costs

Carbon dioxide concentrations have increased from 325 to 414 parts per million over the past 50 years. As pollen levels rise in response to global warming and increased carbon dioxide in the air, so too does the symptom burden. This increased burden of disease often requires more medication, which means more money out of your pocket. The economic cost of managing allergic rhinitis is approximately $3.4 billion, almost half of it for prescription medications. With both pollen seasons lasting longer and more pollen in the air to combat, this number will continue to rise.

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So where do we go from here? 

Knowledge of how environmental changes impact health is important. It can help optimize the management of medications to maximize symptom control. Equally important, it is a constant and unwelcome reminder that the climate crisis affects our health. Climate action through effective government policy and corporate responsibility, as well as transition to a more sustainable lifestyle, are musts to address this growing risk factor. Without it, how far from reality is year-round pollen?

Neelu Tummala is an ENT doctor at The George Washington Medical Faculty Associates, a Clinical Assistant Professor of Surgery at George Washington University School of Medicine and Health Sciences, and a climate advocate with a special interest in the intersection of climate and health. Follow her on Twitter: @NeeluTummala  

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