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    The increasing role of climate, hygiene, and aerobiology in allergy

    The allergy discussion is often more complicated than just pollen exposure

    Although the winter doldrums and mammoth snowstorms in the Northeast would tell you otherwise, spring is actually around the corner. With Earth’s climate change, both higher temperature and carbon dioxide levels have been inducing vigorous amounts of allergen production from multiple plant and tree species blooming faster than expected for at least the past 160 years. In fact, famed naturalists Henry David Thoreau and Aldo Leopold began carefully recording temperature and bloom data which corroborated the correlation to pollen production without the need for expensive instrumentation.1 A perfect example is found within Thoreau’s writings in 1853 in which the highbush blueberry has accelerated its flowering habit approximately six weeks earlier as of 2012.1

     

    The wibbly-wobbly pollen flux

    Historically, the common thought is that allergy season has a May to August schedule.  However, Singh et al illustrated it is actually a year-round phenomenon with known spikes in April/May and August/September.2 What does this mean for all of us? Rather than a punctuated start and stop to an allergenic pollen season, it is more of a sustained release leading to more prolonged exposure. Consequently, depending on geography, pollen will be upon us soon and will be more impactful not only to our environment, but to our symptomatic patients whether they are new or returning to our practices. A word of warning: we are all living through the climate fluctuations which leads to nonlinear short-term peaks and troughs with regard to allergy patient population year after year.            

    Related: 3 tips to navigate the allergy discussion with kids

    Over the past five years, my practice in Connecticut performed a small data study capturing allergy coding which confirms an increase in the number of patients seen for allergic conjunctivitis. A further assessment of follow-up and medication prescriptions from initial presentation also demonstrated that these cases have become more ferocious to treat beyond the simplistic allergy drop. In many cases, a documented allergist and/or ear, nose, and throat specialist referral was necessary to provide systemic stability.

    Next: Hygiene hypothesis 

    Michael S. Cooper, OD
    Michael S. Cooper, OD, is in private practice in Willimantic, CT. He is a consultant to Allergan, BioTissue, Johnson & Johnson Vision ...

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