Lexington, Ky., deep in bluegrass country and known as the horse capital of the world, is a pleasant place if you’re a horse fan. But if you’re the allergic type — especially to springtime pollens — not so much.
The city earned the dubious honor of being named the worst of the worst on the latest list of “The 100 Most Challenging Places to Live with Spring Allergies.” Los Angeles, much maligned for its air pollution, ranked far better — number 86 on the 2008 list. San Francisco was 99, and Spokane came in at number 100. (See full list at the end of this article)
What do the worst allergy cities have in common? What makes a city good for people with allergies? Unfortunately, there are no easy answers. But allergy experts say there are key factors to look for.
How the ‘Worst’ Allergy Cities Are Computed
Unveiling the worst spring allergy cities in America has become an annual tradition. The lists are released by the Asthma and Allergy Foundation of America, in Washington, D.C., and many factors are plugged in to figure out which cities will get the dubious honor each year, says Mike Tringale, a spokesman for the foundation.
The foundation experts look at the most populated cities and take into account factors such as the region’s pollen score (pollen count and other factors), along with the number of allergy medications prescribed and the number of board-certified allergists practicing there. Each city gets a score and then the list of 100 cities is drawn up.
While Lexington got a score of 100, the average score was about 40. And the top 10 is a bit overloaded with southern cities: Greensboro, N.C.; Johnson City, Tenn.; Augusta, Ga.; Jackson, Miss.; Knoxville, Tenn.; Birmingham, Ala.; New Orleans; and Little Rock, Ark.
But San Diego is also in the top 10 worst allergy list — debunking the myth that ocean breezes get rid of pollen.
Why Are Some Cities Worse for Allergies Than Others?
“The fundamental issue with cities is the type of plant or grasses, trees or weeds that grow in the area,” says Daniel Waggoner, MD, an allergist in Mystic, Conn., who is not affiliated with the list creation but is familiar with it.
Cities with an exceptionally high concentration of trees, grass, or weeds may have more pollen in the air, he says. Local environmental factors such as wind, humidity, typical temperatures — and air pollution — also play a role in allergies, notes Miguel Wolbert, MD, an allergist in Evansville, Ind. and a certified pollen counter.
What if you don’t live in a major city? How can you tell if your region is especially bad for allergies? Here’s what the experts have to say.
Allergy Risks by Region
Near River Basins
“If you are around certain river basins, such as in Ohio or Mississippi, higher pollen counts occur due to high humidity levels,” says Wolbert.
In the middle of Mississippi, everything sits, Wolbert says, so pollen is likely to be worse.
In the Mountains
In the mountains, there are fewer plants that pollinate, Wolbert say, perhaps explaining why West Virginia and other hilly locales are absent from the 2008 list.
Near the Coast
While some seaside towns made the list, in general a sea breeze helps reduce allergens, Leftwich says. The closer to the sea the better. “If you can afford to live in that first quarter mile from the beach, it’s great. Pollens are not so much a problem there.”
The Midwest
The Midwest, known for its ragweed pollen, has several cities on the list including South Bend, Ind. and St. Louis. Some experts believe global warming is making the ragweed season longer, Wolbert says, so pollen may just get worse.
The West
“West of the Rockies, there is no ragweed but there is lots of grass pollen,” Leftwich says.
The South
And allergy wise, he says, “Tennessee is where everything comes together,” noting there are several different types of pollen flourishing there. His town, Nashville, Tenn., made No. 18 on the list.
Putting the Worst Allergy Cities List Into Perspective
Waggoner and other allergists caution that the list of worst cities for springtime allergies may not be that scientific. “The worst city for one person is the best city for another person,” Leftwich agrees. “It depends on what you are allergic to.”
“Being allergic to one tree pollen doesn’t mean you are allergic to another.” The city that has the worst tree pollen count may not have the worst grass pollen count, he says. “It is a common misconception that pollens are pollens. They are not.”
No scientific studies have thoroughly compared allergy risks in different cities, Leftwich says. Instead, we turn to the annual list almost for bragging rights.
So how can we use the annual list of worst allergy cities? Well, don’t use the list to pick one place to live over another, allergy experts say. Instead, get allergy testing to be sure you know what triggers your allergies. And if you must move, find out whether your pollen triggers grow widely in the area and neighborhood you’re considering.
What if you love your home, but you’re in a bad allergy community? Talk to your doctor. There are preventive treatments you can start before allergy season to help you stay home and healthy.
Complete List of 2008 Spring Allergy Capitals
- Lexington, Ky.
- Greensboro, N.C.
- Johnson City, Tenn.
- Augusta, Ga.
- Jackson, Miss.
- Knoxville, Tenn.
- Birmingham, Ala.
- New Orleans
- Little Rock, Ark.
- San Diego
- Oklahoma City
- Mobile, Ala.
- South Bend, Ind.
- Omaha, Neb.
- Stockton, Calif.
- McAllen, Texas
- Greenville, S.C.
- Nashville, Tenn.
- Tulsa, Okla.
- Harrisburg, Pa.
- Louisville, Ky.
- Dallas-Fort Worth
- Charlotte, N.C.
- Tampa, Fla.
- Philadelphia
- St. Louis
- Scranton, Pa.
- Lansing, Mich.
- Madison, Wis.
- Rochester, N.Y.
- Daytona Beach, Fla.
- Memphis
- Milwaukee, Wis.
- Norfolk, Va.
- Pensacola, Fla.
- Charleston, S.C.
- Cleveland
- Indianapolis
- Houston
- Lakeland, Fla.
- Baltimore
- Sacramento, Calif.
- Columbia, S.C.
- Kansas City, Mo.
- New York
- San Antonio
- Allentown, Pa.
- Wichita, Kan.
- Albuquerque, N.M.
- Baton Rouge, La.
- Washington, D.C.
- Providence, R.I.
- Fort Wayne, Ind.
- Austin, Texas
- Canton, Ohio
- Atlanta
- Kalamazoo, Mich.
- Chattanooga, Tenn.
- Boston
- Detroit
- Grand Rapids, Mich.
- Hartford, Conn.
- Denver
- Dayton, Ohio
- Tucson, Ariz.
- Buffalo, N.Y.
- Des Moines, Iowa
- Syracuse, N.Y.
- Salt Lake City
- Minneapolis-St. Paul
- Cincinnati
- Columbus, Ohio
- Chicago
- Boise City, Idaho
- Albany, N.Y.
- El Paso, Texas
- Richmond, Va.
- Raleigh-Durham-Chapel Hill, N.C.
- Las Vegas
- Jacksonville, Fla.
- Melbourne, Fla.
- Pittsburgh
- Miami
- Toledo, Ohio
- Modesto, Calif.
- Los Angeles
- Springfield, Mass.
- Youngstown, Ohio
- Colorado Springs, Colo.
- Seattle
- Phoenix-Mesa, Ariz.
- Fresno, Calif.
- Portland, Ore.
- Fort Myers, Fla.
- Orlando, Fla.
- Lancaster, Pa.
- Sarasota, Fla.
- Bakersfield, Calif.
- San Francisco
- Spokane, Wash.
SOURCES: American Academy of Asthma Allergy & Immunology: “Outdoor Allergens,” “National Allergy Bureau.” Asthma and Allergy Foundation of America: “Pollen and Mold Counts.” National Institutes of Health: “Airborne Allergens: Something in the Air.” Daniel Waggoner, MD, allergist, Mystic, Conn. Miguel P. Wolbert, MD, allergist, Evansville, Ind. Russell Leftwich, MD, allergist, Nashville, Tenn. WebMD Health News: “Worst Spring Allergy Cities?”
Reviewed by Brunilda Nazario, MD on 2/25/2009