Illustration via Getty Images
My interest in allergies began when I was a child. Each fall, my father and I suffered from severe ragweed allergy. In Philadelphia, where I grew up, ragweed is the most significant allergen and can be debilitating. In Richmond, spring pollen is more problematic, and I suffer much less than I did in Philly.
Over the years, medications and monitoring have resulted in great strides in treatments of allergies. If the medicines and ability to know when pollen is first in the air had been available when I was a child, my fall suffering would not have existed. That progress comes in handy for allergy sufferers in a city like Richmond, especially now.
In 2022, the Asthma and Allergy Foundation of America rated Richmond in the top five of the most challenging cities for pollen allergy in the United States. The foundation looks at pollen scores, use of over-the-counter medication and the availability of board-certified allergists/immunologists; the higher the pollen counts and the lower the availability of trained specialists, the more challenged the city. And while the recently released 2023 report ranks Richmond at No. 23, a mild winter is linked to an earlier and longer allergy season, and is by no means a reason to ignore health precautions in a city that historically ranks high for pollen allergies.
The Richmond area’s problem with pollen has been documented for the past 35 years at my Henrico Doctors’ Hospital office building on Forest Avenue. On the top of our building stands a device called a Rotorod sampler. Almost every day during the spring and fall pollen seasons, my partner, Becky Collie aka “The Pollen Lady,” makes the climb to the top of the building to retrieve a coated slide to which pollen grains have adhered over 24 hours. Becky then takes the slide to our lab and examines it under a microscope to determine the amount of pollen and its source.
All plants produce pollen that looks different through the microscope, so we can differentiate amongst the different trees and grasses. This information is critical for allergists in deciding how to treat our patients.
Becky and I have worked together at my medical practice, Allergy Partners of Richmond, for over 40 years. And with the help of Jeremy Hoffman, chief scientist at the Science Museum of Virginia, we have tracked trends in pollen counts since the 1980s. We have found that overall pollen counts are 20% higher than they were then, and tree pollen counts are now rising 20 days earlier than when we started our measurements. While tree pollen season used to be in April, it now extends from February to May. The change in counts correlates best with a rise in average temperature, although increases in rainy days and outdoor carbon dioxide levels also play a role.
Richmond suffers from its location east of oak tree forests and from the westerly wind that blows this pollen into the city. High pollen counts, particularly oak pollen, are linked with greater use of over-the-counter medication and more urgent care visits.
Patients suffer from allergies, asthma, sinus disease and viral infections related directly to tree pollen counts. These respiratory diseases impact children and adults and lead to days missed from school and work.
Higher pollen counts affect anyone, not just people with allergies.
Higher pollen counts affect anyone, not just people with allergies. Recent research shows that it is associated with a decrease in innate immunity, the type of immunity that helps fight viral infections. Because of this, it is recommended that people at risk for respiratory disease avoid extensive outdoor activities when both respiratory viruses and pollen are prevalent. This is especially true for those in our community with preexisting respiratory diseases like asthma and COPD.
How does a Richmond resident survive spring allergy season? The most important advice is to get ahead of the symptoms. Often that means consulting an allergist/immunologist who can identify what you are allergic to and recommend the best treatment and the best time to begin.
Knowing what you are allergic to is the basis for prevention and treatment. The most effective preventive for many people is the use of over-the-counter, nonsedating antihistamines or steroid nose sprays. The topical steroid sprays reduce inflammation and are my first choice. These sprays also decrease the risk of asthma symptoms by allowing the nose to warm, humidify and filter the air we breathe.
You also need to check the pollen count and keep your windows closed and air conditioner running. Changing your clothes after being outside and using a nasal rinse are also helpful.
Dr. Michael Z. Blumberg of Allergy Partners of Richmond is board certified in allergies and immunology.
