It is officially springtime. The sun is shining, the birds are singing and green things are -- yikes! -- blooming once again.
While many look forward to a fresh season, those with allergies may approach springtime with caution and Kleenex. And they might suffer even more because of their location.
The Asthma and Allergy Foundation of America released its annual list of the Top 100 most challenging places to live with spring allergies for 2008 last week.
The AAFA used pollen counts and medication utilization data from last year and the number of board-certified allergists per patient in an area to rank the 100 largest cities in the country.
These criteria counterbalanced each other, according to Mike Tringale, director of external affairs for the AAFA. When the pollen count or medication usage is very high, a city will move up in the ranks. However, if there is a large number of allergists available to treat those affected, the city's ranking will drop.
Tringale said that this is the AAFA's sixth year creating this report and that they look at the same 100 cities each year.
"We definitely see regional consistency," Tringale said, adding that cities in the Southeast are hit hardest with allergies in the spring while fall allergies are worse in the Northeast.
Though the AAFA takes three specific criteria into account when ranking cities, allergists point out that factors such as rainfall, winds and indoor allergens can contribute to allergies. Allergies have become the third most common disease of childhood, according to Beth Miller, division chief of allergy and immunology at the University of Kentucky in Lexington.
"You have to have the right genetic potential, the right exposure," Miller said. "But there are lots of things allergists can do to improve your life."
While allergists agree that the best course of action for a person with allergies is avoidance, that is not always a viable option. In those cases, working with an allergist to get proper treatment, like allergy medications or immunotherapy, is vital.
The following are the Top 10 most allergy ridden cities to live in from the AAFA's annual list.
Rank last year: 54
San Diego has some of the most pleasant, least-variable weather in the United States. But increased rain and fires in the past year may have contributed to the city's rank as the 10th most challenging place to live with allergies.
After the massive fires in southern California, including much of San Diego County, as well as an average rainfall, many of the area's trees gave way to pollen-producing grasses and weeds, said Stephen Wasserman, professor of medicine at the University of California at San Diego.
"I think each city has its own allergic issues," Wasserman said.
Olive trees, for example, are large pollen producers for the area that is not seen in other parts of the country, Wasserman said.
Rank last year: 8
The capital and most populous city in Arkansas got its name from a small rock formation on the bank of the Arkansas River called la petit roche, or the little rock. The humid, subtropical climate of the area is characterized by short, mild winters and hot humid summers. A variety of flowering trees, grasses and wildflowers lend themselves to allergy season.