April 8, 2011— -- "Today is going to be beautiful, now let's just chop off my nose and smooth my eyeballs with sandpaper," Patrick Kuc wrote on his Facebook wall Wednesday.
That's because Kuc lives in Louisville, Ky., a place known for its lovely springtime but is notorious for wreaking havoc on the lives of allergy sufferers.
Louisville is not the only locale that poses problems for the allergic. It turns out that in many cities, the welcoming of spring weather is overshadowed by runny noses, itchy eyes and antihistamine-induced sleeps.
For nine years, the Asthma and Allergy Foundation of America has released a list of the 100 worst cities for allergies in the United States. This year, Louisville ranked second on the list. Kuc has always suffered from seasonal allergies triggered by pollen and mold, but now on most mornings, he wakes up with red itchy eyes, a sore throat and runny nose before popping his daily antihistamine.
"This year is particularly horrible in Louisville," said 27-year-old Kuc. "I've had allergies in November. It's this Ohio Valley. The air sticks and pollen is just everywhere. The sidewalks become yellow from it."
Worst Cities for Allergies
"Allergic symptoms in the spring are caused by a significant increase in the tree and grass pollen," said Dr. Wesley Burks, professor and chief of pediatric allergy and immunology at Duke University Medical Center. "Other environmental conditions, such as pollution can then exacerbate the person's symptoms.
"The climate in these cities is good for a long and heavy pollen season."
Knoxville, Tenn., Louisville, Ky., and Charlotte, N.C. rounded out the top three worst cities for allergies in the United States.
"Some of these cities mentioned in the Southeast are known to have prolific amounts of seasonal tree, grass, weed, pollens and mold spores that can wreak havoc in those susceptible to seasonal allergies," said Dr. Clifford Bassett, medical director of the Allergy and Asthma Care of New York.
Allergy Ranking System
The Asthma and Allergy Foundation of America used a ranking system took into account three factors to grade the top 100 worst allergy cities -- tree pollen prevalence, the number of allergy medications used by residents in the area and the number of allergy specialists in the area.
In warmer climates, pollen seasons are much longer for various trees, grasses and weeds. On the East Coast, ragweed can be a culprit for many seasonal allergies. In the mountain states, ragweed is not a factor. Dust mites, length of allergy season and type of pollen are all determined by local climate in that area.
"April allergies are almost always tree pollens, and those tend to be the most highly local of the pollens -- so small local variations in the tree population may carry a lot more weight for a specific individual than the total tree pollen counts for the metro area," said Dr. Daniel Maddox, a consultant in the department of allergic diseases and internal medicine at Mayo Clinic.
According to the Asthma and Allergy Foundation of America, an estimated 40 million Americans suffer from indoor/outdoor allergies as their primary allergy, and allergy is the fifth leading chronic disease in the U.S. of all ages.
But despite the weather and climate, doctors said that allergy sufferers outside of those cities should not expect to come out scot free of symptoms.
Individualized Is Best
"Personal habits, combined with highly local details, like exactly what trees are in your yard, may carry a lot more weight in predicting how a person will feel than any citywide pollen index measure," said Maddox.
And Dr. Stanley Fineman, president-elect of the American College of Allergy Asthma and Immunology, agreed that a patient's symptoms should be based more on individual exposure than citywide stats. He said the list is problematic because an individual patient with respiratory allergies who is exposed to the pollen that triggers their symptoms will have problems regardless of where they live.
Ranking Cities by Allergies Arbitrary
"In reality the individual patient's allergy sensitivity combined with their exposure will determine their symptom severity," said Fineman. "A ranking of cities based on an arbitrary rating system is not relevant for individual patients.
"Of course, this ranking does increase public awareness of the problem of allergies and for those folks in the cities listed there may be an even more heightened awareness."
Curb those Symptoms
Doctors offered several recommendations to curb allergy symptoms, no matter where you live.
Be sure to pay attention to the clock.
"Pollen counts often peak early in the morning, between 5 a.m. and 10 a.m., for many but not all, pollens," said Bassett. "Some sufferers may experience less pollen later in the day."
Avoid drying clothes outside on high pollen days, wear big sunglasses to prevent pollen entering the eyes, steer clear of food that can worsen seasonal allergies to trees, such as apples, almonds, hazelnuts, cherries, kiwis and plums. Take a shower after coming in from outside to wash the pollen off the body and close the windows on high-pollen days to avoid bringing the trigger into the house.
Burks also saidto be sure to be aware "of what is causing the symptoms and then the use of good avoidance measures -- antihistamines, nasal steroids and the allergy immunotherapy if needed."
13 Worst Cities for Spring Allergies
1. Knoxville, Tenn.
2. Louisville, Ky.
3. Charlotte, N.C.
4. Jackson, Miss.
5. Chattanooga, Tenn.
6. Birmingham, Ala.
7. Dayton, Ohio
8. Richmond, Va.
9. McAllen, Texas
10. Madison, Wis.
11. Columbia, S.C.
12. Greensboro, N.C.
13. Wichita, Kan.