Top American Cities for Spring Allergies

Mostly southern locations lead the sneezing on this yearly ranking.

April 29, 2009, 4:29 PM

May 5, 2009— -- There may have been more running in Louisville, Ky., this past weekend than the thoroughbred race horses at the Kentucky Derby. Thousands of noses of Louisville residents may also have been running, since the city was named the No. 1 spot for spring allergies in the United States.

According to the annual rankings recently released by the Asthma and Allergy Foundation of America (AAFA), Louisville was considered "the most challenging place to live with spring allergies" out of 100 cities where data were compiled during 2008.

"Kentucky is taking a hit for the second time in a row," said Mike Tringale, director of external affairs for the AAFA. "Last year, Lexington was number one; this year it's Louisville."

Rounding out the top five after Louisville, which took top honors for springtime allergies, was Knoxville, Tenn., followed by Charlotte, N.C.; Madison, Wis.; and Wichita, Kan.

McAllen, Texas, ranked sixth; Greensboro, N.C., was seventh; and Dayton, Ohio; Little Rock, Ark.; and Augusta, Ga., completed the top 10 listings. With the exception of Madison and Dayton, it's primarily Southern locations that landed in the top 10.

The rankings, which are published by AAFA each spring and fall, are determined by considering three key factors. The analysis looks at a city's pollen scores (its grass, tree and weed pollen and also mold spores), as well as the number of allergy medications -- either over-the-counter or prescription -- used by each person, and the number of allergy specialists available per person.

To earn its spot attop the listings, Louisville had a severe pollen problem in 2008, along with high usage of allergy medication among its residents that year, and a paucity of allergy specialists relative to the number of allergy sufferers.

Some 35 to 40 million Americans have nasal allergies, also known as hay fever or allergic rhinitis.

"Some people have them seasonally, while others have them perennially," Tringale said.

In spring, it's the trees that pollinate; while in summer, grasses are the main culprit, and come fall, it's the weeds.

The Allergists Perspective from High-Ranking Cities

As a private practice allergist in Louisville for the last 15 years, Dr. Mark Corbett has been keeping extremely busy. He wasn't surprised to hear that his city led the spring allergy listings.

"We've historically been pretty high up on the list, either at the top or in the top five," he said. "But we don't really know why this is."

Often he said, the blame has been placed on the Ohio River Valley, because the area has both high pollen counts and very high mold counts. The region also has a fair amount of moisture, so he speculated that "perhaps things sit around here longer than in other places."

Springtime in Louisville brings high pollen counts for oak and mulberry trees, and also some birch, Corbett said.

And this has been a particularly bad spring, he said.

"The tree pollen rates have been very high, and I'm seeing some patients who had been doing reasonably well for years and years on over-the-counter medications, but this spring they're just miserable," he said

"[Louisville] is not a good place to own a convertible in the spring," Corbett said.

It's also tough to drive a car with the top down in Greensboro, N.C., which ranked seventh on this year's spring allergy capitals after a second-place finish last year.

"In recent years, we've frequently been high on the list," said Dr. Teresa Sue Bratton, an allergist and director of the asthma clinic at Guilford Child Health in Greensboro, "but this year we bow to Charlotte," referring to the third-place ranking of the other North Carolina city.

"We have lots of warmth, rain and humidity, and a fairly long growing season that produces wind pollinated plants," Bratton said.

The city also has a great deal of mold, which forms when plant matter breaks down, due to lots of humidity, she explained.

These conditions make for "a steady supply of people every spring who have allergy symptoms," Bratton said.

Allergy Capitals Face Lingering Pollen Problems

Asked how her patients in Greensboro might react to their city's place on the allergy ranking, Bratton replied, "They don't see much difference between a number two or number seven.

"If you're the person who is miserable, I don't think you care. You just want some relief," she said.

"We also have people who are going to be suffering more with their allergies this year because of the economy," Bratton noted.

The good news, though, is that a growing number of allergy products are available over the counter or generically, which makes them more economical.

Although you can't control the quantity of pollen released in the city where you live, you can control your allergies and their symptoms.

"One of the reasons we do this report is to draw people into the health care system to get the care they need for their allergies," Tringale said.

The ranking is not intended to inspire people to move to New Haven, Conn., which placed 100th on the 2009 list, Tringale said.

"There's really no place free of allergy triggers," he said.

But the message Tringale hoped the listings help to get across is "Don't move, but improve."

In other words, improve your understanding of your allergies by getting a proper diagnosis for them so you don't confuse their symptoms with a cold, follow the right course of treatment and reduce your exposure to your triggers as much as possible.

Seasonal allergies themselves are not life threatening, but they do threaten quality of life, Tringale said.

Asthma and Allergy Foundation of America's Spring Allergy Capitals 2009

  • 1. Louisville, Ky.
  • 2. Knoxville, Tenn.
  • 3. Charlotte, N.C.
  • 4. Madison, Wis.
  • 5. Wichita, Kan.
  • 6. McAllen, Texas
  • 7. Greensboro, N.C.
  • 8. Dayton, Ohio
  • 9. Little Rock, Ark.
  • 10. Augusta, Ga.

View the complete list provided by the Asthma and Allergy Foundation of America.


Spring allergy season is here. Visit the OnCall+ Allergy Center to get all your questions answered about pollen, allergic rhinitis, sinusitis and more.

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