Hay fever sufferers rarely welcome summer with gusto. If the reports of a giant pollen cloud over the east coast of England two weeks ago didn’t dampen their enthusiasm, then the fact that they can expect pollen counts as least as bad as the unusual highs of last summer might do. The recent warm, wet weather means that grass growth has flourished and levels of hay fever symptoms are likely to be high. We’re in the run-up to an expected peak in grass pollen levels during the second week of June, when for many people, symptoms such as a runny nose and itchy eyes will be at their worst.
For sufferers, the key is to start preparing now. Hay fever, which is essentially an allergy to pollen (its formal name is intermittent rhinitis), can be hugely debilitating and has a psychological as well as physical impact. Sufferers find their sleep, sex lives and work are affected by the condition. Research has shown that performances in exams and sport can also deteriorate. Our own studies at the National Pollen and Aerobiology Research Unit have indicated that students’ performance declines significantly on days with medium to high pollen counts.
But there are ways to minimise its impact; your GP can recommend an NHS allergy clinic where you can get tests to help you work out which pollens trigger your hay fever. Then you can time your treatment accordingly.
Check your pollen calendar Hay fever does not just occur in the summer months. Each year the pollen seasons follow the same general pattern. In spring comes tree pollen, especially birch and oak, but also hazel, yew, alder and ash. Some people are allergic to more than one type of pollen. Hazel, birch, hornbeam and alder, for example, all have similar allergens so if you suffer with one you will probably react to the rest. The tree pollen season starts in about January and runs through to May. About one quarter of hay fever sufferers are allergic to pollen from the birch tree. Its pollen seasons tend to alternate between high and low for severity. This year was very high, but besides our own birch pollen, every year it travels long distances to Britain from Germany and Scandinavia. This is the likely cause of the yellow pollen cloud early this month, which luckily has dispersed. If you’re still feeling itchy and uncomfortable, it’s likely that oak pollen is the cause of your hay fever.
If your symptoms arise in June or July, you are probably allergic to grass pollen, like 95 per cent of UK sufferers. As temperatures have risen in the UK, so the grass pollen season has got longer. It used to finish in July, but now it tends to last until the first or second week of August. There has also been a trend in the past ten years for the effects of grass pollen to become more severe. If plants are stressed by high temperature or pollution, they produce more pollen to increase their chance of reproduction. If you get symptoms in August, your hay fever is most likely to be linked to weeds such as nettle and dock. If your symptoms occur in autumn, fungal spores are likely to be the predominant cause.
Avoidance strategies If you can pinpoint the time of year when the particular type of pollen you are allergic to becomes widespread, you can make plans to minimise your exposure. Check the pollen forecasts daily and if your symptoms are troublesome stay indoors when the pollen counts are high. This is usually on dry, warm days with a slight wind. The worst times of the day for grass pollen are usually early morning and late afternoon, when many grasses release their pollen. Wear sunglasses and a rimmed hat, and don’t hang out the washing at these times as it will collect pollen from the air. It’s also a good idea to change your clothes and wash your hair after being outdoors. Because pollen is quite heavy, it will settle on surfaces quickly, so cover beds and desks when you are not using them. Brush or wash your cat or dog, as pets can carry a lot of pollen in their fur, and keep the windows closed when driving. For some respite, close the windows and doors of a room, sit still and after 20 minutes most of the pollen in the room will have settled so you will be breathing pollen-free air. If these measures sound a lot of trouble, remember that once you know which pollens you are allergic to, you may have to take them for only a few weeks every year.
Where you live It is theoretically possible to move around the country to avoid the worst of your particular hay fever season. In general, the season kicks off earlier in the South where it’s warmer. But there are other regional variations.
Many sufferers find symptoms disappear at the coast as the sea breezes clear the air of pollen. Inland and lowland areas, such as the Midlands and parts of East Anglia, typically have higher levels of grass pollen. Mountains or moorland are also less problematic because the type of grasses growing there tend not to produce as much pollen.
Avoid air pollution Research suggests that exposure to air pollution can make hay fever symptoms worse. Pollen allergens can interact with other particles, especially from diesel exhaust, which sticks to the surface of pollen grains. The combination of diesel and allergen produces an enhanced allergic reaction. Gaseous pollutants such as nitrogen oxide, which is produced by traffic fumes, can also have effects, for example by slowing the action of the cilia in the respiratory tract and by causing irritation of the mucous membranes, which makes the symptoms worse. In Sweden, Italy and other countries, researchers have found that hay fever rates are higher in polluted cities than in surrounding rural areas where pollen counts are higher. Japanese researchers have shown that the incidence of hay fever is higher in populations living near busy roads: exhaust fumes and diesel particles may be making people more susceptible to allergens.
Best treatments Most people can control their hay fever symptoms by combining avoidance strategies with medication. You will need to talk to your GP or pharmacist about treatments, but they are all similar, whatever the trigger for your condition. Most medications are available in Boots, Superdrug and independent pharmacies. Most treatments need to be started a few weeks before the hay fever season Oral antihistamines medications are a common treatment for multiple symptoms: try Benadryl capsules, Clarityn and Zirtek tablets. Histamine, a naturally-occurring hormone in the body, is released when you come into contact with pollen. It causes irritation, the blood vessels dilate and fill with blood, and membranes become more permeable so fluid can leak across. Antihistamines reverse this to relieve symptoms.
Sneezing and runny noses are the body’s way of trying to get rid of the pollen or fungal spores. Nasal sprays work by suppressing the allergic response and reducing inflammation. Try Beconase, Flixonase and Livostin. Eye drops, such as Aller-eze, Optrex Allergy and Clarityn, are also useful for localised symptoms.
Nasaleze is inert powder that is puffed up the nose, where it forms a protective barrier. It helps to prevent the pollen and spores reaching the mast cells in the nose where the allergic reaction takes place. Our double-blind trials on this have shown the powder can help to reduce symptoms. It has no known side-effects and can be taken by pregnant women and children.
Diet Studies have shown that a diet rich in the antioxidant vitamins A, C and E found in fruit and veg is helpful for people with asthma. It is likely, but not proven, that it will also help hay fever sufferers. People who eat foods rich in these nutrients seem less susceptible to allergens.
Professor Jean Emberlin is the director of the National Pollen and Aerobiology Research Unit at the University of Worcester. She was talking to Peta Bee
