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Allergic rhinitis is an inflammation in the nose caused by overreaction of the immune system to allergens in the air. Managing allergic rhinitis symptoms is challenging and requires timely intervention. The following are major questions often posed by those with allergic rhinitis: How should I prepare for the forthcoming season? How will the season’s severity develop over the years? No country yet provides clear guidance addressing these questions. We propose two previously unexplored approaches for forecasting the severity of the grass pollen season on the basis of statistical and mechanistic models. The results suggest annual severity is largely governed by preseasonal meteorological conditions. The mechanistic model suggests climate change will increase the season severity by up to 60%, in line with experimental chamber studies. These models can be used as forecasting tools for advising individuals with hay fever and health care professionals how to prepare for the grass pollen season.

Environmental DNA reveals links between abundance and composition of airborne grass pollen and respiratory health Highlights d Airborne grass pollen assemblages are quantitatively structured in space and time d The respiratory health impacts of grass pollen may vary according to grass species

32Grass pollen is the world's most harmful outdoor aeroallergen and sensitivity varies between 33 species. Different species of grass flower at different times, but it is not known how airborne 34 communities of grass pollen change in time and space. Persistence and high mobility of grass 35 pollen could result in increasingly diverse seasonal pollen communities. Conversely, if grass 36 pollen does not persist for an extended time in the air, shifting pollen communities would be 37 predicted throughout the summer months. Here, using targeted high throughput sequencing, 38we tracked the seasonal progression of airborne Poaceae pollen biodiversity across Britain, 39 throughout the grass allergy season. All grass genera displayed discrete, temporally restricted 40 peaks of pollen incidence which varied with latitude, revealing that the taxonomic composition 41 of grass pollen exposure changes substantially across the allergy season. By developing more 42 refined aeroallergen profiling, we predict that our findings will facilitate the exploration of links 43 between taxon-specific exposure of harmful grass pollen and disease, with concomitant socio-44 economic benefits. 45 46 47

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Availability of data and materials: Data have been archived on University of Plymouth's PEARL repository.Code availability: Relevant code to ensure reproducibility has been included in the article.

Natural environments can promote well-being through multiple mechanisms. Many studies have investigated relationships between residential green/blue space (GBS) and well-being, fewer explore relationships with actual use of GBS. We used a nationally representative survey, the National Survey for Wales, anonymously linked with spatial GBS data to investigate associations of well-being with both residential GBS and time in nature (N = 7631). Both residential GBS and time spent in nature were associated with subjective well-being. Higher green-ness was associated with lower well-being, counter to hypotheses (predicting the Warwick and Edinburgh Mental Well-Being Scale (WEMWBS): Enhanced vegetation index β =  − 1.84, 95% confidence interval (CI) − 3.63, − 0.05) but time spent in nature was associated with higher well-being (four hours a week in nature vs. none β = 3.57, 95% CI 3.02, 4.13). There was no clear association between nearest GBS proximity and well-being. In support of the equigenesis theory, time spent in nature was associated with smaller socioeconomic inequalities in well-being. The difference in WEMWBS (possible range 14–70) between those who did and did not live in material deprivation was 7.7 points for those spending no time in nature, and less at 4.5 points for those spending time in nature up to 1 h per week. Facilitating access and making it easier for people to spend time in nature may be one way to reduce socioeconomic inequalities in well-being.

Background Evidence that greenspaces are related to mental health and wellbeing mostly relies on residential exposure and few studies have considered actual use. We aimed to link the National Survey for Wales (NSW) to environmental metrics to determine whether there is an association between increased residential exposure to greenspace and subjective wellbeing, and whether this is mediated by visits to outdoor spaces. MethodsIn this cross-sectional data linkage study, we linked NSW data (2016-17 and 2018-19; repeat cross-sectional) to the Secure Anonymised Information Linkage (SAIL) Databank. Survey data included the Warwick and Edinburgh Mental Wellbeing Scale (WEMWBS), and self-reported time spent on leisure visits to open spaces in Wales (including bluespaces; derived from visit frequency in the past 4 weeks and duration of the main activity on the most recent visit). Linkage at individual level augmented this data with home neighbourhood greenspace data (Enhanced Vegetation Index [EVI] derived from satellite imagery). Using multivariate linear regression models, we estimated associations between home or visit exposures and WEMWBS, adjusting for various covariates including area level (via Welsh Index of Multiple Deprivation) and individual deprivation indicators. EVI, weekly time outdoors, and WEMWBS were standardised and both linear and quadratic terms were included in analyses. The e-cohort uses anonymised data and was approved by the SAIL Information Governance Review Panel. Findings Among NSW respondents providing outcome measures (n=5971), EVI was significantly related to both WEMWBS (U-shaped relationship, EVI beta -0•02, p=0•13; EVI² beta 0•02, p= 0•0098), and weekly time outdoors (EVI beta 0•04, p=0•020). Time outdoors was also significantly related to WEMWBS (time outdoors beta 0•17, p<0•0001; time outdoors 2 beta -0•04, p=0•018). Despite the conditions for potential mediation being met-i.e., EVI predicting both time outdoors and WEMWBS and time outdoors predicting WEMWBS-there was no evidence that time outdoors mediated the relationship between EVI and WEMWBS. EVI coefficients were not attenuated after including time outdoors (EVI beta -0•03, p=0•076; EVI² beta 0•02, p=0•018).Interpretation Living near and time spent visiting greenspaces and bluespaces were both related to better subjective wellbeing. The absence of mediation suggests that better wellbeing associated with EVI occurs through a different mechanism than visiting.