Strategies for prevention and mitigation of hay fever

Abstract

Seasonal allergic rhinitis is a widespread disorder in westernized countries. It has a strong negative impact on the patient's health-related quality of life and is accompanied by considerable medical and economic costs. Currently, the socioeconomic interest in prevention is growing. Reducing or avoiding allergen exposure may result in a significant reduction of sensitization and mitigation of allergic complaints, and this reduction is in addition to existing medical prevention strategies. It will require good communication to (potential) patients on the importance and possibilities for reducing the contact with allergenic pollen. Longterm pollen monitoring and forecasts of the flowering period of allergenic plants are important tools in this respect. Reducing the allergenic load may prove an alternative prevention strategy. Pollen sources are heterogeneously distributed throughout the landscape and may be avoided or selectively removed. The use of selection, conventional breeding strategies or genetic modification may reduce the allergenicity of the pollen sources. Strategies that involve genetic modification are, however, likely to raise some public concern and acceptability of these strategies has to be considered.

The public health impact of hay fever: is it time to look at prevention through environmental modification?

“…Consequently, there is a large financial cost resulting both from medical treatment and the loss of school and working days; in 2004, this was estimated for Europe at €3.7 billion per annum. 5 Apart from the medical treatment of hay fever, prevention strategies have largely consisted of recommending that individuals shorten the time that they spend in outdoor air in periods during which the pollen concentration is at its highest. 6 However, this relies on accurate pollen monitoring and forecasting; it also has the major disadvantage of restricting social activities for hay fever sufferers.…”

“…interventions. For example, a strategy to decrease the number of allergenic trees in the urban environment could be considered, 5 or the replacement of perennial ryegrass with low-allergen alternatives. 6 A reduction in urban pollution is another obvious intervention, with other positive health benefits.…”