The associations between daily spring pollen counts, over-the-counter allergy medication sales, and asthma syndrome emergency department visits in New York City, 2002-2012

Abstract

BackgroundMany types of tree pollen trigger seasonal allergic illness, but their population-level impacts on allergy and asthma morbidity are not well established, likely due to the paucity of long records of daily pollen data that allow analysis of multi-day effects. Our objective in this study was therefore to determine the impacts of individual spring tree pollen types on over-the-counter allergy medication sales and asthma emergency department (ED) visits.MethodsNine clinically-relevant spring tree pollen genera (elm, poplar, maple, birch, beech, ash, sycamore/London planetree, oak, and hickory) measured in Armonk, NY, were analyzed for their associations with over-the-counter allergy medication sales and daily asthma syndrome ED visits from patients’ chief complaints or diagnosis codes in New York City during March 1st through June 10th, 2002-2012. Multi-day impacts of pollen on the outcomes (0-3 days and 0-7 days for the medication sales and ED visits, respectively) were estimated using a distributed lag Poisson time-series model adjusting for temporal trends, day-of-week, weather, and air pollution. For asthma syndrome ED visits, age groups were also analyzed. Year-to-year variation in the average peak dates and the 10th-to-90th percentile duration between pollen and the outcomes were also examined with Spearman’s rank correlation.ResultsMid-spring pollen types (maple, birch, beech, ash, oak, and sycamore/London planetree) showed the strongest significant associations with both outcomes, with cumulative rate ratios up to 2.0 per 0-to-98th percentile pollen increase (e.g., 1.9 [95 % CI: 1.7, 2.1] and 1.7 [95 % CI: 1.5, 1.9] for the medication sales and ED visits, respectively, for ash). Lagged associations were longer for asthma syndrome ED visits than for the medication sales. Associations were strongest in children (ages 5-17; e.g., a cumulative rate ratio of 2.6 [95 % CI: 2.1, 3.1] per 0-to-98th percentile increase in ash). The average peak dates and durations of some of these mid-spring pollen types were also associated with those of the outcomes.ConclusionsTree pollen peaking in mid-spring exhibit substantive impacts on allergy, and asthma exacerbations, particularly in children. Given the narrow time window of these pollen peak occurrences, public health and clinical approaches to anticipate and reduce allergy/asthma exacerbation should be developed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-015-0057-0) contains supplementary material, which is available to authorized users.

Mental Health in Allergic Rhinitis: Depression and Suicidal Behavior

“…Depending on the allergen source (e.g., trees, grass, weeds), the pollen counts in the air are generally highest during mid-spring to early summer when 75% of environmental pollen exposure occurs. The link between spring peaks in highly allergenic trees (such as oak) and allergic rhinitis in spring is confirmed by multiple lines of evidence, including over-the-counter allergy medication purchases [42]. In temperate regions, grass pollen is principally released during the summer months.…”

Maternal Exposure to Aeroallergens and the Risk of Early Delivery

“…Short-term increases in aeroallergens have been associated with allergic and asthma exacerbations in the general population, 1–6 and among children. 7,8 In addition, one study found that exposure to high levels of pollen during late pregnancy was associated with an increased risk of hospitalization for asthma within the first year of life of children.…”

Impact of respiratory infections, outdoor pollen, and socioeconomic status on associations between air pollutants and pediatric asthma hospital admissions

“…Details of the experimental technique used for sample collection and measurement of various genera of pollen are described elsewhere [29, 30]. We log-transformed daily concentrations (grains per cubic meter) for tree, weed, and total pollen, and created an indicator variable for outdoor pollen if daily concentrations exceeded the 5 th percentile of the concentration distribution.…”