Doctor Kara Wada, MD, allergist, and immunologist at The Ohio State Wexner Medical Center, talks about how climate change could be the cause for severe allergy symptoms.
Interview conducted by Ivanhoe Broadcast News in April 2022.
What’s happening with season allergies?
DR WADA: This time of year, as the snow thaws, we see the trees starting to bud. That signals that the trees are starting to pollinate, and when those trees release all that pollen, we start to see the influx of patients for their seasonal allergy symptoms.
So, what’s happening with people who have never had seasonal allergies growing up and are starting to have symptoms now?
DR WADA: So, we’re seeing two things. One is we are seeing emergence of more people with allergies. So, certainly, the immune system can change over time and over time, we can see people, even in adulthood, develop new allergies. The second thing we’re seeing is sometimes the pollen counts are so high, it’s equivalent to one of us walking into a sawmill or, in the old days, a smoky bar where all that particulate matter in the air is aggravating to the sinuses and the eyes as well. The purpose of our nasal passageways in our sinuses is to warm and humidify air and to filter it out before it reaches our lungs. So, you can imagine that if we’re getting hit with a large load of particulate, that can be very aggravating to those tissues as well.
For people who have never struggled with seasonal allergies, what are they going through? What kind of symptoms are they having and how severe can that be?
DR WADA: The common symptoms of seasonal allergies include itchy, watery, red and sometimes swollen eyes, sneezing, nasal drainage, either out the front of their nose or down the back of their throat, sore throat, cough and sometimes wheezing if someone has allergy induced asthma.
How much does the climate change play a part now?
DR WADA: We’re seeing it every day in the office and we’re seeing the effects of climate change in patients every day. The pollen seasons have lengthened over the last 20, or so, years. We’re seeing earlier thaws and later freezes, which makes for a greater number of days we’re exposed to pollen. But we’re also seeing increased levels on those high days. So, the highs are higher and, in those instances, we’re seeing more symptoms. We’re seeing more consequences of severe symptoms – so things like allergic asthma or sinus infections from untreated allergies.
How much does the strange fluctuation in temperatures affect people with allergies?
DR WADA: We see that the big swings in temperature and in barometric pressure are huge triggers for people’s sinus congestion but also those who deal with chronic headaches will find those to be a significant trigger as well.
How much of an increase do you think you’ve seen over the last couple of years in seasonal allergies?
DR WADA: Well, we have a couple of things at play. I am definitely seeing more patients, but I’m also seeing, with the pandemic, that there is lower tolerance to having sniffles and sneezes. When you walk into the office with a scratchy throat or a change in your voice, runny nose, there’s less tolerance for people to understand and to accept that. So, I think it’s a little hard to tease out, but we’re seeing an increase in our volumes overall.
What can, and should, people do if they have allergies?
DR WADA: So, I like to take a three-way approach to the treatment of allergies. One is minimizing exposure. In order to do that, it’s helpful to know what exactly you’re allergic to. That’s where allergy testing can be helpful. But rinsing off before bed using a saltwater solution or saline solution to rinse out the sinus and nasal passageways can be helpful as well. Additionally, keeping your bedroom windows closed during the pollen seasons is helpful as well. Second step is medications. Long-acting antihistamines can be very helpful for the itching and sneezing. Eye drops can be helpful for the eyes. And if you’re very congested, that’s where things like the nose sprays like Flonase can be very helpful. I think it’s helpful to know that those take two to four weeks to see their full effect, so, they aren’t an overnight night-and-day change that you’ll see with using those. And then the third approach is immunotherapy. So, that’s a treatment that changes the immune response from fighting the particular allergen to ignoring it over time. And that, over the long term, can help change the root cause of what’s going on, to help switch how that immune system is functioning and is helpful after you finish therapy as well.
How important is testing? How does that play into all of this?
DR WADA: Testing is helpful to determine why and are you allergic or is it this irritant situation that I explained as well where there’s just too much particulate in the air? So, it helps distinguish and that can help determine what medications are going to be more helpful or less helpful. It also helps determine what that formulation would be if you’re going to do immunotherapy, what needs to be put in that mix, because it’s custom made specific for your immune system.
Is it just spring allergies or are there other times during the year where people who struggle with allergies will be more highly impacted, especially with climate change?
DR WADA: In the spring, we see a little bit of a one-two punch, so to speak. We have the trees that pollinate early. And then, as the spring warms up, we see the grass pollen add in on top of it. But later into the summer and into fall, we have not only the persistence of some of the grass allergy, but then, we have weed, like ragweed season, that comes into play. And on top of both of those, depending on the amount of rain and moisture we have each year, we may see high levels of mold allergy as well.
Is it taking longer to get cold in the fall now because of climate change?
DR WADA: Yes. It is taking longer for us to have that hard freeze and our winters aren’t necessarily as cold as they used to be in some instances as well. So, that is affecting the length of the pollen season as well.
Can most people find relief with over-the-counter medications? What percentage of your patients do you think would find relief with over-the-counter medications? And what percentage really do need to come in for some specialized treatment?
DR WADA: So, if you are using your over-the-counter medications regularly but you’re still noticing you’re foggy in the head, having facial pressure or pain, ongoing drainage, having to clear your throat or a cough that just won’t resolve, those are all the reasons that I would suggest talking with your primary care doctor or making an appointment with a board-certified allergist/immunologist to get further evaluation. The other situation I would suggest is if you’re someone who likes to have more natural treatment or would really like to focus your treatment on attacking that root cause, that’s another instance where working with an allergist can be helpful to see if immunotherapy might be a good option for you.
How is this season stacking up this year as compared to two decades ago?
DR WADA: So far, we’re already seeing record pollen counts. And I anticipate we’re going to see continued worsening as it warms up in the next few weeks and as we get into grass season.
When is grass season?
DR WADA: That typically starts at the end of April and runs through the summer.
Is there anything else you would want to make sure people know?
DR WADA: One common misperception is that using medications too early or too often may mean that they’re going to be less effective over time. But actually, using some of those medications ahead of time can decrease the amount of medication you need over the course of the season. I like to think of it as trying to keep the horses in the barn. If you can keep those allergy cells calm and controlled, it’s less likely to become more of a problem over the course of the season. And if those medications aren’t working as well, then that means that the allergy themselves or the symptoms have maybe gotten a little bit worse to the point where you should seek medical care and evaluation for those symptoms.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
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