Correlation of environmental factors with asthma and rhinitis symptoms in Tulsa, OK

Non-Specific Lipid Transfer Protein Amb a 6 Is a Source-Specific Important Allergenic Molecule in Ragweed Pollen

Pollen from common ragweed is an important allergen source worldwide and especially in western and southern Romania. More than 100 million patients suffer from symptoms of respiratory allergy (e.g., rhinitis, asthma) to ragweed pollen. Among the eleven characterized allergens, Amb a 6 is a non-specific lipid transfer protein (nsLTP). nsLTPs are structurally stable proteins in pollen and food from different unrelated plants capable of inducing severe reactions. The goal of this study was to produce Amb a 6 as a recombinant and structurally folded protein (rAmb a 6) and to characterize its physicochemical and immunological features. rAmb a 6 was expressed in Spodoptera frugiperda Sf9 cells as a secreted protein and characterized by mass spectrometry and circular dichroism (CD) spectroscopy regarding molecular mass and fold, respectively. The IgE-binding frequency towards the purified protein was evaluated using sera from 150 clinically well-characterized ragweed-allergic patients. The allergenic activities of rAmb a 6 and the nsLTP from the weed Parietaria judaica (Par j 2) were evaluated in basophil activation assays. rAmb a 6-specific IgE reactivity was associated with clinical features. Pure rAmb a 6 was obtained by insect cell expression. Its deduced molecular weight corresponded to that determined by mass spectrometry (i.e., 10,963 Da). rAmb a 6 formed oligomers as determined by SDS-PAGE under non-reducing conditions. According to multiple sequence comparisons, Amb a 6 was a distinct nsLTP with less than 40% sequence identity to currently known plant nsLTP allergens, except for nsLTP from Helianthus (i.e., 52%). rAmb a 6 is an important ragweed allergen recognized by 30% of ragweed pollen allergic patients. For certain patients, rAmb a 6-specific IgE levels were higher than those specific for the major ragweed allergen Amb a 1 and analysis also showed a higher allergenic activity in the basophil activation test. rAmb a 6-positive patients suffered mainly from respiratory symptoms. The assumption that Amb a 6 is a source-specific ragweed allergen is supported by the finding that none of the patients showing rAmb a 6-induced basophil activation reacted with Par j 2 and only one rAmb a 6-sensitized patient had a history of plant food allergy. Immunization of rabbits with rAmb a 6 induced IgG antibodies which strongly inhibited IgE binding to rAmb a 6. Our results demonstrate that Amb a 6 is an important source-specific ragweed pollen allergen that should be considered for diagnosis and allergen-specific immunotherapy of ragweed pollen allergy.

Ragweed pollen concentration predicts seasonal rhino-conjunctivitis and asthma severity in patients allergic to ragweed

In this work, we investigate the correlation between ragweed pollen concentration and conjunctival, nasal, and asthma symptom severity in patients allergic to ragweed pollen using ambient pollen exposure in the Milan area during the 2014 ragweed season We calculate the pollen/symptom thresholds and we assess the effectiveness of ragweed allergen immunotherapy (AIT). A total of 66 participants allergic to ragweed (Amb a 1) were enrolled in the study and divided into two groups: AIT treated (24) and no AIT treated (42). Pollen counts and daily symptom/medication patient diaries were kept. Autoregressive distributed lag models were used to develop predictive models of daily symptoms and evaluate the short-term effects of temporal variations in pollen concentration on the onset of symptoms. We found significant correlations between ragweed pollen load and the intensity of symptoms for all three symptom categories, both in no AIT treated (τ = 0.341, 0.352, and 0.721; and ρ = 0.48, 0.432, and 0.881; p-value < 0.001) and in AIT treated patients (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\tau$$\end{document}τ= 0.46, 0.610, and 0.66; and ρ = 0.692, 0.805, and 0.824; p-value < 0.001). In both groups, we observed a positive correlation between the number of symptoms reported and drug use. Mean symptom levels were significantly higher in no AIT treated than in AIT treated patients (p-value < 0.001) for all symptom categories. Pollen concentration thresholds for the four symptom severity levels (low, medium–low, medium–high and high) were calculated. Ragweed pollen concentration is predictive of symptom severity in patients with a ragweed (Amb a 1) allergy. Patients treated with AIT had significantly reduced mean symptom levels compared to those without AIT.

Influence of the environment on ragweed pollen and their sensitizing capacity in a mouse model of allergic lung inflammation

Common ragweed (Ambrosia artemisiifolia) is an invasive plant with allergenic pollen. Due to environmental changes, ragweed pollen (RWP) airborne concentrations are predicted to quadruple in Europe by 2050 and more than double allergic sensitization of Europeans by 2060. We developed an experimental RWP model of allergy in BALB/c mice to evaluate how the number of RWP and how RWP collected from different geographical environments influence disease. We administered RWP six times over 3 weeks intranasally to the mice and then evaluated disease parameters 72 h later or allowed the mice to recover for at least 90 days before rechallenging them with RWP to elicit a disease relapse. Doses over 300 pollen grains induced lung eosinophilia. Higher doses of 3,000 and 30,000 pollen grains increased both eosinophils and neutrophils and induced disease relapses. RWP harvested from diverse geographical regions induced a spectrum of allergic lung disease from mild inflammation to moderate eosinophilic and severe mixed eosinophilic-neutrophilic lung infiltrates. After a recovery period, mice rechallenged with pollen developed a robust disease relapse. We found no correlation between Amb a 1 content, the major immunodominant allergen, endotoxin content, or RWP structure with disease severity. These results demonstrate that there is an environmental impact on RWP with clinical consequences that may underlie the increasing sensitization rates and the severity of pollen-induced disease exacerbation in patients. The multitude of diverse environmental factors governing distinctive patterns of disease induced by RWP remains unclear. Further studies are necessary to elucidate how the environment influences the complex interaction between RWP and human health.

Outdoor pollen concentration is not associated with exercise-induced bronchoconstriction in children

BACKGROUND

Free running exercise test outdoors is an important method to diagnose asthma in children. However, the extent of how much exposure to pollens of outdoor air affects the results of the test is not known.

METHODS

We analyzed all reliable exercise challenge tests with impulse oscillometry in children (n = 799) between January 2012 and December 2014 in Tampere University Hospital. Pollen concentrations at the time of the test were collected from the register of Biodiversity Unit of the University of Turku. We compared the frequency of exercise-induced bronchoconstriction and pollen concentrations.

RESULTS

The analyses were restricted to birch and alder pollen as high counts of grass and mugwort pollen were so infrequent. The relative change in resistance at 5 Hz after exercise or the frequency of exercise-induced bronchoconstriction were not related to alder or birch pollen concentrations over 10 grains/m³ (p = 0.125-0.398). In logistic regression analysis comparing the effects of alder or birch pollen concentrations, immunoglobulin E (IgE)-mediated alder or birch allergy and absolute humidity over 10 g/m³ only absolute humidity was independently associated with change in airway resistance (odds ratio [OR]: 0.32, confidence interval [CI]: 0.13-0.67, p: 0.006).

CONCLUSIONS

In our large clinical sample, outdoor air pollen concentration was not associated with the probability of exercise-induced bronchoconstriction in free running test in children while low absolute humidity was the best predictor of airway obstruction.

Airborne fungi in Universiti Sains Malaysia: knowledge, density and diversity

Airborne fungi are among common contaminants in indoor and outdoor environments, leading to poor indoor air quality (IAQ), and to some extent, implicate health risks to humans worldwide. In Malaysia, fungal contamination in institutional buildings is rarely documented although these places are frequently visited by many. This study was conducted to assess the density and diversity of airborne fungi in Universiti Sains Malaysia (USM) main campus, Penang. A total of 11 sampling sites were assessed. Fungi were collected by using Andersen Single Stage Impact Air Sampler N-6 and MEA plates. Two separate trials, namely Trial 1 and Trial 2, were conducted in 2008 and 2019, respectively. The recovered fungi were identified up to the genus level-based morphological features. A survey involving 400 respondents among USM staff and students in relation to fungal contamination in indoor air environment was also conducted to evaluate the knowledge on indoor fungi among USM community. The densities of indoor air fungi in Trial 1 were higher; ranging from 81 to 1743 CFU/m³, exceeding the recommended level set by the Malaysia Industry Code of Practice (MCPIAQ) in some sampling sites, compared to that of in Trial 2 where the densities ranged from 229 to 699 CFU/m³. A total of 154 isolates and 230 isolates of airborne fungi were recovered in Trial 1 and Trial 2, respectively. In total, 11 fungal genera were identified in both trials, and three genera were predominant: Aspergillus, Penicillium, and Cladosporium. The survey also revealed that knowledge of IAQ among staff and students was limited and that they were unaware of fungal contamination and IAQ. A continuous and wide-spread awareness should be implemented at USM main campus for safer and healthier indoor air environments, particularly university students where productivity and efficiency are of the utmost importance.

Short-term exposure to pollen and the risk of allergic and asthmatic manifestations: a systematic review and meta-analysis

BACKGROUND

Several studies have assessed effects of short-term exposure to pollen on allergic and asthmatic manifestations. The evidence is inconclusive, and no meta-analysis has been published.

OBJECTIVE

To synthesise the evidence on the relations between short-term pollen exposure and the risk of allergic and asthmatic manifestations.

METHODS

We performed a systematic literature search of PubMed and Scopus databases up to the end of August 2018. In addition, we reviewed the reference lists of relevant articles. Two authors independently evaluated the eligible articles and extracted relevant information in a structured form. We calculated summary effect estimates (EE) based on the study-specific ORs and regression coefficients (β) by applying both fixed-effects and random-effects models.

RESULTS

26 studies met the a priori eligibility criteria, and 12 of them provided sufficient information for the meta-analysis. The summary EE related to 10 grains per m³ increase in pollen exposure showed an 1% increase (EE 1.01, 95% CI 1.00 to 1.02) in the risk of lower respiratory symptoms and a 2% increase (EE 1.02, 95% CI 1.01 to 1.03) in the risk of any allergic or asthmatic symptom. Correspondingly, the risk of upper respiratory symptoms and ocular symptoms increased 7% (EE 1.07, 95% CI 1.04 to 1.09) and 11% (EE 1.11, 95% CI 1.05 to 1.17), respectively, in relation to such pollen exposure. Short-term exposure to pollen did not show any significant effect on daily lung function levels.

CONCLUSION

Our results provide new evidence that short-term pollen exposure significantly increases the risks of allergic and asthmatic symptoms.

Airborne fungi spores distribution in various locations in Lagos, Nigeria

Exposure to outside air microorganisms especially fungi has been linked with illness such as allergic respiratory symptoms, rhinitis, asthma, and infection such as mycosis. Airborne fungal composition was sampled from five locations in Lagos State, Nigeria, between May 2014 and April 2016. Fungi spores were collected using the sedimentation plate method with the Petri dishes of dichloran-glycerol 18 (DG-18) and potato dextrose agar (PDA) media. Fungi sporulated faster on DG-18 agar plate as compared with PDA. The abundances of fungal spores collected monthly at the locations varied. The most abundant spores came from the fungi were Aspergillus niger (14.47%), Aspergillus sydowii (10.37%), and Aspergillus flavus (7.93%). Additional species were present in the collections including Ascomycetes: Penicillium funiculosum (5.49%), Neurospora crassa (5.32%), Penicillium oxalicum (4.71%), Penicillium pinophilum (2.88%), Fusarium verticillioides (3.05%), Penicillium simplicissimum (1.83%), Aphaderanum sp. (0.22%), Curvularia sp. (0.22%), Aspergillus oryzae (0.22%), and Paecilomyces sp. (0.61%) and the Mucoromycotina Zygomycetes: Rhizopus oryzae (4.10%) and Mucor sp. (3.44%). Fungal concentrations were significantly higher (P ≤ 0.05) during the rainy season compared with the dry season. Aspergillus and Penicillium were the most predominant airborne fungal genera while Mucor, Alternaria, and Cladosporium were some of the least observed. Generally, abundance of fungi was significantly high during the wet season in all the studied locations.

Ragweed pollen and allergic symptoms in children: Results from a three-year longitudinal study

Common ragweed is a highly allergenic invasive species in Europe, expected to become widespread under climate change. Allergy to ragweed manifests as eye, nasal and lung symptoms, and children may retain these throughout life. The dose-response relationship between symptoms and pollen concentrations is unclear. We undertook a longitudinal study, assessing the association between ragweed pollen concentration and allergic eye, nasal and lung symptoms in children living under a range of ragweed pollen concentrations in Croatia. Over three years, 85 children completed daily diaries, detailing allergic symptoms alongside daily location, activities and medication, resulting in 10,130 individual daily entries. The daily ragweed pollen concentration for the children's locations was obtained, alongside daily weather and air pollution. Parents completed a home/lifestyle/medical questionnaire. Generalised Additive Mixed Models established the relationship between pollen concentrations and symptoms, alongside other covariates. Eye symptoms were associated with mean daily pollen concentration over four days (day of symptoms plus 3 previous days); 61 grains/m³/day (95%CI: 45, 100) was the threshold at which 50% of children reported symptoms. Nasal symptoms were associated with mean daily pollen concentration over 12 days (day of symptoms plus 11 previous days); the threshold for 50% of children reporting symptoms was 40 grains/m³/day (95%CI: 24, 87). Lung symptoms showed a relationship with mean daily pollen concentration over 19 days (day of symptoms plus 18 previous days), with a threshold of 71 grains/m³/day (95%CI: 59, 88). Taking medication on the day of symptoms showed higher odds, suggesting responsive behaviour. Taking medication on the day prior to symptoms showed lower odds of reporting, indicating preventative behaviour. Different symptoms in children demonstrate varying dose-response relationships with ragweed pollen concentrations. Each symptom type responded to pollen exposure over different time periods. Using medication prior to symptoms can reduce symptom presence. These findings can be used to better manage paediatric ragweed allergy symptoms.

Qualitative Analysis of Indoor and Outdoor Airborne Fungi in Cowshed

Air pollution is one of the most serious problems to human health. Fungi are the causal agents for different diseases in animals, plants, and human beings. Otomycosis, chronic bronchitis, emphysema, asthma, allergy, and systemic mycosis are among the fungal diseases caused. The present study was conducted to analyze the monthly incidence of airborne fungi, seasonal variation, and influence of meteorological parameters in indoor and outdoor fungi of cowshed at Hesaraghatta village, Bangalore. An aeromycological survey of indoor and outdoor area of cowshed at Hesaraghatta village in Bangalore city was carried out using the Andersen two-stage sampler onto a petri dish containing malt extract agar from January 2011 to December 2011. Altogether, 29 species belonging to 13 genera from indoor and 26 species belonging to 12 genera were recorded from outdoor environment of the cowshed; the dominant fungal species identified were Cladosporium sp., Aspergillus sp., and Alternaria alternata. Seasonal occurrence of fungal spores in both indoor and outdoor of the cowshed revealed that maximum spores were recorded in summer season followed by winter and rainy season.

Childhood intermittent and persistent rhinitis prevalence and climate and vegetation: a global ecologic analysis

BACKGROUND

The effect of climate change and its effects on vegetation growth, and consequently on rhinitis, are uncertain.

OBJECTIVE

To examine between- and within-country associations of climate measures and the normalized difference vegetation index with intermittent and persistent rhinitis symptoms in a global context.

METHODS

Questionnaire data from 6- to 7-year-olds and 13- to 14-year-olds were collected in phase 3 of the International Study of Asthma and Allergies in Childhood. Associations of intermittent (>1 symptom report but not for 2 consecutive months) and persistent (symptoms for ≥2 consecutive months) rhinitis symptom prevalences with temperature, precipitation, vapor pressure, and the normalized difference vegetation index were assessed in linear mixed-effects regression models adjusted for gross national income and population density. The mean difference in prevalence per 100 children (with 95% confidence intervals [CIs]) per interquartile range increase of exposure is reported.

RESULTS

The country-level intermittent symptom prevalence was associated with several country-level climatic measures, including the country-level mean monthly temperature (6.09 °C; 95% CI, 2.06-10.11°C per 10.4 °C), precipitation (3.10 mm; 95% CI, 0.46-5.73 mm; per 67.0 mm), and vapor pressure (6.21 hPa; 95% CI, 2.17-10.24 hPa; per 10.4 hPa) among 13- to 14-year-olds (222 center in 94 countries). The center-level persistent symptom prevalence was positively associated with several center-level climatic measures. Associations with climate were also found for the 6- to 7-year-olds (132 center in 57 countries).

CONCLUSION

Several between- and within-country spatial associations between climatic factors and intermittent and persistent rhinitis symptom prevalences were observed. These results provide suggestive evidence that climate (and future changes in climate) may influence rhinitis symptom prevalence.

Associations between ozone, PM2.5, and four pollen types on emergency department pediatric asthma events during the warm season in New Jersey: a case-crossover study

BACKGROUND

Asthma is one of the most common chronic diseases among school-aged children in the United States. Environmental respiratory irritants exacerbate asthma among children. Understanding the impact of a variety of known and biologically plausible environmental irritants and triggers among children in New Jersey - ozone, fine particulate matter (PM2.5), tree pollen, weed pollen, grass pollen and ragweed - would allow for informed public health interventions.

METHODS

Time-stratified case-crossover design was used to study the transient impact of ozone, PM2.5 and pollen on the acute onset of pediatric asthma. Daily emergency department visits were obtained for children aged 3-17 years with a primary diagnosis of asthma during the warm season (April through September), 2004-2007 (inclusive). Bi-directional control sampling was used to select two control periods for each case for a total of 65,562 inclusion days. Since the period of exposure prior to emergency department visit may be the most clinically relevant, lag exposures were investigated (same day (lag0), 1, 2, 3, 4, and 5 as well as 3-day and 5-day moving averages). Multivariable conditional logistic regression controlling for holiday, school-in-session indicator, and 3-day moving average for temperature and relative humidity was used to examine the associations. Odds ratios are based on interquartile range (IQR) increases or 10 unit increases when IQR ranges were narrow. Single-pollutant models as well as multipollutant models were examined. Stratification on gender, race, ethnicity and socioeconomic status was explored.

RESULTS

The associations with ozone and PM2.5 were strongest on the same day (lag0) of the emergency department visit (RR IQR=1.05, 95% CI 1.04-1.06) and (RR IQR=1.03, 95% CI 1.02-1.04), respectively, with a decreasing lag effect. Tree and weed pollen were associated with pediatric ED visits; the largest magnitudes of association was with the 5-day average (RR IQR=1.23, 95% CI 1.21-1.25) and (RR 10=1.13, 95% CI 1.12-1.14), respectively. Grass pollen was only minimally associated with the outcome while ragweed had a negative association.

CONCLUSIONS

The ambient air pollutant ozone is associated with increases in pediatric emergency department asthma visits during the warm weather season. The different pollen types showed different associations with the outcome. High levels of tree pollen appear to be an important risk factor in asthma exacerbations.

A GIS based approach for assessing the association between air pollution and asthma in New York State, USA

Studies on asthma have shown that air pollution can lead to increased asthma prevalence. The aim of this study is to examine the association between air pollution (fine particulate matter (PM_2.5), sulfur dioxide (SO₂) and ozone (O₃)) and human health (asthma emergency department visit rate (AEVR) and asthma discharge rate (ADR)) among residents of New York, USA during the period 2005 to 2007. Annual rates of asthma were calculated from population estimates for 2005, 2006, and 2007 and number of asthma hospital discharge and emergency department visits. Population data for New York were taken from US Bureau of Census, and asthma data were obtained from New York State Department of Health, National Asthma Survey surveillance report. Data on the concentrations of PM_2.5, SO₂ and ground level ozone were obtained from various air quality monitoring stations distributed in different counties. Annual means of these concentrations were compared to annual variations in asthma prevalence by using Pearson correlation coefficient. We found different associations between the annual mean concentration of PM_2.5, SO₂ and surface ozone and the annual rates of asthma discharge and asthma emergency visit from 2005 to 2007. A positive correlation coefficient was observed between the annual mean concentration of PM_2.5, and SO₂ and the annual rates of asthma discharge and asthma emergency department visit from 2005 to 2007. However, the correlation coefficient between annual mean concentrations of ground ozone and the annual rates of asthma discharge and asthma emergency visit was found to be negative from 2005 to 2007. Our study suggests that the association between elevated concentrations of PM_2.5 and SO₂ and asthma prevalence among residents of New York State in USA is consistent enough to assume concretely a plausible and significant association.

An investigation of airborne allergenic pollen at different heights

BACKGROUND AND AIMS

Airborne pollen is an important source of allergens in a number of allergic diseases. Data on the concentrations of pollen at different heights in the air are scarce. The aim of the present study was to investigate different types and numbers of airborne pollen and their seasonal variation at different heights in the urban area of Shenzhen (China) and their associations with meteorological factors.

METHODS

The concentration of airborne pollen at different heights was monitored with Burkard traps from July 1, 2006, to June 30, 2007, in Shenzhen; the results were analyzed with SAS 9.13 software.

RESULTS

In total, 1,095 films (at 3 heights, 365 films at each height) were exposed throughout the year, and 48 families and 85 genera of pollen taxa were identified. The total pollen count was 55,830 grains (25,204 grains at 1.5 m; 16,218 grains at 35 m, and 14,408 grains at 70 m); pollen grains were present in the atmosphere throughout the year, with two peaks of airborne pollen: one peak in February to April and the other in September to November.

CONCLUSIONS

On the basis of our local investigations, the pollen concentrations and the pollen types in the air decrease gradually with increasing height. The distribution and concentrations of airborne pollen at different heights in the atmosphere were influenced by composite factors such as the season and meteorological factors.

Effects of ambient pollen concentrations on frequency and severity of asthma symptoms among asthmatic children

BACKGROUND

Previous studies on the associations between ambient pollen exposures and daily respiratory symptoms have produced inconsistent results. We investigated these relationships in a cohort of asthmatic children using pollen exposure models to estimate individual ambient exposures.

METHODS

Daily symptoms of wheeze, night symptoms, shortness of breath, chest tightness, persistent cough, and rescue medication use were recorded in a cohort of 430 children with asthma (age 4-12 years) in Connecticut, Massachusetts, and New York. Daily ambient exposures to tree, grass, weed, and total pollen were estimated using mixed-effects models. We stratified analyses by use of asthma maintenance medication and sensitization to grass or weed pollens. Separate logistic regression analyses using generalized estimating equations were performed for each symptom outcome and pollen type. We adjusted analyses for maximum daily temperature, maximum 8-hour average ozone, fine particles (PM2.5), season, and antibiotic use.

RESULTS

Associations were observed among children sensitized to specific pollens; these associations varied by use of asthma maintenance medication. Exposures to even relatively low levels of weed pollen (6-9 grains/m(3)) were associated with increased shortness of breath, chest tightness, rescue medication use, wheeze, and persistent cough, compared with lower exposure among sensitized children on maintenance medication. Grass pollen exposures ≥ 2 grains/m(3) were associated with wheeze, night symptoms, shortness of breath, and persistent cough compared with lower exposure among sensitized children who did not take maintenance medication.

CONCLUSION

Even low-level pollen exposure was associated with daily asthmatic symptoms.

Associations between atmospheric concentrations of spores and emergency department visits for asthma among children living in Montreal

The authors carried out a time-series study to determine whether short-term increases in the concentrations of spores were associated with emergency department visits from asthma among children 0 to 9 years of age in Montreal, 1994-2004. Concentrations of spores were obtained from one sampling monitor. The authors used parametric Poisson models to model the association between daily admissions to emergency rooms for asthma and ambient exposures to a variety of spores, adjusting for secular trends, changes in weather, and chemical pollutants. For first admissions and exposures to Basidiomycetes, the authors found positive associations at all lags but the concurrent day. For Deuteromycetes and Cladosporium, risks were positive starting at lag 3 days and diminished at lag 6 days. There was little evidence of associations for readmissions, except for Basidiomycetes. The results indicate that Basidiomycetes and Cladosporium spores may be implicated in the exacerbation of asthma among children, most notably in the case of first-time visits to emergency departments, and that the effects appear to be delayed by several days.

Pollen loads and allergic rhinitis in Darwin, Australia: a potential health outcome of the grass-fire cycle

Although the prevalence of asthma and allergic rhinitis has been increasing in tropical regions, little is known about the allergenicity of pollens from tropical plant families or the importance of ongoing environmental changes. We investigated associations between daily average pollen counts of several tropical plant families and sales of medications for the treatment of allergic rhinitis in Darwin, Australia-a tropical setting in which grass abundance has increased due to increased fire frequencies and the introduction of African pasture grasses. Daily pollen counts with detailed identification of plant species were undertaken in conjunction with a weekly survey of flowering plant species from April 2004 to November 2005. Five pharmacies provided daily sales data of selected medications commonly used to treat allergic rhinitis. We used generalized linear modeling to examine outcomes. All analyses accounted for the potential confounding effects of time trends, holidays, respiratory viral illnesses, meteorological conditions, and air pollution. The peak total pollen count was 94 grains/m(3). Despite the low levels of Poaceae (grass) pollen (maximum daily count, 24 grains/m(3)), there was a clear association with daily sales of anti-allergic medications greatest at a lag of 1 day. Sales increased by 5% with an interquartile range rise (3 grain/m(3)) in Poaceae pollen (5.07%, 95%CI 1.04%, 9.25%). No associations were observed with pollen from other plant families. Although further testing is required, we suggest that an overlooked aspect of the "grass-fire cycle" that is degrading many tropical landscapes, could be an increase in the prevalence of allergic rhinitis.

Allergenic pollen and pollen allergy in Europe

The allergenic content of the atmosphere varies according to climate, geography and vegetation. Data on the presence and prevalence of allergenic airborne pollens, obtained from both aerobiological studies and allergological investigations, make it possible to design pollen calendars with the approximate flowering period of the plants in the sampling area. In this way, even though pollen production and dispersal from year to year depend on the patterns of preseason weather and on the conditions prevailing at the time of anthesis, it is usually possible to forecast the chances of encountering high atmospheric allergenic pollen concentrations in different areas. Aerobiological and allergological studies show that the pollen map of Europe is changing also as a result of cultural factors (for example, importation of plants such as birch and cypress for urban parklands), greater international travel (e.g. colonization by ragweed in France, northern Italy, Austria, Hungary etc.) and climate change. In this regard, the higher frequency of weather extremes, like thunderstorms, and increasing episodes of long range transport of allergenic pollen represent new challenges for researchers. Furthermore, in the last few years, experimental data on pollen and subpollen-particles structure, the pathogenetic role of pollen and the interaction between pollen and air pollutants, gave new insights into the mechanisms of respiratory allergic diseases.

Relationship between climate, pollen concentrations of Ambrosia and medical consultations for allergic rhinitis in Montreal, 1994-2002

The aim of this study is to evaluate the influence of meteorological factors on Ambrosia pollen concentrations and its impact on medical consultations for allergic rhinitis of residents from various socio-economic levels in Montréal (Québec, Canada) between 1994 and 2002. The study was conducted to recognize the sensitivity of pollen productivity to daily climate variability in order to estimate the consequences on human health vulnerability in the context of global climate change. Information related to medical consultations for allergic rhinitis due to pollen comes from the Quebec Health Insurance Board (Régie de l'assurance-maladie du Québec). Ambrosia pollen concentration was measured by the Aerobiology Research Laboratories (Nepean, Ontario). Daily temperature (maximum, minimum, and mean) and precipitation data were obtained from the Meteorological Service of Canada. Socio-economic data come from the 1996 and 2001 census data of Statistics Canada. Between 1994 and 2002, during the Ambrosia pollen season, 7667 consultations for allergic rhinitis due to pollen were recorded. We found a significant association between the number of medical consultations and pollen levels. Significant associations were detected for over-consultation the day of exposure, 1, 2, 3 and 5 days after exposure to high levels of pollen. The consultation rate is higher from low-income residents (3.10 consultations per 10,000 inhabitants) than for high-income (1.65 consultations per 10,000 inhabitants). Considering the demonstrated impact of pollen levels on health, it has become critical to ensure adequate monitoring of Ambrosia and its meteorological sensivity in the context of the anticipated climate change and its potential consequences on human health.

Long distance transport of ragweed pollen as a potential cause of allergy in central Italy

BACKGROUND

Ambrosia pollen is an important allergen in North America and, as recently discovered, in some European countries. In Italy, the most affected area is the northeast, whereas ragweed has not been reported in the central and southern parts of the country.

OBJECTIVE

To identify the source of ragweed pollen detected in Florence and Pistoia in central Italy.

METHODS

Ragweed pollen data were collected in Florence and Pistoia for a 6-year period (1999-2004). The relationship between pollen counts and local ground prevalent wind directions was evaluated with analysis of variance and the least significant difference test. Weather conditions were also evaluated on a large-scale circulation pattern by analyzing weather maps and air mass back trajectories.

RESULTS

A highly statistically significant relationship between daily prevailing wind direction and pollen count was found in the period under investigation; the ragweed pollen peaks were recorded when winds from northeast in Florence and north-northeast in Pistoia were observed. The synoptic weather situation and the path of back trajectories suggest an area around southern Hungary as a possible source of Ambrosia pollen. Furthermore, the pollen count was above the clinical threshold several times in both Florence and Pistoia.

CONCLUSIONS

Several factors indicate that the detection of ragweed pollen in central Italy is due to long distance transport. Taking into consideration the high allergenicity of Ambrosia pollen, the present findings, if confirmed, suggest that the number of sensitized individuals might significantly increase in the near future.