Why is hay fever worse this year than last?

Allergies can be frustrating to manage, because their symptoms can be widespread whilst their cause illusive. Unfortunately, children with such symptoms can be dismissed, where their need for medical support is being overlooked. Symptoms can include;

  • Itching and congestion of nasal passages
  • Running nose and sneezing
  • Itching eyes and eyelid swelling
  • Coughing and chest tightness if allergic asthma is a concern, which may progress to difficulty in breathing in peak pollen exposure
  • Itching of the mouth
  • Worsening of eczema, especially over exposed areas such as face and hands
  • Urticaria (raised nettle-rash hives) can become problematic in contact with open rural or park environments

Correct diagnosis for your child may or may not involve testing. Recommendation for pollen avoidance, pragmatic first-line treatment and specialist treatment where appropriate allows the greatest restoration of activities outside, sleeping and lifestyle.

There are many reasons why potential symptoms vary day-by-day, as well as season-by-season;

The timing of different pollens varies throughout the year

The ‘Pollen Count’ is the measure of how many grains of pollen there are per cubic metre of air. 

The seasonal timing of various pollen peaks varies throughout the year, with tree pollens blooming from late February, grass pollen in May, molds and weeds in the autumn. The relative contribution of these are reported by the Worcester Department of Aerobiology, which works in partnership with the UK Met Office to produce the most accurate regional pollen forecast. You can also search for regional pollen peaks over the season.

Local weather patterns affect local pollen counts

Many factors impact upon the exposure of pollen counts;

  • Wind speed
  • Temperatures
  • Precipitation and rain
  • Wind direction; on-shore breezes from the sea costal areas carry less pollen

Greater outline of the impact of weather on pollen exposure can be found from the Royal Meteorological Society.

Time of day influences pollen exposure

As the day warms, air rises suspending pollen particles until the greatest release is at the warmest part of the day. However, there is also a peak in pollen load as the same particles start to settle from the suspended air towards the evening and dusk. Many are surprised to hear that peaks throughout the day and during the evening can become particularly troublesome and many affect the best time of day to take relieving medications.

Steps to consider for reducing pollen exposure

  • Reviewing local weather reports including pollen counts and limiting time spent outside when the count is high
  • Avoiding drying laundry outdoors, particularly clothes and bedding, when pollen counts are high
  • Keeping doors and windows closed during peak months for pollen exposure
  • Consider putting Vaseline around your nostrils to trap pollen
  • Wear wraparound sunglasses to stop pollen getting into your eyes
  • Shower and change your clothes after you have been outside to wash pollen off
  • Avoiding playing in the garden or on parks after lawn mowing or during peak pollen exposure
  • Consider seaside breaks for greater relief from dust bowl urban areas with high concentrations of Victorian parks or modern built suburban areas adorned with sleek Silver Birch

It is possible to investigate your own personal symptom impact in closer detail. After appropriate diagnostic review, you may wish to take part in a Europe-wide study run from Vienna, recording your symptoms online through the European Aeroallergen Network (EAN) Patient’s Pollen Diary www.pollendiary.com. The website allows you to document your symptoms and compare them with concentrations of pollen in the air, to help identify which pollen you are allergic to. You can look back at pollen levels from previous seasons and read the latest pollen news.

When pollen avoidance and hayfever tablets do not help

The extent of hay fever can be enormous, both in terms of the severity of driving symptoms, the widespread nature of its impact and resulting limitation on activities.

The severity of airway symptoms can involve:

  • Children find that they trouble getting to sleep, or wake early in the morning
  • Symptoms of difficulty in breathing, whether outside, in the evening or overnight, should be taken seriously. This may be associated with coughing, chest tightness or feeling chest discomfort
  • Resulting limitation of sporting activities, holiday commitments or ability to enjoy family activities
  • The exam grades of children with grass hay fever have been shown to sink lower than winter-mocks, owing to distraction, poor sleep and reduced concentration

Antihistamine therapy may have enable some relief from these conditions, however nasal sprays are rarely considered early enough in the treatment pathway. Simple nasal saline sprays are of very limited value, however low-dose steroid sprays can bring considerable benefit, when used consistently. The Fluticasone and Mometasone nasal sprays have lesser absorbance into the blood and have minimal side effects. ‘Decongestant’ nasal sprays are not recommended in children although they can be bought over the counter for adults. Concern of asthma with coughing and chest tightness requires a clinical review because the implications of pollen count swings are of potentially unsafe impact.

Where sleep and lifestyle are still affecting your child, further assessment and immunotherapy may be a more suitable treatment option to allow longer term relief if appropriate. Do not hesitate to get in touch where further assessment is of interest.

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