Get ready for the sneezing season

Hay fever is on the rise, with city dwellers suffering worst of all. But a few simple lifestyle changes can help you keep a clear head, discovers Fiona Roberts

Hay fever is already the curse of summer for around a quarter of people in the UK. One in four of us spend the warmer months clinging to tissues and cursing the more fortunate souls eating picnics in sunny parks. But according to a new report, by 2030 the number of picnickers will have dwindled – by then, one in two people living in towns and cities could be suffering from hay fever.

According to Professor Jean Emberlin, director of the National Pollen and Aerobiology Unit at the University of Worcester, who wrote the Hay Fever Health Report commissioned by Kleenex, across the country as a whole 39 per cent of us will succumb to the condition by 2030. As many as 32 million people could be affected.

Otherwise known as allergic rhinitis, hay fever is an allergic reaction to pollen. The body’s immune system overreacts to this otherwise harmless substance, producing histamines which in turn cause the symptoms that can plague sufferers throughout the summer months.

The symptoms of hay fever are very similar to those you get when you have a cold. The natural reaction is to sneeze, as the body tries to rid itself of the pollen. But if sneezing fails, the pollen causes an allergic reaction and releases histamines which inflame the lining of the throat, nose and eyes. This causes a runny nose, a sore and itchy throat, itchy, red, watery eyes and even pain in the sinuses as they become congested by the increased mucus. As a result of these symptoms, sufferers can find it difficult to concentrate, and sleep can be disturbed too. In some more serious cases, hay fever sufferers can develop ear infections, sinusitis and, after prolonged exposure to the allergen later in the season, pollen asthma.

Hay fever affects some people much more than others. It has long been seen as a young persons’ illness – 38 per cent of UK teenagers suffer from it as opposed to 25 per cent of the general population – and young sufferers tend to grow out of it as they get older. But according to Professor Emberlin, that might be changing: “There’s also the possibility

that people can get hay fever for the first time in middle age or perhaps later. Why this should be is not clear, it might be that new allergens are triggering it, or perhaps an increased pollen load in the air. But we are particularly finding that when people’s immune systems change – perhaps they move to a different part of the country, get a new job or have a baby – they are getting hay fever.” So why are more of us suffering?

Diet and lifestyle

According to Professor Emberlin, lifestyle choices play a huge part in our susceptibility to hay fever. She says city living is one of the main culprits, because lack of exercise, lack of sleep and stress can all exacerbate the symptoms. Professor Emberlin explained: “If you are stressed then your body will produce more of the stress hormone cortisol. This has all sorts of effects on the body, including on the immune system, so it will tend to make your hay fever symptoms worse.”

And turning to a glass of wine may not help either – surveys carried out in Spain and Denmark have shown there could be a link between alcohol consumption and allergic sensitisation. It can be exacerbated by diet, too. Around two-thirds of those who rated their diet as poor described their symptoms as unbearable or very uncomfortable. Professor Emberlin explained that the better your diet, the stronger your immune system will be and the more chance your body will have of fighting off the symptoms of hay fever.

But even the healthiest of foods can make symptoms worse. For example apples, tomatoes and stoned fruits react with birch pollen, causing an itchy mouth and a swollen tongue. And it might be best to steer clear of dairy too – it can increase mucus production and make a runny nose even worse.

The pollution factor

Urban lifestyles are just one factor. Air pollution from vehicle exhaust fumes also plays a significant part, both directly and indirectly. Professor Emberlin explains that certain pollutants will stop the body from ridding itself of the allergens as effectively as it normally would. She said: “Nitrous oxides will slow down the beating of the cilia so that allergens will stay in the respiratory tract, and also certain air pollutants will affect the permeability of the membrane so they will leak into the lining of the respiratory tract more easily.”

Air pollution also alters the pollen itself. Professor Emberlin explains that nitrous oxides, found in vehicle exhaust fumes, will alter the proteins on some trees and make them more allergenic. “I think that the problem, particularly in London and other large cities, is that grass pollen is released first thing in the morning and in the evening, which coincides with the rush hour. Plus the air pollution tends to be high on the same days and the same weather types as when the pollen count is high – dry and sunny – so you get a synchronisation in the peaks of pollution and of grass pollen.”

Climate change

Will climate change affect our susceptibility to hay fever? The short answer is yes. Professor Emberlin said: “Increased sunlight and dry hot summers will make photochemical smogs more frequent and intense, so there’ll be more pollution and hay fever will be exacerbated.”

But increased pollution will not be the only consequence. According to a new study presented to the American Academy of Allergy, Asthma and Immunology, higher temperatures may increase the length of the pollen season for certain plants. Estelle Levin from the academy said: “Longer pollen seasons and high levels of pollen certainly can exacerbate symptoms for people with allergic rhinitis (hay fever) and for those who previously had minimal symptoms.”

Know your allergens

The pollen season varies according to the type of pollen you are susceptible to. For those who are sensitive to pollen from trees such as alder and hazel the season can begin as early as January, but it really gets under way in March and April when the birch pollen season begins. Although only |25 per cent of sufferers are affected by birch pollen, it can trigger a much more severe reaction than the more common grass pollen.

The birch pollen season started later this year – in mid-April – than it did last year because we had a very cold winter and a cold spring. “Birch pollen seasons tend to alternate between high and low, just because of the natural rhythm of the trees,” says Professor Emberlin. “This year is a high. It can start from virtually nothing then get to a high count within a couple of days, then it will last for about four weeks.”

Oak is also particularly allergenic, and is most prevalent during April and May. But the most common culprit is grass pollen, affecting around 95 per cent of hay fever sufferers. Its season starts at the beginning of May and can continue right through until September, making autumn as miserable as summer for those worst affected.

HAY FEVER: HOW TO TREAT IT

Avoid the allergens

The best way to stop hay fever in the first place is to avoid contact with pollen as much as possible. Professor Emberlin suggests common-sense measures including wearing sunglasses and a broad-rimmed hat to keep pollen away from face and eyes when outside, then washing your face and eyes when you get back inside to get rid of the pollen, as well as keeping doors and windows shut.

She adds that it’s important to “know your enemy” and use a pollen calendar to work out which type of pollen you are most sensitive to. She explained: “The best choice really is to avoid pollution where possible, avoid high pollen count – although no one wants to be indoors all the time. You can watch the pollen count forecasts so that you can modify your activity pattern in relation to days with a |high pollen count.”

Drugs

“The best thing is for people to go and speak to their pharmacist or GP to find out what suits them best,” Professor Emberlin says. “But there are a whole range of nasal sprays and antihistamines to help them cope, and carrying tissues and water with you will make things more comfortable.”

Many remedies are available over the counter. Antihistamine tablets and sprays can be a helpful way of treating sneezing and itchy or watery eyes, but they are less effective at clearing a blocked nose and can cause drowsiness. If your main problem is a blocked nose, your GP may prescribe cortosteroid sprays, which contain steroids to help reduce the inflammation of the nose lining. Decongestants and eye drops can also help. If your hay fever is very persistent and debilitating, your doctor may recommend a course of immunotherapy. This is a type of vaccination, in which small does of the allergen are slowly introduced into the system so it builds up a tolerance to it.

Lifestyle Changes

A longer-term solution is to address some of the lifestyle triggers which can make hay fever worse. The stronger your immune system is, the better, so sleeping more, drinking less and making sure you get a balanced diet can all help. Professor Emberlin said: “It’s good to try to reduce stress and to take some exercise – people don’t realise how much difference that can make. If hay fever’s really bothering you then it’s worth making that bit of effort to do these things.”

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