[Threshold pollen count necessary to evoke allergic symptoms]

Co-exposure to highly allergenic airborne pollen and fungal spores in Europe

The study is aimed at determining the potential spatiotemporal risk of the co-occurrence of airborne pollen and fungal spores high concentrations in different bio-climatic zones in Europe. Birch, grass, mugwort, ragweed, olive pollen and Alternaria and Cladosporium fungal spores were investigated at 16 sites in Europe, in 2005-2019. In Central and northern Europe, pollen and fungal spore seasons mainly overlap in June and July, while in South Europe, the highest pollen concentrations occur frequently outside of the spore seasons. In the coldest climate, no allergy thresholds were exceeded simultaneously by two spore or pollen taxa, while in the warmest climate most of the days with at least two pollen taxa exceeding threshold values were observed. The annual air temperature amplitude seems to be the main bioclimatic factor influencing the accumulation of days in which Alternaria and Cladosporium spores simultaneously exceed allergy thresholds. The phenomenon of co-occurrence of airborne allergen concentrations gets increasingly common in Europe and is proposed to be present on other continents, especially in temperate climate.

Five-year airborne pollen calendar for a Sonoran Desert city and the relationships with meteorological variability

Aerobiological studies are still scarce in northwestern Mexico where allergenic pollen have great impacts on health. Current global pollution and climate change problems are closely related to many allergic diseases, enhancing the need to continue researching these issues and improve life quality. This study provides the first Pollen Calendar for Hermosillo, Sonora, México. Airborne pollen were continuously collected for 5 years (2015-2019). The standardized methodology with a Hirst-type spore trap proposed for global aerobiological studies was used. Weather data were also taken from a station located in the city and used to explore correlations between climate and airborne pollen concentrations in different seasons. The most important pollen taxa recorded in air belongs to herbaceous pollen, such as Poaceae, Ambrosia, Asteraceae, Chenopodiaceae-Amaranthaceae, and some shrub trees typical of this arid region, such as Nyctaginaceae, Prosopis, Parkinsonia, and Fabaceae. The most critical herbaceous pollen related to allergies have a long mean pollen season throughout the years, and the most critical periods with high pollen concentration in air occur in two seasons, spring (March-April) and summer-fall (August-October). In these 5 years, the correlation analyses for these two peaks indicate that a link exists between pollen in the air and decreases in precipitation and temperatures, and an increase in relative humidity. An inter-annual variability in pollen concentrations was recorded related to different weather conditions. Although pollen calendars are location-specific, they are useful for future research on biological air quality scenarios in different cities. Using this standardized method for other regions can provide pollen calendars that have been proven clinically important in allergic disease management worldwide.

Impact of meteorological parameters and air pollutants on airborne concentration of Betula pollen and Bet v 1 allergen

The intensity of birch pollen season is expressed by seasonal pollen integral (SPIn, the sum of the mean daily pollen concentration during the birch pollination period) and the amount of Bet v 1 allergen released per birch pollen grain expressed by pollen allergen potency (PAP). Betula pollen and Bet v 1 allergen were simultaneously measured in the air of Bratislava from 2019 to 2022 by using two Burkard traps (Hirst-type and cyclone) in order to evaluate the causes of the seasonal variation in the SPIn and PAP levels. The highest SPIn (19,975 pollen/m3) was observed in 2022 and the lowest one (1484 pollen/m3) in 2021. The average daily PAP level (4.0 pg Bet v 1/pollen) was highest in 2019 and lowest (2.5 pg Bet v 1/pollen) in 2020. We found that seasonal variation in SPIn was associated mainly with the changes in environmental conditions during the pre-season period, whereas the year-to-year variation in PAP levels was attributed to environmental conditions during both pre- and in-season periods. Our results indicate that rainy weather in June 2020 and cold overcast weather in January‒February 2021 resulted in low SPIn in 2021. On the other hand, dry weather in June 2021 and warm weather in January‒February 2022 resulted in high SPIn in 2022. The low average daily PAP level in 2020 was associated with (1) low levels of gaseous air pollutants in March, when the ripening of pollen takes place; (2) an earlier start of the birch main pollen season (MPS); and (3) dry weather during the MPS. On the other hand, high PAP level in 2019 was associated with higher levels of air pollutants in March and during the MPS.

A Modified Spectroscopic Approach for the Real-Time Detection of Pollen and Fungal Spores at a Semi-Urban Site Using the WIBS-4+, Part I

The real-time monitoring of primary biological aerosol particles (PBAP) such as pollen and fungal spores has received much attention in recent years as a result of their health and climatic effects. In this study, the Wideband Integrated Bioaerosol Sensor (WIBS) 4+ model was evaluated for its ability to sample and detect ambient fungal spore and pollen concentrations, compared to the traditional Hirst volumetric method. Although the determination of total pollen and fungal spore ambient concentrations are of interest, the selective detection of individual pollen/fungal spore types are often of greater allergenic/agricultural concern. To aid in this endeavour, modifications were made to the WIBS-4 instrument to target chlorophyll fluorescence. Two additional fluorescence channels (FL4 and FL5 channels) were combined with the standard WIBS channels (FL1, FL2, FL3). The purpose of this modification is to help discriminate between grass and herb pollen from other pollen. The WIBS-4+ was able to successfully detect and differentiate between different bioaerosol classes. The addition of the FL4 and FL5 channels also allowed for the improved differentiation between tree (R² = 0.8), herbaceous (R² = 0.6) and grass (R² = 0.4) pollen and fungal spores (R² = 0.8). Both grass and herbaceous pollen types showed a high correlation with D type particles, showing strong fluorescence in the FL4 channel. The additional fluorescent data that were introduced also improved clustering attempts, making k-means clustering a comparable solution for this high-resolution data.

Modeling past and future spatiotemporal distributions of airborne allergenic pollen across the contiguous United States

Exposures to airborne allergenic pollen have been increasing under the influence of changing climate. A modeling system incorporating pollen emissions and atmospheric transport and fate processes has been developed and applied to simulate spatiotemporal distributions of two major aeroallergens, oak and ragweed pollens, across the contiguous United States (CONUS) for both historical (year 2004) and future (year 2047) conditions. The transport and fate of pollen presented here is simulated using our adapted version of the Community Multiscale Air Quality (CMAQ) model. Model performance was evaluated using observed pollen counts at monitor stations across the CONUS for 2004. Our analysis shows that there is encouraging consistency between observed seasonal mean concentrations and corresponding simulated seasonal mean concentrations (oak: Pearson = 0.35, ragweed: Pearson = 0.40), and that the model was able to capture the statistical patterns of observed pollen concentration distributions in 2004 for most of the pollen monitoring stations. Simulation of pollen levels for a future year (2047) considered conditions corresponding to the RCP8.5 scenario. Modeling results show substantial regional variability both in the magnitude and directionality of changes in pollen metrics. Ragweed pollen season is estimated to start earlier and last longer for all nine climate regions of the CONUS, with increasing average pollen concentrations in most regions. The timing and magnitude of oak pollen season vary across the nine climate regions, with the largest increases in pollen concentrations expected in the Northeast region.

The correlation between middle schoolchildren allergic symptoms and airborne particle season: A cross-sectional study

Limited studies correlate allergic symptoms and associated outdoor biological particle exposure among schoolchildren globally.This study aimed to investigate the relationship between the seasonality of symptoms of allergic diseases among middle schoolchildren and the annual variation of airborne pollen and fungal spore in a hot and humid geographical region (Qatar).During November 2017 to January 2018, a self-reported study of middle schoolchildren living in the Doha capital city of Qatar was conducted, and data gathered were evaluated in relation to the collected monthly pollen and fungal spores. Participants' data were collected by conducting a survey based on a modified questionnaire adopted from the International Study of Asthma and Allergy in Childhood (ISAAC). The airborne pollen and fungal spore in Doha's atmosphere were extracted from the Doha aerobiology project (2017-2020).Among the 1000 distributed questionnaires, 100 were excluded due to significant missing data and 644 middle schoolchildren living in Doha city responded and were included in the final analysis. The symptoms of allergic rhinitis (AR) pattern among the responders with positive symptoms were strongly linked with the higher airborne fungal spore incidence during the month of November. Out of 331 students with positive symptoms, the prevalence of AR, lifetime wheeze, and eczema was 62.8%, 28.1%, and 26.6%, respectively. Asthma was significantly higher in Qatari (39.8%) compared to non-Qatari (26.7%) middle schoolchildren (P = .02).Outdoor aeroallergen may be a contributing factor in addition to other environmental and genetic predisposing factors for childhood atopic diseases in the prevalence rate of allergic symptoms among middle schoolchildren in the peninsula of Qatar.

Changes in the Sensitization Pattern to Alternaria alternata Allergens in Patients Treated with Alt a 1 Immunotherapy

Alternaria alternata is the most important allergenic fungus, with up to 20% of allergic patients affected. The sensitization profile of patients sensitized to A. alternata and how it changes when treated with immunotherapy is not known. Our objective is to determine the allergen recognition pattern of allergic patients to A. alternata and to study its association to the parameters studied in a clinical trial recently published. Sera of 64 patients from the clinical trial of immunotherapy with native major allergen Alt a 1 were analyzed by immunoblotting; 98. 4% of the patients recognized Alt a 1. The percentage of recognition for Alt a 3, Alt a 4, and/or Alt a 6, Alt a 7, Alt a 8, Alt a 10 and/or Alt a 15 was 1.6%, 21.9%, 12.5%, 12.5%, and 12.5% respectively. Of the 64 patients, 45 (70.3%) only recognized Alt a 1 among the allergens present in the A. alternata extract. Immunotherapy with Alt a 1 desensitizes treated patients, reducing their symptoms and medication consumption through the elimination of Alt a 1 sensitization, which is no longer present in the immunoblotting of some patients. There may be gender differences in the pattern of sensitization to A. alternata allergens, among others.

Extension of WRF-Chem for birch pollen modelling-a case study for Poland

In recent years, allergies due to airborne pollen allergens have shown an increasing trend, along with the severity of allergic symptoms in most industrialized countries, while synergism with other common atmospheric pollutants has also been identified as affecting the overall quality of citizenly life. In this study, we propose the state-of-the-art WRF-Chem model, which is a complex Eulerian meteorological model integrated on-line with atmospheric chemistry. We used a combination of the WRF-Chem extended towards birch pollen, and the emission module based on heating degree days, which has not been tested before. The simulations were run for the moderate season in terms of birch pollen concentrations (year 2015) and high season (year 2016) over Central Europe, which were validated against 11 observational stations located in Poland. The results show that there is a big difference in the model's performance for the two modelled years. In general, the model overestimates birch pollen concentrations for the moderate season and highly underestimates birch pollen concentrations for the year 2016. The model was able to predict birch pollen concentrations for first allergy symptoms (above 20 pollen m^-3) as well as for severe symptoms (above 90 pollen m^-3) with probability of detection at 0.78 and 0.68 and success ratio at 0.75 and 0.57, respectively for the year 2015. However, the model failed to reproduce these parameters for the year 2016. The results indicate the potential role of correcting the total seasonal pollen emission in improving the model's performance, especially for specific years in terms of pollen productivity. The application of chemical transport models such as WRF-Chem for pollen modelling provides a great opportunity for simultaneous simulations of chemical air pollution and allergic pollen with one goal, which is a step forward for studying and understanding the co-exposure of these particles in the air.

Polyvalent Mechanical Bacterial Lysate Administration Improves the Clinical Course of Grass Pollen-Induced Allergic Rhinitis in Children: A Randomized Controlled Trial

BACKGROUND

Recent studies highlight the immunoregulatory potential of bacterial lysates, indicating their potential use in the prevention and treatment of allergic diseases.

OBJECTIVE

To investigate the clinical efficacy of polyvalent mechanical bacterial lysates (PMBLs) in children with grass pollen-induced allergic rhinitis.

METHODS

Seventy children with seasonal allergic rhinitis were enrolled to this study and were randomly assigned to the PMBL and placebo groups. Severity of seasonal allergic rhinitis symptoms was assessed by the total nasal symptom score, total ocular symptom score, and visual analogue scale. During 3 visits, peak nasal inspiratory flow was measured, and nasal smears for the presence of eosinophils and nasal lavage fluids for the presence of allergen-specific IgE against timothy grass pollen allergens were sampled.

RESULTS

A statistically significant decrease in total nasal symptom score (P = .001), total ocular symptom score (P = .04), and visual analogue scale score for nasal and eye symptoms (P < .001 and P < .001, respectively) and an increase in peak nasal inspiratory flow (P = .04) were observed in the PMBL group versus the placebo group. During the grass pollen season, an increase and then a decrease in the number of eosinophils in nasal smears was observed in both groups; however, the number of eosinophils was significantly lower in the PMBL group versus the placebo group. No significant changes in allergen-specific IgE concentrations were observed in the PMBL group, whereas in the placebo group a statistically significant increase in allergen-specific IgE concentration was observed.

CONCLUSIONS

Sublingual administration of PMBLs during the grass pollen season offers significant efficacy in alleviating seasonal allergic rhinitis symptoms in children sensitized to grass pollen allergens. PMBLs probably affect mucosal immunity, weakening the response of T_H2 cells.

The Clinical Utility of Pollen Counts

In this review, we describe how pollen counts are performed, the health effects caused by exposure to varying amounts of pollen, the clinical utility of reporting pollen counts to the public, and how that information can be used by patients who have allergies to improve their health. The public is very interested in pollen counts, particularly if the counts provide a forecast of expected pollen exposure for the next few days. Traditional pollen counts are labor-intensive; poorly distributed; and, since the counts are usually 1-day-old, do not provide forecasts that can be acted on. New methods that provide short- and long-term pollen forecasts can provide this information to allergic individuals so that they can respond to changing outdoor conditions. Studies of the relationship between artificial and natural exposure to pollen and development of symptoms have provided improved understanding into how much pollen it takes to cause symptoms. Thresholds for pollen counts that trigger symptoms vary by pollen type, sensitivity of the population, and interactions with other atmospheric exposures. Strategies to inform the public when the pollen count poses a health risk have been proposed along with computerized systems that provide personalized pollen alerts. The best performing public notification system was a "traffic light system" that reported pollen exposure as low, 0-30; intermediate, 31-50; or high, 51-150. This system outperformed other threshold systems used in Sweden and in Britain/Denmark. Continued improvements in pollen forecasting models combined with data provided by automated pollen counters and better public reporting should permit allergic individuals and urban planners to adapt effectively to changes in outdoor aeroallergen exposures.

Pollen calendars and maps of allergenic pollen in North America

Pollen is a common allergen that causes significant health and financial impacts on up to a third of the population of the USA. Knowledge of the main pollen season can improve diagnosis and treatment of allergic diseases. Our objective in this study is to provide clear, quantitative visualizations of pollen data and make information accessible to many disciplines, in particular to allergy sufferers and those in the health field. We use data from 31 National Allergy Bureau (NAB) pollen stations in the continental USA and Canada from 2003 to 2017 to produce pollen calendars. We present pollen season metrics relevant to health and describe main pollen season start and end dates, durations, and annual pollen integrals for specific pollen taxa. In most locations, a small number of taxa constitute the bulk of the total pollen concentration. Start dates for tree and grass pollen season depend strongly on latitude, with earlier start dates at lower latitudes. Season duration is correlated with the start dates, such that locations with earlier start dates have a longer season. NAB pollen data have limited spatiotemporal coverage. Increased spatiotemporal monitoring will improve analysis and understanding of factors that govern airborne pollen concentrations.

Exposure to pollen allergens in allergic rhinitis expressed by diurnal variation of airborne tree pollen in urban and rural area

Exposure to airborne pollen allergens results in allergic symptoms in subjects who are sensitized. The paper presents diurnal variation in the counts of airborne allergenic pollen of selected trees (Betula L., Alnus Mill., Corylus L., Fagus L. and Ulmus L.) in two localities differing in the degree of urbanization: the city of Szczecin (urban) and the village of Gudowo, West Pomerania in northwest Poland (rural) in the years 2012–2014. The measurements were made by the volumetric method using a Burkardtype sampler operating in a continuous mode. The greatest similarities in the beginning of the main pollen season between the two sites studied were observed for birch and elm trees, while in the length of the main pollen season, for birch and alder trees. Pollen counts of alder and hazel reached higher levels in the rural area, while the levels of ash tree pollen counts were higher in the urban area. The level of birch tree pollen counts was similar in the two sites studied. For the majority of taxons observed in the urban and rural areas the dynamics of hourly changes in tree pollen counts were similar. The pollination peak was noted in the daytime, usually in the afternoon. For ash and elm trees increased pollen counts were observed at nighttime, while the birch tree pollen counts were at a high level for most of the 24 h cycle. The knowledge of seasonal and diurnal variations in tree pollen counts is crucial for prevention in patients with allergic rhinitis, sensitized to tree pollen allergens.

Prevalence of allergic rhinitis and asthma in Poland in relation to pollen counts

Introduction

Despite the known role of pollen allergens in causing allergy symptoms in sensitized individuals, there are few publications investigating the relationship between pollen exposure in different regions and the prevalence of inhalant allergy.

Aim

To assess the association between the prevalence of allergic rhinitis and asthma and the degree of exposure to pollen in various regions of Poland.

Material and methods

Completed questionnaires of 9,443 subjects living in four urban centres (Wroclaw, Katowice, Warsaw, Bialystok), collected within part of the ECAP project, were analyzed. Children aged 6–7 (n = 2,278), adolescents aged 13–14 (n = 2,418), and adults aged 20–44 (n = 4,747) constituted 24.2%, 25.6% and 50.3% of the respondents, respectively. The clinical part (including skin prick tests, an assay of Timothy grass-specific IgE), was attended by 24% of the respondents. Data from 6-year pollen monitoring served to characterize birch and grass pollen seasons.

Results

We found insignificant negative associations between the duration of birch pollen season and the prevalence of declared allergic rhinitis and asthma during the season across all age groups. There were insignificant inverse associations between the number of days with above-threshold and high grass pollen concentrations, total grass pollen count and the prevalence of declared allergic rhinitis and asthma during the season across all age groups. Associations noted in the clinical part were also non-significant; however, these trends were not uniform across the age groups.

Conclusions

Our findings do not confirm the hypothesis of a positive association between pollen exposure and the prevalence of allergic rhinitis and asthma.

The impact of meteorological conditions on the concentration of alder pollen in Sosnowiec (Poland) in the years 1997-2017

The aim of the work was to compare the alder pollen seasons in the years 1997-2017 in Sosnowiec. The measurements of pollen concentration were taken with the volumetric method using Burkard's apparatus. The impact of atmospheric conditions on the daily alder pollen grain concentration, the annual totals, and the duration of pollen seasons were studied. The dependency between each meteorological condition and different features of the alder pollen season was determined by using Pearson's correlation coefficients, variance analysis with multiple comparison tests, and the linear regression model using backward elimination. It was proven that the temperatures directly preceding the pollination, i.e. the January and February temperatures as well as those from the period from 210 to 180 days preceding the beginning of the season, have the greatest impact on the beginning of the alder pollen season. The value of the daily alder pollen concentration in Sosnowiec showed a positive statistically significant correlation with the air temperature and sunshine duration and a negative correlation with the thickness of the snow cover and air relative humidity. The daily concentration also depended on the type of the weather front, direction of air mass inflow, and the type of the inflowing air mass. The season temperatures and the thermal conditions which were present in the summer of the preceding year impacted the annual totals (SPI) of the alder pollen grains.

Health hazards related to conidia of Cladosporium-biological air pollutants in Poland, central Europe

The spores of Cladosporium Link. are often present in the air in high quantities and produce many allergenic proteins, which may lead to asthma. An aerobiological spore monitoring program can inform patients about the current spore concentration in air and help their physicians determine the spore dose that is harmful for a given individual. This makes it possible to develop optimized responses and propose personalized therapy for a particular sensitive patient. The aim of this study was to assess the extent of the human health hazard posed by the fungal genus Cladosporium. For the first time, we have determined the number of days on which air samples in Poland exceeded the concentrations linked to allergic responses of sensitive patients, according to thresholds established by three different groups (2800/3000/4000 spores per 1m³ of the air). The survey was conducted over three consecutive growing seasons (April-September, 2010-2012) in three cities located in different climate zones of Poland (Poznan, Lublin and Rzeszow). The average number of days exceeding 2800 spores per cubic meter (the lowest threshold) ranged from 61 (2010) through 76 (2011) to 93 (2012), though there was significant variation between cities. In each year the highest concentration of spores in the air was detected in either Poznan or Lublin, both located on large plains with intensive agriculture. We have proposed that an effective, science-based software platform to support policy-making on air quality should incorporate biological air pollutant data, such as allergenic fungal spores and pollen grains.

Indoor birch pollen concentrations differ with ventilation scheme, room location, and meteorological factors

Indoor pollen concentrations are an underestimated human health issue. In this study, we measured hourly indoor birch pollen concentrations on 8 days in April 2015 with portable pollen traps in five rooms of a university building at Freising, Germany. These data were compared to the respective outdoor values right in front of the rooms and to background pollen data. The rooms were characterized by different aspects and window ventilation schemes. Meteorological data were equally measured directly in front of the windows. Outdoor concentration could be partly explained with phenological data of 56 birches in the surrounding showing concurrent high numbers of trees attaining flowering stages. Indoor pollen concentrations were lower than outdoor concentrations: mean indoor/outdoor (I/O) ratio was highest in a room with fully opened window and additional mechanical ventilation (.75), followed by rooms with fully opened windows (.35, .12) and lowest in neighboring rooms with tilted window (.19) or windows only opened for short ventilation (.07). Hourly I/O ratios depended on meteorology and increased with outside temperature and wind speed oriented perpendicular to the window opening. Indoor concentrations additionally depended on the previously measured concentrations, indicating accumulation of pollen inside the rooms even after the full flowering period.

Co-occurrence of Artemisia and Ambrosia pollen seasons against the background of the synoptic situations in Poland

The Asteraceae family is one of the largest families, comprising 67 genera and 264 species in Poland. However, only a few genera, including Artemisia and Ambrosia are potential allergenic sources. The aim of the study was to estimate how often and to what degree Artemisia and Ambrosia pollen seasons co-occur intensifying human health risk, and how synoptic situations influence frequency of days with high pollen concentrations of both taxa. Artemisia and Ambrosia pollen data were collected, using the volumetric method, at 8 sites in Poland. Daily concentrations of Artemisia pollen equal to 30 grains or more and Ambrosia pollen equal to 10 grains or more were accepted as high values. Concentrations of more than 10 pollen grains were defined as high in the case of Ambrosia because its allergenicity is considered higher. High concentrations were confronted with synoptic situations. Analysis was performed on the basis of two calendars on circulation types of atmosphere in Poland (Niedźwiedź, 2006, 2015). Co-occurrence of Artemisia and Ambrosia pollen seasons is being found most often, when Ambrosia pollen season starts in the first half of August. If it happens in the last 10 days of August high pollen concentrations of Artemisia and Ambrosia do not occur at the same days. At three sites (Sosnowiec, Rzeszów, Lublin) high Ambrosia pollen concentrations during the Artemisia pollen season appear more often than in other sites under question. The high Artemisia pollen concentrations occur, when continental or polar maritime old air masses inflow into Poland. The impact of air masses on high Ambrosia pollen concentrations depends on site localizations. It is likely, that in the south-eastern part of Poland high Ambrosia pollen concentrations result from the pollen transport from east-south-south-westerly directions and the local sources. Co-occurrence of both taxa pollen seasons depends on the air masses inflow and appears more often in a south-eastern part of Poland.

Madeira-a tourist destination for asthma sufferers

Madeira Island is a famous tourist destination due to its natural and climatic values. Taking into account optimal weather conditions, flora richness and access to various substrates facilitating fungal growth, we hypothesised a very high risk of elevated fungal spore and pollen grain concentrations in the air of Funchal, the capital of Madeira. Concentration levels of the most allergenic taxa were measured from 2003 to 2009, using a 7-day volumetric air sampler, followed by microscopy analysis. Dependence of bioaerosols on the weather conditions and land use were assessed using spatial and statistical tools. Obtained results were re-visited by a comparison with hospital admission data recorded at the Dr. Nélio Mendonça Hospital in Funchal. Our results showed that despite propitious climatic conditions, overall pollen grain and fungal spore concentrations in the air were very low and did not exceed any clinically established threshold values. Pollen and spore peak concentrations also did not match with asthma outbreaks in the winter. Identification of places that are "free" from biological air pollution over the summer, such as Madeira Island, is very important from the allergic point of view.

Spatiotemporal models for predicting high pollen concentration level of Corylus, Alnus, and Betula

Corylus, Alnus, and Betula trees are among the most important sources of allergic pollen in the temperate zone of the Northern Hemisphere and have a large impact on the quality of life and productivity of allergy sufferers. Therefore, it is important to predict high pollen concentrations, both in time and space. The aim of this study was to create and evaluate spatiotemporal models for predicting high Corylus, Alnus, and Betula pollen concentration levels, based on gridded meteorological data. Aerobiological monitoring was carried out in 11 cities in Poland and gathered, depending on the site, between 2 and 16 years of measurements. According to the first allergy symptoms during exposure, a high pollen count level was established for each taxon. An optimizing probability threshold technique was used for mitigation of the problem of imbalance in the pollen concentration levels. For each taxon, the model was built using a random forest method. The study revealed the possibility of moderately reliable prediction of Corylus and highly reliable prediction of Alnus and Betula high pollen concentration levels, using preprocessed gridded meteorological data. Cumulative growing degree days and potential evaporation proved to be two of the most important predictor variables in the models. The final models predicted not only for single locations but also for continuous areas. Furthermore, the proposed modeling framework could be used to predict high pollen concentrations of Corylus, Alnus, Betula, and other taxa, and in other countries.

Short-Term Effect of Pollen and Spore Exposure on Allergy Morbidity in the Brussels-Capital Region

Belgium is among the European countries that are the most affected by allergic rhinitis. Pollen grains and fungal spores represent important triggers of symptoms. However, few studies have investigated their real link with disease morbidity over several years. Based on aeroallergen counts and health insurance datasets, the relationship between daily changes in pollen, fungal spore concentrations and daily changes in reimbursable systemic antihistamine sales has been investigated between 2005 and 2011 in the Brussels-Capital Region. A Generalized Linear Model was used and adjusted for air pollution, meteorological conditions, flu, seasonal component and day of the week. We observed an augmentation in drug sales despite no significant increase in allergen levels in the long term. The relative risk of buying allergy medications associated with an interquartile augmentation in pollen distributions increased significantly for Poaceae, Betula, Carpinus, Fraxinus and Quercus. Poaceae affected the widest age group and led to the highest increase of risk which reached 1.13 (95% CI [1.11-1.14]) among the 19- to 39-year-old men. Betula showed the second most consistent relationship across age groups. Clear identification of the provoking agents may improve disease management by customizing prevention programmes. This work also opens several research perspectives related to impact of climate modification or subpopulation sensitivity.

Forecasting model of Corylus, Alnus, and Betula pollen concentration levels using spatiotemporal correlation properties of pollen count

The aim of the study was to create and evaluate models for predicting high levels of daily pollen concentration of Corylus, Alnus, and Betula using a spatiotemporal correlation of pollen count. For each taxon, a high pollen count level was established according to the first allergy symptoms during exposure. The dataset was divided into a training set and a test set, using a stratified random split. For each taxon and city, the model was built using a random forest method. Corylus models performed poorly. However, the study revealed the possibility of predicting with substantial accuracy the occurrence of days with high pollen concentrations of Alnus and Betula using past pollen count data from monitoring sites. These results can be used for building (1) simpler models, which require data only from aerobiological monitoring sites, and (2) combined meteorological and aerobiological models for predicting high levels of pollen concentration.

Temporal and spatiotemporal autocorrelation of daily concentrations of Alnus, Betula, and Corylus pollen in Poland

The aim of the study was to determine the characteristics of temporal and space-time autocorrelation of pollen counts of Alnus, Betula, and Corylus in the air of eight cities in Poland. Daily average pollen concentrations were monitored over 8 years (2001-2005 and 2009-2011) using Hirst-designed volumetric spore traps. The spatial and temporal coherence of data was investigated using the autocorrelation and cross-correlation functions. The calculation and mathematical modelling of 61 correlograms were performed for up to 25 days back. The study revealed an association between temporal variations in Alnus, Betula, and Corylus pollen counts in Poland and three main groups of factors such as: (1) air mass exchange after the passage of a single weather front (30-40 % of pollen count variation); (2) long-lasting factors (50-60 %); and (3) random factors, including diurnal variations and measurements errors (10 %). These results can help to improve the quality of forecasting models.

Long-term intense exposure to grass pollen can mask positive effects of allergenic immunotherapy on non-specific bronchial hyperresponsiveness

INTRODUCTION

There are many potential factors that can modulate bronchial reactivity, including exposure to allergens, viral infections, and medications. The aim of this study was to analyze the effect of grass pollination intensity on the bronchial reactivity in seasonal allergic rhinitis (SAR) patients subjected to subcutaneous allergenic immunotherapy (SCIT).

MATERIAL AND METHODS

This study, performed between 2005 and 2008, included 41 patients with confirmed sensitivity to grass pollens and predominating symptoms of SAR, randomly assigned to desensitization by pre-seasonal or maintenance SCIT. Bronchial provocation challenge with histamine was performed before the onset of immunotherapy, and repeated three times after each pollen season covered by this study. Bronchial reactivity was analyzed with regard to grass pollination intensity in 2005-2008 (air concentration of grass pollen grains, seasonal number of days when air concentration of grass pollen reached at least 20 or 50 grains per 1 m(3)).

RESULTS

After 3 years of SCIT, a significant decrease in bronchial responsiveness was observed in the analyzed group as confirmed by an increase in PC20 FEV1 histamine values (p = 0.001). An inverse tendency was observed after 2 years of SCIT, however. This second year of SCIT corresponded to the 2007 season, when a significantly higher number of days with at least 50 grains of pollen per 1 m(3) of air was recorded.

CONCLUSIONS

FLUCTUATIONS IN POLLINATION INTENSITY OBSERVED DURING CONSECUTIVE YEARS OF IMMUNOTHERAPY CAN INFLUENCE BRONCHIAL REACTIVITY IN PATIENTS SUBJECTED TO SCIT (ISRCTN REGISTER: ISRCTN 86562422).

Personal exposure to grass pollen: relating inhaled dose to background concentration

BACKGROUND

Very few studies on human exposure to allergenic pollen have been conducted using direct methods, with background concentrations measured at city center monitoring stations typically taken as a proxy for exposure despite the inhomogeneous nature of atmospheric pollen concentrations. A 2003 World Health Organization report highlighted the need for an improved understanding of the relation between monitoring station data and actual exposure.

OBJECTIVE

To investigate the relation between grass pollen dose and background concentrations measured at a monitoring station, to assess the fidelity of monitoring station data as a qualitative proxy for dose, and to evaluate the ratio of dose rate to background concentration.

METHODS

Grass pollen dose data were collected in Aarhus, Denmark, in an area where grass pollen sources were prevalent, using Nasal Air Samplers. Sample collection lasted for approximately 25 to 30 minutes and was performed at 2-hour intervals from noon to midevening under moderate exercise by 2 individuals.

RESULTS

A median ratio of dose rate to background concentration of 0.018 was recorded, with higher ratio values frequently occurring at 12 to 2 PM, the time of day when grass species likely to be present in the area are expected to flower. From 4 to 8 PM, dose rate and background concentration data were found to be strongly and significantly correlated (rs = 0.81). Averaged dose rate and background concentration data showed opposing temporal trends.

CONCLUSION

Where local emissions are not a factor, background concentration data constitute a good quantitative proxy for inhaled dose. The present ratio of dose rate to background concentration may aid the study of dose-response relations.

Variations in Quercus sp. pollen seasons (1996-2011) in Poznań, Poland, in relation to meteorological parameters

The aim of this study is to supply detailed information about oak (Quercus sp.) pollen seasons in Poznań, Poland, based on a 16-year aerobiological data series (1996-2011). The pollen data were collected using a volumetric spore trap of the Hirst design located in Poznań city center. The limits of the pollen seasons were calculated using the 95 % method. The influence of meteorological parameters on temporal variations in airborne pollen was examined using correlation analysis. Start and end dates of oak pollen seasons in Poznań varied markedly from year-to-year (14 and 17 days, respectively). Most of the pollen grains (around 75 % of the seasonal pollen index) were recorded within the first 2 weeks of the pollen season. The tenfold variation was observed between the least and the most intensive pollen seasons. These fluctuations were significantly related to the variation in the sum of rain during the period second fortnight of March to first fortnight of April the year before pollination (r = 0.799; p < 0.001). During the analyzing period, a significant advance in oak pollen season start dates was observed (-0.55 day/year; p = 0.021), which was linked with an increase in the mean temperature during the second half of March and first half of April (+0.2 °C; p = 0.014). Daily average oak pollen counts correlated positively with mean and maximum daily temperatures, and negatively with daily rainfall and daily mean relative humidity.

Allergenic immunotherapy and seasonal changes in nitric oxide concentration in exhaled air in seasonal rhinitis patients

BACKGROUND

Concentration of nitric oxide in exhaled air (FeNO) was revealed to decrease as a result of immunotherapy. However, individuals who are exposed to environmental allergens are characterized by elevated values of FeNO. The aim of this study was to analyze the effects of subcutaneous immunotherapy (SCIT) on the dynamics of FeNO determined during consecutive pollination seasons.

METHODS

This study, performed between 2005 and 2008, included 41 patients with confirmed sensitivity to grass pollens and predominating symptoms of seasonal allergic rhinitis, randomly assigned to desensitization by preseasonal or maintenance SCIT. FeNO was measured prior to and during each pollen season (November-January and May-July, respectively). The results were conferred to data on grass pollination intensity in 2006-2008 (air concentration of grass pollen grains, seasonal number of days when air concentration of grass pollen reached at least 50 grains per 1 m(3)).

RESULTS

Median content of FeNO in exhaled air was significantly higher in 2007 compared to 2006 and 2008 pollen seasons. During 2007 and 2008 pollen seasons, significant increase in FeNO was observed compared to the respective preseasonal values. Median number of days with air concentration of grass pollen ≥ 50 grains per 1 m(3) of air during 4 weeks preceding seasonal FeNO measurement was significantly higher in 2007, corresponding to higher FeNO value recorded during this pollen season. However, no significant correlation was observed between seasonal number of days with ≥ 50 grass pollen grains per 1 m(3) of air and FeNO in exhaled air (r=0.09, p=0.362).

CONCLUSIONS

Most seasonal allergic rhinitis patients show physiological levels of FeNO prior to the pollen seasons and a marked increase in this parameter, probably proportional to pollination intensity, is observed within the seasons. ISRCTN Registry: ISRCTN86562422.

Determination of ranges for reporting pollen aeroallergen levels in the Washington, DC, metropolitan area

BACKGROUND

Local aeroallergen monitoring provides useful information for the atopic patient and medical community. Currently, National Allergy Bureau (NAB) ranges are used for reporting pollen count levels in the Washington, DC, area.

OBJECTIVE

To determine standard range criteria (low, moderate, high, and very high) for the reporting of specific tree, grass, and weed aeroallergens representative of the Washington, DC, metropolitan region.

METHODS

Atmospheric sampling for pollen aeroallergens was performed using a volumetric rotating-arm impaction sampler (model 40 Rotorod, SDI Company, Plymouth Meeting, PA). The cumulative pollen count, over a 12-year period (1998-2009), was determined for specific pollen aeroallergens. Local ranges were developed using methodology previously employed to determine NAB ranges. A comparison was made between NAB and Washington, DC, area ranges.

RESULTS

The local median count, and low and moderate range criteria, are markedly lower than NAB range counts for tree, grass, and weed pollen. The NAB 99th percentile (high) count is significantly higher for grass and weed pollen but lower for tree pollen. Using new local range criteria, an increase was seen in the number of high days recorded for weed pollen (1,300%), grass pollen (258.6%), and tree pollen (11.8%). Previously, using NAB range criteria, no very high days were reported for grass and weed pollen over the 12-year period.

CONCLUSION

Washington, DC, ranges establish more relevant reporting standards for our local patient population and will allow for comparison with reporting levels developed for sampling locations nationwide as well as with other regional sites.

Prospective validation of 'Allergy-Control-SCORE(TM)': a novel symptom-medication score for clinical trials

BACKGROUND

Combined symptom and medication scores (SMS) are recommended as primary endpoints in clinical trials. Several SMS have been created, but none has been formally validated.

OBJECTIVE

To evaluate the validity of the 'Allergy-Control-SCORE© (ACS)', a novel instrument to assess patient's allergy severity by recording symptoms and rescue medication.

METHODS

One hundred and twenty-one consenting subjects (age 18-65 year), including 81 patients with allergic rhino-conjunctivitis and/or asthma and 40 healthy controls, participated in the study. They recorded daily nasal, eye, and lung symptoms using a 4-point scale (none, mild, moderate, and severe) and use of anti-symptomatic medication. Pollen counts were monitored during the study period. Symptom and medication scores values were compared to global allergy severity, quality of life, and allergy-related medical consultations. Feasibility was tested through a questionnaire on comprehensibility, easiness of use, and completeness. Retest reliability was assessed by testing consistency, in relation to pollen exposure, and for values recorded during each of 2 consecutive weeks.

RESULTS

Convergent reliability analysis indicated a highly significant correlation between ACS© and global allergy severity (P < 0.0001), quality of life (P < 0.0001), and allergy-related medical consultations (P < 0.0001). Scores were highly related to pollen counts. Allergy-Control-SCORE© showed a good retest reliability (r = 0.81; P < 0.0001) and discriminated extremely well between patients with allergy and healthy controls (6.1 ± 4.8 vs 0.2 ± 0.5; t = 10.82; P < 0.0001) with a sensitivity of 97% and a specificity of 87%. Study participants evaluated the feasibility of the SMS as excellent.

CONCLUSIONS

Allergy-Control-SCORE© is a valid and reliable instrument to assess allergy severity in clinical trials and observational studies of respiratory allergic diseases.

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.