While this spring’s much-anticipated “pollen vortex” – a massive, simultaneous release of tree pollen following the frigid “Polar Vortex” we experienced this winter – turned out to be something less spectacular, allergy experts are reminding us that we’re still in the earlier parts of what will certainly be a long, miserable allergy season.
And yet, while millions of Canadians suffer from allergies, many still aren’t getting the treatment they need. It’s a pattern that Dr. Gordon Sussman, Specialist in Allergy and Immunology at the University of Toronto, is hoping can finally be broken.
“What patients often do is that they don’t accept the symptoms,” he says, “and then the symptoms sort of drag them down. So allergies themselves will limit people’s work, sleep and overall productivity. [But] the treatment is quite safe and effective if it’s done correctly.”
Debunking the ‘Pollen Vortex’
Earlier in the spring, there were a lot of news stories that talked about a so-called “pollen vortex” – a sort of perfect storm of tree pollen releases, all at once as opposed to over a couple of weeks, precipitated by an unusually cold winter. But Dr. Sussman suggests there wasn’t much scientific evidence behind the purported cataclysm.
“It depends on more things than just the cold winter,” he says. “It depends on the summer before, whether it was a warm summer or a moist summer. And then when the buds come out from the trees, you’ll see the temperature influencing the pollen counts. But it’s more complex in terms of what’s going on than just the cold winter.
“Aerobiology is a pretty complex area, and what they’re talking about with the pollen vortex is very high [tree] pollen counts. Tree pollen counts in general for about the past decade have been really high. Whether that’s because of the weather or because of other reasons, we’re not really sure.”
In reality, Dr. Sussman suggests that this year has not been an exceptional one for pollen counts. But that doesn’t mean people aren’t suffering any less from allergies.
What are allergies – and how serious can they get?
It’s important to recognize just how serious allergies can be for many people. They’re not just a matter of a runny nose and watery eyes. Often, they can be considerably more debilitating.
“We’re talking about being allergic to what you breathe,” says Dr. Sussman. “ These pollens are landing in your nose and eyes, and they’re setting up an inflammatory allergic response so that your nose runs, sneezes and itches and your eyes itch and water.”
These symptoms affect millions of Canadians. A 2010 survey from Johnson & Johnson indicated that as many as 10 million Canadians suffer from allergic symptoms, while women are more likely than men to admit to them. And according to a 2013 survey commissioned by Claritin/Leger, 64 per cent of Canadians said allergies negatively affect either their own quality of life or that of a family member. The same survey indicated that one in seven allergy sufferers considered their symptoms to be “severe”.
Dr. Sussman is quick to add that while the “polar vortex” referred to the tree pollen season that peaks in the spring, other pollens such as grass and ragweed carry the season well into the fall. For many sufferers, it can be a long, difficult time, particularly if they don’t seek treatment.
“Allergies is more of a problem than just a little bit of running and sneezing and sniffling,” he says. “It’s daily stuffiness. It’s daily running and sneezing. It’s daily itchy eyes, itchy throat, itchy ears. It’s daily tears and feeling miserable. It’s more than just some running and sneezing. So if you go through that for six weeks, you can be pretty miserable.”
Asthma, air pollution and other complications
The connections between allergies, asthma and air pollution are complex, with wide-ranging implications.
“Air pollution is something that would generally make people with asthma worse,” Dr. Sussman explains. “So pollution can trigger asthma and respiratory symptoms. And it may help keep allergens in the air, because if there’s a lot of pollution in the air it would tend to hold it in.”
There’s also some evidence to suggest that pollutants in the air can have an effect on the allergenic qualities of plants. Dr. Sussman points to studies on ragweed that have shown samples of the plant found closer to high-traffic roads are more highly allergenic than samples found in the woods. This may mean that in areas of higher pollution, ragweed can cause more problems for allergy sufferers than it might in less-polluted areas – problems that become further exacerbated when that same pollution keeps pollen suspended in the air for longer periods of time.
Further complicating things for seasonal allergy sufferers is a phenomenon known as “pollen-food syndrome“, whereby pollen in the air can cause allergic reactions when eating certain kinds of food. While Dr. Sussman suggests these reactions are typically benign, causing an itchy sensation in the mouth or throat, rather than anaphylactic, it’s still some cause for discomfort. It’s reason enough for people to avoid eating certain foods, especially during allergy season when these sensitivities can be enhanced.
And it’s common, too. He points out that 50-70 per cent of those with an allergy to birch pollen, for example, will react to some raw vegetables and fruit such as apples and plums, or even some nuts. For those allergic to ragweed pollen, they may react when eating fruits in the melon family.
The first thing that’s typically recommended to allergy sufferers, says Dr. Sussman, is to avoid what you’re allergic to. But it’s a less than ideal course of action, especially in Canada, where we have short summers and thus limited time to enjoy the outdoors. In any event, pollen is light, airborne and travels long distances. “So unless you’re going to stay in a sealed building,” he says, “you’re going to be exposed to pollen because you have to breathe.”
That said, there are still some ways to minimize exposure to the offending allergens. These include keeping windows closed while indoors, using an air conditioner as a filter, and avoiding outdoor activities during morning hours, when pollen counts are typically higher.
Beyond that, Dr. Sussman recommends antihistamines – most of which do not cause unwanted side effects such as drowsiness. These drugs, he adds, can be used regularly for the duration of the allergy season. Other products, like nose sprays and eye drops, can be effective treatments as well.
For patients may not see much relief from these medications or who experience more severe symptoms, immunotherapy may be a more effective option. As Dr. Sussman explains, it works by exposing the allergy sufferer to a controlled dose, either orally or by injection, of the offending allergen. This exposure, over time, leads the patient to develop a degree of tolerance or immunity – and effectively treats the allergy itself rather than just managing the symptoms.
Still, the first thing allergy sufferers need to do is acknowledge the problem and go see their doctor. Unfortunately, many people are not doing that: 19 per cent of respondents in the Claritin/Leger survey said they did not seek treatment for their allergy symptoms.
“It’s important for people to be aware that allergies are treatable and its’ not just a trivial disease,” says Dr. Sussman. “It’s a common disease. It affects 20 per cent of the population, so it’s a pretty significant problem. People don’t really understand the impact it has on their lives.