NASE News

Gesundheit! How To Cope With Hay Fever

Ladies and gentlemen: grab your tissues! For those who suffer from hay fever, the sneezing season has begun.

The Mayo Clinic estimates that 20 percent of Americans suffer from this misnamed malady, which doesn’t cause fever and has nothing to do with hay. Instead, the problem is an allergic reaction to plant pollens light enough to be borne on the wind.

The common name came from British doctors in the early 1800s, who observed that some of their patients were affected by sneezing, congested or runny noses, and itchy, watering eyes during the haying season.

Symptoms can also include itching of the nose, throat, mouth and ears. When nasal congestion is severe, the allergic response can interfere with sleep. Some allergy sufferers also experience headaches, fatigue or irritability.

Although we can’t stop Mother Nature from producing allergens, people susceptible to hay fever can do plenty to minimize the dripping, sniffing and sneezing. This article provides the tools and information you need.

The Causes Of Allergic Reactions
Allergies are a false alarm that occurs when the body tries to defend itself against substances that aren’t actually dangerous—like pollen, dust, cat hair and mold.

In susceptible people, the immune system considers the allergen an invader, as a germ or virus would be, and produces antibodies to fight it. This response initiates the release of inflammatory chemicals, including histamine, which causes swelling of mucous membranes in the nose, eyes and sinuses.

Pollens—the cause of hay fever—are some of the most common allergens. Of the top-10 allergens in the U.S., five are plant pollens from ragweed, Bermuda grass, rye grass, white oak and Russian thistle, says the National Institute of Allergy and Infectious Diseases (NIAID).

Spring isn’t the only time hay fever can strike, the American Lung Association cautions. Your allergenic season depends on whether you’re sensitive to trees, grasses or weeds—or all of the above.

Allergens are abundant in early spring, when trees such as ash, beech, maple, birch, elm, cedar, hickory, oak and poplar are busy making pollen.

Grass pollens—allergens for about half of those who suffer from hay fever—circulate in late spring and early summer.

Weeds can be a problem from mid-summer to late fall. The worst offender is ragweed, to which 75 percent of plant-allergic people are sensitive, reports the American College of Allergy, Asthma & Immunology.

Over-The-Counter Medicines Can Help Relieve The Misery
Your local drugstore’s shelves are full of products that promise to relieve allergy symptoms. Several of the newer offerings, including loratadine (Claritin) and cetirizine (Zyrtec), were introduced as prescription medicines but are now available over the counter (OTC).

  • Antihistamines work by blocking the release of histamine, the immune-system chemical that causes itching, sneezing, watery eyes, and runny nose. Cromolyn sodium (NasalCrom) is an antihistamine nasal spray that targets drippy nose and helps prevent sneezing. Some antihistamine tablets cause drowsiness, so talk to your pharmacist about which ones are safe to use while working and driving.

    These drugs are most effective when taken regularly rather than in response to an allergy attack. The American Academy of Family Physicians reports that OTC antihistamines usually work as well as their prescription counterparts.

  • Decongestants—whether tablets or nasal sprays—help shrink swollen nasal membranes and make breathing easier. Decongestant sprays should be used only for brief periods, though, as they can cause rebound congestion. In tablet form, these drugs affect the entire body and can cause nervousness, heart palpitations and sleep difficulties. They may also interact with prescription medicines, so discuss the options with your doctor or pharmacist.

Doctors Can Prescribe Treatments
If your allergies are mild and can be controlled by OTC medicines, there’s probably no need to see a doctor.

But if your symptoms are severe or persistent and interfere with your work, leisure activities or sleep, it’s time to visit an allergist or your general practitioner. Don’t minimize the problem by telling yourself, “It’s just allergies.”

The National Institutes of Health states that in some people, allergies can lead to even more serious consequences such as chronic inflammation of the sinus cavities or even asthma, a lung disease that narrows the airways.

The treatment plan for allergies may include prescription medicines, immunotherapy (allergy shots), or both.

Several kinds of medicine are available by prescription, including nasal sprays, antihistamines, decongestants and leukotriene inhibitors.
  • Nasal sprays: Corticosteroid sprays are often highly effective against hay fever, although you may not notice improvement for a week or more. They can be used for long periods of time. Nasal atropine spray helps treat runny nose.

  • Antihistamines: Older drugs in this category often cause sleepiness, but more recent releases, such as fexofenadine (Allegra), are less likely to make you drowsy. Some antihistamines that were formerly prescription-only are now available OTC, including loratadine (Claritin) and cetirizine (Zyrtec). Prescription eye drops are available to help calm itchy, swollen eyes.

  • Decongestants: These medicines come in liquid, tablet and spray form and in both prescription and OTC formulas. If you have high blood pressure or an enlarged prostate, oral decongestants may not be suitable.

  • Leukotriene inhibitors: The tablet form of montelukast (Singulair) can reduce production of histamine and mucous by interfering with the action of certain immune-system chemicals.

  • Allergy shots: In addition to prescribing medicines, your doctor may wish to try allergy shots, also known as immunotherapy. The goal is to reduce and perhaps even eliminate allergic reactions by injecting increasing doses of the target allergens. Eventually the immune system becomes desensitized to the allergens, so its response becomes less severe.

Before beginning immunotherapy, you’ll probably be asked to undergo skin-testing to determine which substances you’re allergic to. Tiny amounts of purified allergens are injected into the skin of the arm or upper back. The doctor then checks to see which injection sites show redness or swelling. Another option is a blood test called the radioallergosorbent test, or RAST.

If you go the immunotherapy route, shots are typically administered in two phases. In the buildup phase, often lasting three to six months or more, shots are given as often as three times a week, with incrementally larger doses of allergens. The maintenance phase can last several years but shots are less frequent—perhaps once a month.

Immunotherapy can be especially useful for people whose allergies act up most of the year and who don’t respond well to drugs.

Allergy Fact And Fiction
Medical treatments for allergies are better than ever—but that doesn’t mean you won’t hear some questionable advice on the street. Here’s the truth:
  • Can locally produced honey reduce symptoms? Probably not. The theory is that because local honey contains pollen, eating it could desensitize you to local allergens. But there’s no reputable medical evidence to back it up. In fact, the Asthma and Allergy Foundation of America reports that ragweed-sensitive individuals may have intense reactions, possibly including shock, after eating honey that contains pollen from plants in the same family.

  • What about vitamin C? Researchers have found no evidence that vitamin C and other food supplements are effective against allergies, although they may have other health benefits.

  • Should people with allergies exercise?Generally speaking, yes. But avoid exercising outside when pollen counts are high (check the National Allergy Bureau online at www.aaaai.org/nab). Pollen generally peaks between 10 a.m. and 4 p.m. and travels farthest on warm, dry, windy days. If symptoms are severe, take the day off. If you feel overly fatigued or short of breath while working out, rest for a few minutes and reduce the intensity. Those who have exercise-induced asthma should seek a doctor’s advice before beginning a fitness program.

  • Does it help to wash the nasal passages with saltwater? Yes. A 2007 study published by the University of Michigan Health System found that flushing the nasal passages with a saltwater solution provided better relief of symptoms than using an over-the-counter saline spray. Ask your doctor how it’s done.

Hay Fever In The Workplace
Reducing you and your employees’ exposure to allergens can make the workplace more comfortable—and the people more productive. Here are some tips:

  • During peak pollen seasons, keep doors and windows closed.

  • Use air-conditioning to remove allergens and humidity from the air, and set the equipment on re-circulate so fresh pollen isn’t continuously brought in.

  • Depending on the size of the office, consider running one or more air cleaners with a HEPA (high-efficiency particulate air) filter. These special filters are effective at trapping extremely small allergen particles.

  • Keep the grounds around your building neatly mowed and free of weeds.

  • If employees are also allergic to dust mites, have the office cleaned frequently, and consider eliminating drapes, silk flowers, fabric-upholstered furniture, rugs, carpeting and other dust-catchers.

Finally, if employees are undergoing a regimen of allergy injections, be flexible to ensure they can meet their appointments. Immunotherapy works best when shots aren’t missed.

For More Information
To learn more, visit these government-sponsored and independent Web sites.

The National Institute of Allergy and Infectious Diseases
Offers detailed information for consumers, including free downloadable pamphlets in English and Spanish
www.niaid.nih.gov/

The American College of Allergy, Asthma & Immunology
Features an allergist locator and extensive patient information
www.acaai.org/

The National Allergy Bureau of the American Academy of Allergy, Asthma and Immunology
Check pollen counts for your area
www.aaaai.org/nab/

Asthma and Allergy Foundation of America
Contacts for regional chapters and details on coping with allergies
www.aafa.org/