Written by: Carrie Marzolf PA-C

May is National Asthma and Allergy Month.  Environmental allergies, also known as allergic rhinitis, affect 15-30% of people in the United States making it the fifth most common chronic disease in the United States (Weaver-Agostoni, 465). Allergic rhinitis is a reaction that occurs when an allergen in the environment is inhaled and causes the immune system to overreact. This results in symptoms that can be seasonal or year-round. Environmental allergies can be caused by seasonal allergens such as pollen from trees, grasses, and weeds or year-round allergens such as dust mites, cockroaches, and animals.  Mold can cause either seasonal or year-round symptoms.

It is important to recognize the signs and symptoms of environmental allergies because allergic rhinitis can negatively impact quality of life due to associated sleep disturbances, fatigue, and impairment of physical and social functioning (Dykewicz, 723). It can also cause decreased school performance and work productivity (Dykewicz, 724). In addition, allergic rhinitis in children and adolescents can cause irritability and inattention. (Weaver-Agostoni, 465).

There are several symptoms that can be due to environmental allergies. The allergens can cause swelling in the nose leading to symptoms such as nasal congestion, runny nose, sniffling, itchy nose, postnasal drip, or sneezing. In addition, some people also have eye irritation resulting in watery and itchy eyes. Other possible symptoms include sore throat, itching of the roof of the mouth or ear, throat clearing, fatigue, and cough.

The diagnosis of environmental allergies can be made based on symptoms and a physical exam by a medical provider. However, some people need skin allergen testing or a blood test, especially those who do not respond to standard treatment.  Skin allergen testing can help determine if allergens are playing a role in the person’s symptoms as well as identifying specific allergens.  This procedure is done in the office with results available the same day. Blood work is another option to identify allergy triggers. However, the blood test takes longer to get results, is not as good at identifying allergens, and can be more expensive (Weaver-Agostoni, 467).

For environmental allergies, there are ways to help decrease symptoms depending on the specific allergen. The list below has a few of the recommendations from the Academy of Allergy, Asthma and Immunology Association (AAAAI) to help manage environmental allergies:

Pollen

•   Shower or take a bath and change clothes after being outside
•   Keep car and house windows closed
•   Try to stay indoors more when pollen and mold counts are high
•   Avoid hanging clothes outside to dry

Dust mites.

•   Wash bedding weekly in hot water
•   Use dust mite covers for pillows and mattresses

Cats and dogs

•   No breed is allergy-free
•   Keep pets out of bedroom and off upholstered furniture
•   Remove carpeting and rugs which can trap pet dander

Medications are available to help treat environmental allergies. Some treatment options include nasal rinses, nasal corticosteroid sprays and oral antihistamines. These medications are available over the counter, but additional medication options are also available by prescription.

Some people continue to have allergy symptoms even with medications. Fortunately, other options are available. Allergy shots and allergy drops are a long-term treatment option for certain individuals.

Some people have environmental allergies that trigger asthma, which is referred to as allergic asthma.  Approximately 1 in 10 patients with allergic rhinitis will develop asthma (Weaver-Agostoni, 465). Asthma causes swelling and inflammation in the lungs that can make it hard to breathe. Allergic asthma is the most common type of asthma. An estimated 80% of childhood asthma and more than 50% of adult asthma cases may have an allergic component (Akar-Ghibril, 429).

Asthma symptoms usually include cough, shortness of breath, wheezing, and/or chest tightness. Symptoms can be worse at night or with activity and can be triggered by allergens or with acute illness. Asthma is primarily managed with inhalers, but other treatment options are available. It is important to have good control of asthma because asthma exacerbations can cause missed school or work days, emergency department visits, and hospitalizations. Asthma causes more than 3000 deaths annually in the United States (Gans and Gavrilova, 118).

Environmental allergies and asthma are common medical problems. Identifying any signs or symptoms that might be due to these medical conditions is important. Medical providers can help diagnose the condition(s) and guide treatment options. Referral to a specialist might be needed.

If you have any concerns or questions regarding your allergies and/or asthma, please contact Western Wisconsin Health at 715-684-1111 to set up an appointment.

Akar-Ghibril, Nicole, et al. “Allergic Endotypes and Phenotypes of Asthma.” The Journal 

Of Allergy And Clinical Immunology Practice, vol. 8, no. 2, 2020, pp. 429-40. doi:10.1016/j.jaip.2019.11.008

Dykewicz, Mark S et al. “Rhinitis 2020: A practice parameter update.” The Journal           of  allergy and clinical immunology vol. 146,4 (2020): 721-767. doi:10.1016/j.jaci.2020.07.007

Gans, Melissa D, and Tatyana Gavrilova. “Understanding The Immunology Of Asthma:

Pathophysiology, Biomarkers, And Treatments For Asthma Endotypes.” Paediatric Respiratory Reviews, vol. 36, 2020, pp. 118-27. doi:10.1016/j.prrv.2019.08.002

Pongdee, Thanai, editor. “Managing Indoor Allergy Culprits.” American Academy of 

Allergy, Asthma and Immunology.org. https://www.aaaai.org/Aaaai/media/Media

Library/PDF%20Documents/Libraries/EL-indoor-allergies-managing-patient.pdf. Accessed April 21, 2024.

“Spring Allergies.” American Academy of Allergy, Asthma and Immunology.org. https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/spring-allergies. Accessed April 21, 2024.

Weaver-Agostoni, Jackie et al. “Allergic Rhinitis: Rapid Evidence Review.” American 

Family Physician, vol. 107, no. 5, 2023, pp. 466-73.