According to the Asthma and Allergy Foundation of America’s 2021 Allergy Capitals, New York City ranks 58th in the top 100 allergy capitals in the United States.
Yet, NYC allergies are influenced by more than just seasonal bursts.
Rather, a number of factors including perennial environmental allergens, air quality, pollutants and climate change also influence NYC allergies. Recognizing this regional mix of triggers is essential to the prevention and proper treatment of allergies in New York.
Dogwood in the spring, leaves turning in the fall, snow blanketing Central Park in January… NYC residents must deal with all four seasons of the northeastern U.S. weather pattern that lead to typical seasonal pollen allergies.
The large effort by the NYC parks department to populate the city with greenery has also created a unique urban landscape where exposure to seasonal allergens is inevitable.
Spring allergy season in NYC has an early and late phase. In April and early Mary, tree pollen abounds, culprit trees like oak, elm, ash, cedar, maple and others cause that first burst of intense allergy symptoms.
Late May and early June bring grass allergies. In July and August, NYC’s heat and humidity lead to both indoor and outdoor mold levels rising, a problem for mold-sensitive allergy sufferers.
In late August and into the fall, ragweed begins to surface, peaking in mid-September, but ragweed can persist even into November.
If you live in NYC and suffer from seasonal allergies, you can expect those classic allergy symptoms.
Spring is known for seasonal allergy symptoms that can range from intensely itchy watery eyes, nasal congestion, sneezing and scratchy throats to sinus, asthma exacerbations and bronchitis (to name a few).
Skin symptoms are an increasingly common complaint during allergy season.
Contact with pollens can quickly lead to generalized itch and rash. This typically presents as hives, which resemble mosquito-bite that can be intensely itchy. Others with chronic eczema or atopic dermatitis might find that their itchy skin eruption is worse during the high pollen seasons.
Some only experience itching, redness and swelling periorbitally, or in the skin around their eyes as the eyes can be an area of intense inflammation as well.
Fall ragweed pollen can also lead to severe symptoms for asthmatics in NYC, in part because ragweed is so heavily transported by wind.
In fact, the Allergy and Asthma Foundation of America warns about “peak week” in September, a time when asthma hospitalizations rise because of ragweed, which can produce billions of pollen grains that easily migrate hundreds of miles on windy days in New York.
Mold in the summer and fall commonly causes sinus pressure and chronic cough. Mold spores can also be a significant indoor allergen and lead to chronic coughs with a more protracted year-round presence.
Mold spores may be inhaled, lodge in the respiratory tract and trigger coughing (and more severely), asthma symptoms.
Perennial environmental allergens (in contrast to seasonal ones) are without a doubt part of the NYC allergyscape.
NYC has high levels of dust mite, roach, mold, mouse and animal allergens, particularly in inner-city high rises.
Living in close quarters means that these allergens in one apartment can quickly populate those of neighboring homes.
Studies have also shown that this higher density of allergens has led to an increased prevalence of allergies and asthma, especially in children in New York.
Year-round allergies tend to present with more chronic allergy symptoms like nasal congestion, chronic sinus infections, asthma with chronic cough and eczema.
Ever feel there are days where you are walking down your street in New York and you can’t take in a good deep breath?
Air quality may be to blame.
NYC air quality is less than perfect and can silently but significantly impact allergies.
When we talk about air quality (especially in urban areas) we focus on specific pollutants that are present in the air we breathe and consequently can have an effect on our wellbeing. These include PM2.5 or fine particulate matter, ozone (O3), nitrogen oxides, sulfur dioxide and elemental carbon.
New York’s air quality index specifically measures how polluted the air is and how it can affect health.
Fine particulate matter or PM2.5 are small particles that are two and a half microns or less in width and are produced by vehicle exhaust, fuel combustion, power plants, wood burning, fires and other sources.
These small particles can lodge deep into the respiratory tract and contribute to an inflammatory cascade worsening allergies, asthma and coughs and trigger bronchitis (among other issues).
Ozone is a gas that enters the air from motor vehicle exhaust and industrial emissions.
Ozone is naturally present approximately 10 to 30 miles above the earth’s surface, where it protects us from the sun’s harmful rays; however, at ground level, ozone creates smog which is associated with chronic cough, bronchitis, irritant cough and inflammation that can both trigger and worsen allergies and respiratory illnesses like asthma.
Nitrogen oxides are gases produced by fuel combustion and include nitric oxide (NO), which is converted to nitrogen dioxide (NO2) after emission from vehicles and other sources. Nitrogen oxides also contribute to the formation of ozone.
Exposures have been associated with causing and worsening respiratory conditions.
Other pollutants such as elemental carbon (EC) and sulfur dioxide are produced by industrial fossil fuel combustion. Both are significant air pollutants that can also lead to increased respiratory illnesses, cough, worsening asthma and allergies.
Compounding these air quality effects is the overarching presence of climate change. Climate change is a significant environmental and public health issue.
The Allergy and Asthma Foundation of America and the National Wildlife Federation’s report on Extreme Allergies and Climate Change found that between 1995 and 2011, warmer temperatures in the U.S. due to climate change have caused the pollen season to grow to 11 to 27 days longer.
These warmer temperatures create more pollen in the air, stronger airborne allergens and more allergy symptoms. Climate change also means that more airborne allergens lead to more asthma attacks and other allergens such as mold and poison ivy grow faster and can be more toxic.
NYC allergies are very much affected by these patterns of climate change, with each season seeming to make allergy sufferers wonder why their allergies are worse than ever before.
Allergy and asthma can be severe in NYC, but there are steps you can take to curb symptoms.
If you find that your breathing is worse on hot, humid days, it may be due to poor air quality combined with high allergen levels.
Certain neighborhood factors can also affect your local air quality. For example, high truck and traffic volume, industrial facilities and older heating systems can all contribute to increased levels of air pollution in certain neighborhoods.
Similarly, factors such as poor building maintenance can lead to mold or insect infestation which can also trigger asthma symptoms.
Being aware of your local environment is a big step toward tackling your health issues.
If air quality affects your allergy and asthma, avoid being outdoors for prolonged periods on poor air quality days, wear a mask if you can, take your allergy and asthma medications before going out and have rescue medications at hand. Remove your clothes immediately and shower, making a point to wash your hair and rinse your eyes.
If you live in a more densely populated building or close to environmental pollutants such as highways and industrial facilities, invest in a HEPA-certified air purifier in your home to help monitor air quality and filter out pollutants.
A HEPA vacuum cleaner will make sure indoor allergens from dust mites, rodents, insects, animals and mold stay in the vacuum and do not recirculate in your home for you to breathe.
Allergy and asthma treatment goes hand in hand with prevention. Meeting with an allergy specialist at Curex can identify your allergic triggers and define your diagnosis, opening the window to optimal treatment.
Second-generation antihistamines are newer oral antihistamines with fewer side effects such as drowsiness. They help control symptoms by inhibiting histamine, the essential mediator of the allergic cascade.
These pills are also available as combination antihistamine/decongestants when nasal and ear congestion, sinus pressure and excessive mucous and postnasal drip are issues.
Studies have shown that intranasal steroid sprays are the most effective treatment for allergic rhinitis.
Typically, they are used together with oral antihistamines as the cornerstone of seasonal allergy therapy.
Antihistamine nasal sprays are another potential therapy that can be used as add-on therapy.
Nasal decongestant sprays are popular over-the-counter remedies but should only be used for short bursts when congestion is severe. Long-term use of nasal decongestant sprays is discouraged because they can lead to rebound congestion or rhinitis medicamentosa — a condition where nasal congestion becomes worse from overuse of decongestant spray.
A variety of eye drops might be prescribed for the treatment of ocular allergy.
Eye drops can be anti-inflammatory or work by inhibiting the activity of the main allergic cell, mast cells and the mediator they release, histamine, which leads to those classic symptoms.
In severe cases, a short course of steroid/anti-inflammatory eye drops may be necessary to calm things down.
Additional allergy treatments include anti-inflammatory pills such as Singulair (Montelukast) which inhibits allergic and asthma, as well as oral steroids in severe cases. Similarly, inhalers may be prescribed for allergic asthma and topical therapies may also be used for skin symptoms.
Advising which OTC remedies to use will also be helpful.
Early treatment with allergy medications can help mitigate symptoms by offering a barrier of protection before high pollen levels hit and create a difficult cycle to reverse. Think two weeks ahead of the start of the season as a good time to start daily medication.
Subcutaneous immunotherapy is another term for allergy shots.
Allergy shots introduce the allergens to which you are allergic in increasing doses through frequent shots given by a small injection into the fatty area of your arm.
The shots may be administered in a doctor’s office and then followed by an observation period of up to 45 minutes to make sure you don’t have a reaction.
Sublingual immunotherapy (SLIT) like allergy shots, exposes your body to gradually increasing doses of an allergen in order to increase your tolerance to the allergen. Over time, it may reduce your seasonal allergy symptoms.
With SLIT, the allergen is in the form of a liquid or tablet that is placed under the tongue.
Conveniently, SLIT is self-administered at home and is safer because it may cause fewer reactions.
As climate change and air quality continue to stir up more intense seasons and symptoms, taking steps now will help you feel better before the next NYC allergy season rolls around.
Start with Curex’s at-home allergy testing which will identify which allergens are making you miserable.
With a Curex allergy specialist, you can then create a lasting treatment plan based on your needs, that may help kick those NYC allergies to the curb.