WebMD Health - Allergies

Dec 20, 2010 8:43 PM

Best Cities for Allergies in U.S.

If you sneeze your way through spring, fall, and in between, you probably yearn to live in an allergy-free city. Is there a locale free of allergens? Are there best cities for allergies?

The nonprofit Asthma and Allergy Foundation of America issues lists each year for the worst cities for spring allergies, and the worst cities for fall allergies. Each list looks at 100 metropolitan areas and ranks them. It doesn't label them "best" or "worst," but does say that some cities are ''the most challenging places to live'' with allergies.

The foundation takes into account factors such as pollen counts, the number of people who use allergy medication, and the number of board-certified allergists in that location.

But that doesn't mean cities low on the foundation's list are necessarily the "best cities" for living with allergies, says Mike Tringale, a spokesman for the Asthma and Allergy Foundation of America. "Allergic triggers are everywhere."

Making Sense of Allergy Capitals List

"It's just as important for someone who lives in the No. 99 city [on the list] to use these same allergy management strategies as No. 1. Work with their doctor, be diagnosed, and get the right kind of treatment," says Tringale.

Still, who can resist a top 10 or 100 list, including the allergy foundation? So, for your interest, here are the cities that ranked 90 through 100 on the fall allergy capital list of the Asthma and Allergy Foundation of America. This means, theoretically, they had better than average conditions for allergy sufferers.

  • Boston
  • Stockton, Calif.
  • Ogden, Utah
  • Salt Lake City
  • Sacramento, Calif.
  • Greenville, S.C.
  • San Diego
  • Seattle
  • Albany, N.Y.
  • Portland, Ore.

And the Challenging Cities for Allergy Sufferers Are ...

Which cities ranked 1 to 10 on the allergy capitals list of the Asthma and Allergy Foundation of America? Quite a few warm and humid communities.

  • McAllen, Texas
  • Wichita, Kan.
  • Louisville, Ky.
  • Oklahoma City
  • Jackson, Miss.
  • Dayton, Ohio
  • Augusta, Ga.
  • Tulsa, Okla.
  • Knoxville, Tenn.
  • Little Rock, Ark.

Certain factors within a location do play a role on how miserable allergy sufferers will be, experts agree. Here, some of the factors that can affect whether your allergy symptoms are better or worse.

Allergy Challenge No. 1: City Size

Larger urban areas may be worse for your allergies than less populated cities, says Jeff Demain, MD, a board-certified allergist and immunologist in Anchorage, Alaska and an associate clinical professor of pediatrics, University of Washington, Seattle.

''Larger urban areas are known to have higher pollution levels," he says. And experts have long suspected a link between air pollution and allergies. The common pollutants -- ozone, nitrogen dioxide, sulfur dioxide -- probably act more as irritants than anything, aggravating your existing allergies and worsening your symptoms.

Diesel fumes, however, are thought to promote allergy, and large urban areas have an abundance of truck diesel exhaust.

The exhaust can enhance your body's ability to make the allergy antibody, IgE (immunoglobulin E), in response to allergen exposure, experts believe.

Rising carbon dioxide levels in the atmosphere have been liked with stimulating the pollen production of allergy-provoking plants such as ragweed.

Allergy Challenge No.2: Weather Conditions

If your city is often full of moist air, that's better than dry and cold, Demain says. "Generally speaking, moist is better.''

When air is dry and cold, it tends to dry and disrupt the membranes of the nose, for instance. And that's bad for allergies, Demain says.

Allergy Challenge No.3: Pollen Count

Pollen from trees, grasses, and weeds are powerful triggers for allergies. So areas of high pollen will naturally be more problematic.

But pollen counts vary a lot, says Demain. ''Dry sunny days following a rain will have the highest levels," he says.

Pollen counts may also change from year to year.

Allergy Challenge No. 4: Geography

Living in a city by the water may be good for your allergies, Demain says, as the wind is likely to blow away potential allergens and irritants.

But that's not foolproof either, he says. Pollen can travel in the air a long time -- up to 20 minutes, according to the American Academy of Allergy Asthma & Immunology. How far can pollen travel? Some experts say it can to 200 miles or even farther. So pollen can be blown into the city from afar.

Allergy Challenge No. 5: Access to Medical Care

''If you move where there are not too many allergists'' that too can affect care, says Derek Johnson, MD, an allergist in Fairfax, Va. If it's difficult to get allergy care, chances are your management won't be ideal.

Know Your Personal Allergy Triggers

A city that may be the worst allergy city for a friend may not be bad at all for you. It all depends on your specific triggers. And that varies from person to person, allergists say.

''You have to be aware of what you are allergic to," says Johnson. For some people, molds are the biggest problem; for others, pollen from trees, grasses, or weeds. And one common allergen -- dust mites -- have nothing to do with the climate or locale.

Plus, conditions in a single city can change from year to year, says Andy Nish, MD, a Gainesville, Ga., allergist. One year, the pollen counts may be continually high and another year low. Mold counts can change depending on the weather. And some types of mold thrive in dry weather while others need high humidity.

Says Nash: "I don't think I ever have encouraged someone to move based on allergies or asthma."