Allergy patients have reported worsening symptoms that last longer than the usual allergy season. Amanda Dilger, MD, a member of the Comprehensive Otolaryngology and Facial Plastic and Reconstructive Surgery divisions at Mass Eye and Ear who researches environmental impacts on health care, explains the effects of climate change on allergies and how to treat worsening symptoms.
Seasonal allergies affect a quarter of the world’s population, and those who spend the spring and fall stocking up on tissues, nasal sprays and eye drops may have noticed an alarming trend in recent years. The runny nose, watery eyes and sneezing symptoms that used to occur only once or twice a year have lasted well beyond traditional allergy seasons and have become much more severe.
“I keep seeing patients whose allergies are getting worse not just in the spring and the fall, but year-round,” Dr. Dilger told Focus. “What most people don’t realize is that climate change is a major contributing factor.”
Allergies are a product of your environment
Seasonal allergies occur when the body confuses harmless, airborne substances (called allergens) for invasive pathogens. When the body encounters higher levels of allergens in the fall and spring, the immune system responds as if under attack. This response can vary by person; some people might get a runny nose in the fall, while others might experience itchy eyelids in the spring.
Plants and trees produce common allergens, such as pollen, based on the temperature and carbon dioxide levels in the environment. Climate change is associated with increased temperatures and worsening air pollution, which has had an adverse effect on the amount of allergens produced in recent years.
Since the 19th century, the average surface temperature of the Earth has increased by one degree Celsius from greenhouse gas emissions, according to NASA. The rise in temperature has lengthened traditional growing seasons, which is the time between the last freeze in the spring and the first freeze in the fall. It is when allergen levels are the highest. According to Dr. Dilger, in the past 50 years the growing season has extended anywhere from two to four weeks across the United States.
“When the growing seasons extend, so does a person’s exposure to allergens,” Dr. Dilger explained. “It’s one of the main reasons why we see an increase in patients with more severe symptoms, as well as symptoms that are year-round as opposed to seasonal variations.”
Grass and ragweed specifically produce more pollen in response to higher levels of carbon dioxide. Carbon dioxide levels have soared in recent years from fossil fuels and pollution, and the amount of airborne pollen has soared with it. Dr. Dilger said this trend could lead to more severe allergy symptoms unless the world can reduce its carbon footprint.
How do I treat my allergies?
As allergy symptoms worsen and seasons get longer, it’s important for people to understand their symptoms and how to reduce exposure to allergens. A comprehensive ENT specialist will work with patients to identify their symptom triggers using an allergy test, and evaluate them for other contributing factors, such as chronic sinus disease, or if they need to be referred to an allergist. Once the specific allergen has been identified and all other factors have been accounted for, symptomatic and surgical treatments can be explored, as well as immunotherapy.
Nasal sprays, topical eye drops, steroids and over-the-counter antihistamines are symptomatic medications that can alleviate swollen eyes, sneezing and congestion. If medications are ineffective, a specialist might suggest in-office allergy shots or sublingual immunotherapy, which conditions the body so that its immune system responds less adversely to an allergen over time.
Dr. Dilger says patients might need to adjust how long they use their medications due to the lengthening allergy seasons, which can be bothersome for some due to side effects.
Surgery is only considered when medications fail to provide relief and there are significant structural issues affecting symptoms. Inferior turbinate reduction is one such example. The inferior turbinates, which warm and humidify air in the nose, grow and shrink in response to allergies. When these turbinates are too large, they can obstruct airflow in the nose, which can exacerbate allergy symptoms. If medications fail to shrink the turbinate, then surgery is recommended.
Making a difference
The World Health Organization estimates that more than 100 diseases will continue to worsen from climate change. To buck this trend, Dr. Dilger wants to make physicians and patients aware of climate change’s impact on health, and not just allergies.
As a fellowship-trained facial plastic and reconstructive surgeon, Dr. Dilger also educates patients on the heightened risk of developing head and neck skin cancers, which can be attributed to the depletion of the stratospheric ozone layer from the burning fossil fuels. Much like treating allergies, Dr. Dilger advises patients to practice preventive measures year-round. Sunscreen with at least SPF 30, she said, should be applied throughout the year and patients with a history of skin cancer should schedule regular appointments with a dermatologist.
Dr. Dilger believes each person’s actions can make a difference in alleviating symptoms, especially her own. She recently authored a column in ENT Today about the different ways ENT specialists can reduce their carbon footprint. As of 2018, the healthcare sector was responsible for 8.5% of the total carbon emissions in the United States.
“Something everyone can do to mitigate worsening allergy symptoms is to address climate change,” Dr. Dilger said. “Making people aware of how climate change is affecting allergies and other conditions will help them understand the impact of their carbon footprint and the need to change it.”
About Our Expert
Amanda Dilger, MD is a fellowship-trained ENT specialist. She treats adults and children for ENT conditions and performs facial plastic and reconstructive surgery. Dr. Dilger sees patients at the Mashpee and Harwich locations.