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25 Worst Major Cities for Allergies in 2020

In this article we explore the 25 Worst Cities for Allergies. Click to skip ahead and jump to the 10 worst U.S. cities for allergies.

Scratchy throat, runny nose and cough? Well, before the fear of Covid-19 grips you, consider that allergy season is right around the corner! 

Living with allergies can be a never ending struggle. For a patient with allergies, it is a constant process of identifying the triggers that set off their symptoms. People might be allergic to different things. It might be a specific type of food, some contaminant in the air, or some other allergens like mold  plants, insects, animals, and drugs that one might come in contact with. This makes it important for your surroundings being free from the allergy causing triggers. Specific cities are therefore worse than others when it comes to living with allergies. 

For all you know, the places you are living in might be aggravating the allergies you have. It especially becomes more important to find out if specific places you are planning to travel to or are considering moving to, are safe and free from allergens that might trigger your allergy symptoms. 

While most allergies can be mild, symptoms like sneezing, throat scratching, cough, and annoying rashes are also common. However, symptoms can also be more severe or lead to health issues like low blood pressure (hypotension),breathing issues, hives, eczema and also asthma. Findings have indicated strong connections between allergies and asthma. Asthma can be triggered by pollen, dust or mold in certain patients. Asthma caused by allergies is also the most common type of asthma in the US. This is caused by the inflammation of the lungs as a result of allergy reaction, and ultimately causing asthmatic symptoms. 

Approximately 24 million Americans suffer from asthma, including 6 million children who are affected by it, according to American College of Allergy, Asthma and Immunology (ACAAI)

Quest Diagnostics, one of the leading diagnostic testing companies, has identified in its study that 53% of asthma patients had allergic tendencies. This has also prompted the  National Asthma Education and Prevention Program (NAEPP) to recommend patients to avoid exposure to common allergens in their surroundings. Considering this, the 30 most polluted cities in the US, can also be some of the cities to avoid. 

Food allergies are extremely common too. The  2014 National Health Interview Survey (NHIS), 5.4%  children suffering from food allergies. Eczema can also have a link to food allergies, especially caused by eggs, milk and peanut. Children may also develop hay fever due to progressive food allergies, and 8.4% of children in the US have been found to suffer from hay fever. 

Over the years, it has also been observed that the overall allergies trends have been rising in the US. Allergies connected to ragweed are the most common, and have grown over 15% in the last 4 years.  Southwest, Great Lakes, Mountain, and Plains States are the worst for ragweed allergies. 

Allergies occur when a patient’s immune system identifies an allergen as harmful and triggers the release of histamines to resist the contact with the specific allergens resulting in allergy symptoms. There are a few ways to discover allergy triggers, including skin prick test or food challenges. 

However, the best way or the “gold standard” in the journey of identifying allergens that are triggers for you, is the ImmunoCAP® specific immunoglobulin E (IgE) blood test (ImmunoCAP). The Quest Diagnostics Health Trends Report  by Quest Diagnostics (DGX), is based on a series of ImmunoCAP blood tests and hence, reveals some very comprehensive findings. Through these tests it has been identified that patients are susceptible or sensitized to at least 1 out of 11 common allergens. 

While allergies can be triggered by a number of things, there are certain allergens that most often affect specific patients or sensitization to certain allergens. “Sensitization” implies that a patient has an allergen-specific IgE. For finding out the worst major cities for Allergies, we can therefore take two routes. First is to identify levels of specific allergens like pollen or mold, present in the environment of each city. The widely circulated report by Asthma and Allergy Foundation of America (AAFA), “the 100 most challenging places to live with allergies,” is based on a methodology that tracks pollen levels, as well as allergy prescriptions in each city. 

The second approach is based on sensitization rates, by identifying the worst cities based on the highest sensitization to certain identified allergens. The “Allergen Sensitization Index” developed by the Quest Diagnostics examines combined sensitization levels across  5 allergen categories: food  (egg white, milk, peanut, soybean, and wheat), common ragweed, mold, house dust mites, cat epithelia (skin) and dog dander. 

The research tracks sensitization rates over 4 years in the 30 most populous metros. It was, however,  noted that allergen sensitization was a major cause of concern in all 30 cities. 

An increasing trend in the allergen-sensitization rate has also been noted in the study with a 19% increase in  the number of patients tested for these 11 allergens. Children also appear to be more susceptible to sensitization than adults. Senstiation to at least 1 allergen was 53%  among children while it  was at only 37% for adults. 

We have based our rankings of the worst major cities for allergies based on this comprehensive research. That being said, both studies have reiterated one fact –  “There is no place safe from allergies in America.”

Let’s take a look at our final rankings. 

25. San Antonio

Allergen Sensitization Index – 610

The South-Central Texas city, house house dust mites and ragweed pollen. Pollen count in the air is quite high and a cause of concern. Percentage of patients who are sensitized to ragweed pollen were 17% and those sensitized towards house mites were at 23%.