CLEVELAND, Ohio — Cleveland is among the country’s worst cities for people with asthma, ranking fourth on the Asthma and Allergy Foundation of America’s latest rankings of the 100 most challenging U S. cities for living with asthma.
Several other Ohio cities also landed on the list, including Columbus (number 11), Dayton (19), Toledo (28), Cincinnati (29) and Akron (39).
Increasing levels of pollen from weeds — especially ragweed — and mold, along with the start of flu season and children’s return to school also make breathing more difficult for people with asthma and allergies this time of year, the foundation said.
So while others are out enjoying pumpkin patches and hayrides, seasonal spikes in ragweed pollen and mold make allergy and asthma sufferers retreat indoors.
The ragweed pollen season now lasts longer than ever due to warmer temperatures that last well into November in many parts of the country. In fact, pollen seasons now start about 20 days earlier, and the seasons are prolonged about 10 days longer than they did 30 years ago, according to the foundation.
Mold is another factor affecting people with allergies and asthma in the fall.
“Mold really starts increasing around the beginning of July and then it just keeps increasing,” said Dr. Jill Poole, spokesperson for the Asthma and Allergy Foundation of America, and division chief for Allergy and Immunology at the University of Nebraska Medical Center.
“The mold counts are still high across the country and in the Midwest. And they don’t really go down until there’s a hard freeze,” Poole said.
Other risk factors that can worsen asthma include pollen allergies, poverty, lack of health insurance, air pollution and cigarette smoking, the foundation said.
Allentown, Pennsylvania, was ranked first overall in the foundation’s national asthma rankings, followed by Lakeland, Florida (2), Charleston, South Carolina (3), Cleveland (4) and Detroit, Michigan (5).
There is a strong connection between asthma and allergies, health experts said.
Allergies in the lungs can result in asthma, a breathing disorder causing shortness of breath, wheezing, chest tightness and cough. People can have asthma without having allergies.
Allergies happen when the body has an abnormal response to things that aren’t typically harmful, such as pollen, pet dander and certain foods. People with allergies have an abnormal response that leads to sneezing, nasal congestion, itchy, watery eyes and itchy throat.
Physicians see more people with asthma in the fall due to ragweed allergies. Some also have trouble breathing due to cold or flu, said Dr. Neha Solanki, pulmonologist at the Cleveland Clinic.
“Pollen can make an individual’s asthma worse,” Solanki said. “If someone is struggling with breathing and gets the flu, their breathing symptoms could be much worse and could lead to more trips to urgent care or to the hospital.”
More than 27 million Americans — or 1 in 12 people — have asthma, according to the foundation. Rates are highest among Black and indigenous communities.
The Asthma and Allergy Foundation of America’ asthma report analyzed data from the 100 most populated cities in the continental United States to determine a city’s ranking. The rankings are based on asthma prevalence, emergency department visits for asthma, and deaths due to asthma.
When coping with fall allergens, Poole tells her patients to take their medication before spending the day outdoors. “That’s what I find the biggest problem — people aren’t using a medication,” Poole said.
Poole also advises her patients to take non-sedating antihistamines, and avoid the sedating kind.
“The problem with those sedating ones is they’re really short-acting — only four to six hours,” Poole said. “But we have good non-sedating, long-acting antihistamines that can work up to about 24 hours.”
Allergy sufferers should avoid nasal decongestant sprays because they can be addicting if you use it for more than three days, Poole said.
People with underlying medical conditions, heart problems or over the age of 50 should avoid over-the-counter decongestants. Not only do they carry a risk of stroke, but they aren’t effective.
In September, an advisory committee to the U.S. Food and Drug Administration said phenylephrine, the main ingredient used in many over-the-counter congestion products, is safe but is ineffective in pill form. Other forms like nasal sprays are still believed to be effective.
Avoid yard work, shower at night to avoid pollen
Here are ways to limit exposure to pollen and make fall asthma and allergy season more bearable. Information was contributed by Poole, Solanki, the American College of Allergy, Asthma and Immunology, the Asthma and Allergy Foundation of America, the U.S. Centers for Disease Control and Prevention, and Mayo Clinic.
Don’t rake leaves; they can harbor mold spores.
Stay indoors on dry, windy days.
Shower and wash your hair at night to remove pollen from your skin and hair.
Take off your shoes when entering your home.
If high pollen counts are forecasted, start taking allergy medications before your symptoms start.
Use a portable high-efficiency particulate air filter in your bedroom.
Vacuum carpets and furniture weekly with a vacuum cleaner that has a HEPA filter.
Try over-the-counter medication such as antihistamines, corticosteroid nasal sprays or oral decongestants.
Rinse your nasal passages with saline solution to clear mucus and allergens from your nose.
Julie Washington covers healthcare for cleveland.com. Read previous stories at this link.
