Saturday July 4, 2020



April 09

Long allergy season for 2012

2012 Allergy Season Likely To Last Longer [AUDIO]

And a lot of what allergy and asthma sufferers ill deal with can be pinned on the darker side of that mild winterwe have been telling you so much about. Since mother nature was given the opportunity to put the state into an early…some would say premature…bloom.

Robert Wood Johnson asthma and allergy researcher Doctor Leonard Bielory says because of the warm winter and an early start to the tree pollen season, this year’s overall allergy season is likely to be long, and tough for those who are struggling to feel better. He says, “right now, people who have no allergies may start developing allergies because of the intensity and the duration of the overall allergy season this year.

In addition, Bielory says mold spores from rotting grass and leaves also got an early jump this year, so that part of the allergy season will likely be extended for mold allergy sufferers.

Every year, there are three stages to the pollen season for allergy sufferers. It begins with the tree pollen season, which s where we are now. That is followed by grass pollen in the summer and finally ragweed. Bielory says there can even be a second ragweed season in the fall at times.





April 06

Record high pollen counts

March registered highest pollen counts in New Jersey in the last 25 years

New Jersey just finished the warmest March month on record, said New Jersey State Climatologist Dave Robinson.

New Jersey also registered the highest pollen count on record, according to Leonard Bielory, M.D., an allergy specialist with the Rutgers Center of Environmental Prediction at the School of Environmental and Biological Sciences. He’s been researching the data for the past 25 years and has not seen anything quite like it.

“The numbers we saw in March normally do not occur till mid-April, with birch pollen release. Such numbers have not been recorded since 1994/1995,” he said.


Bielory and colleagues at the Center for Environmental Prediction have been studying the impact of climate change in New Jersey and throughout the U.S. for the potential impact of allergies.


Bielory is also director of the STARx Allergy and Asthma Center in Springfield, New Jersey and provides pollen counts to the local media. He is a certified member of the National Allergy Bureau (NAB) of the American Academy of Allergy, Asthma and Immunology's (AAAAI) Aeroallergen Network that is responsible for reporting current pollen levels to the public. His responsibilities include providing up-to-date pollen information online at and to the NAB website.

Source: Rutgers University 


April 05

Early allergy season


Get out your hankies: Rutgers expert says allergy season blooms early again this year
Warren Cooper/Somerset Messenger-Gazette
SPRINGFIELD — If you think your allergies have been coming on earlier and earlier each year, you’re probably right.

According to Dr. Leonard Bielory, an allergy specialist with Robert Wood Johnson University Hospital and the Rutgers Center of Environmental Prediction, tree pollen counts this week are at moderate levels, “finally where they are expected to be for this time of year.”

Levels in March were in the thousands, Bielory said, “the highest in the past 25 years for that month.”

According to Bielory, who measures and reports pollen counts for the New York/New Jersey area, the data suggest that the pollen season “has started very strong this year and practically one month earlier (than usual.)” Over the past three years, Bielory said, tree pollination has started a week earlier each year.

Moreover, he said, grasses appear to have begun pollinating as well, more than a month early. Grass pollen  was first detected in late March, Bielory said, and are now where they typically are in May — “a novel finding for this time of year.”

Total pollen and mold count is 771 grains of pollen per cubic meter today, April 5, Bielory said, and is expected to approach 1,000 in the next few days. The same index on March 27 was 1,096, a number Bielory called “moderately high” at the time.

Tree pollen counts, measured at 67 gains per cubic meter today, are expected to double and triple over the weekend, he said.


April 04

Allergy risks with the climate change

Climate Change Expands Allergy Risk

A warming climate makes for a brutal allergy season in the U.S., which may become even worse in future

Watery eyes, runny noses and puffy faces will abound this year as a warm winter, human development and climate change converge to create a brutal allergy season that will likely get worse for years to come, according to experts.

Plants like ragweed are in pollen overdrive from very favorable weather, while stinging insects like yellow jackets and hornets are findings new homes farther north. More people are becoming susceptible to allergiesover time as pollen seasons are getting longer.

This increases risks for people who are already sensitized and threatens those with respiratory problems. The spread of allergies can have tremendous economic consequences as patients with reactions fill clinics and emergency rooms and as afflicted workers stay home.

Allergy symptoms result from the body's immune system overreacting to a given substance, known as an allergen. The symptoms range from mild, such as itchy eyes and hives, to life-threatening when airways swell shut. These conditions already afflict 60 million people in the United States, according to the Asthma and Allergy Foundation of America, and annually cost $21 billion.

Though most allergies can be controlled and treated, public health officials have found that an increasing number of people are adversely reacting to pollen, dander, dust and insects. As the climate shifts, these allergens are expanding to new areas, and previously unexposed people are now reaching for antihistamines.

Ragweed is one of the most common allergen sources and has spread in part due to human activity. "There is a growing body of science showing warming temperatures and carbon dioxide levels cause increases in pollen from ragweed," said Miriam Rotkin-Ellman, a public health scientist at the Natural Resources Defense Council. The plant's pollen is most dangerous from when it flowers in midsummer until when it's killed by the first frost in the fall.

Other pollen sources, like trees, peak in the spring, while grass pollen peaks in the early summer. Warming temperatures have lengthened the risk period for these plants up to several weeks. "It means more misery for allergy sufferers because you're looking at a longer time for exposure to pollen," Rotkin-Ellman said. "All of these factors combine to create a really terrible allergy season."

A rising atmospheric carbon dioxide concentration is also important because it nourishes plants, and fast-growing pollen producers like ragweed are often the quickest to avail themselves of its increasing abundance.

The growing potency of weeds and mold
"When we look at weeds that are associated with pollen, those changes are having a disproportionate effect on their ability to grow and their ability to produce pollen," said Lewis Ziska, a plant physiologist with the U.S. Department of Agriculture's Agricultural Research Service. He noted that, geographically, these patterns change with latitude, with northern areas of the country showing the most drastic increases in environmental allergens.

Already, parts of the country have broken allergy records. In New Jersey, officials observed the highest pollen levels ever recorded in February this year. "I've never seen that in 25 years of my work in this area," said Leonard Bielory, an attending physician and allergist at the Robert Wood Johnson University Hospital and a professor at Rutgers University's Center for Environmental Prediction. "I told people before the year began that it's going to be a horrendous year."

Bielory co-authored a paper with Ziska last year in the Proceedings of the National Academy of Sciences documenting how the ragweed season has grown up to 27 days in parts of the country since 1995. "It's clear that just in New Jersey over the past 20 to 25 years, there's been an increase of five to seven days for pollen," he said.

A changing climate also increases the likelihood of extreme weather events like heavy rainfall, which can exacerbate allergies from mold spores. Rotkin-Ellman cited the aftermath of Hurricane Katrina in New Orleans as an example of this. "It wasn't only dangerous levels of mold spores in homes, but all of the elevated levels of flooding created spores in the air as a whole," she said.

Stinging insects invade Alaska
Farther north, the shifting climate is proving to be a boon for stinging insects. Jeffrey Demain, director of the Allergy, Asthma & Immunology Center of Alaska, noted that America's northernmost state saw a 46 percent increase in insect stings, with some parts of the state suffering increases as high as 626 percent. Two insect fatalities were also recorded in 2006. Alaskans' "likelihood of exposure and interface with stinging insects is increasing," Demain said.

This comes largely from warmer winter temperatures leading to more snowfall, since Alaskan winters often reach the point where it's too cold to snow. The snow helped insulate insect dwellings, and as a result, more stinging insects survived the winter and expanded their ranges. Now people are finding out the hard way whether they are allergic to stings.

Birch trees, a major pollen source in Alaska, have also benefited from the recent climate changes. "Not only is there a likelihood we are insulating the insect queen's hibernaculum, the snowpack also protects the trees and it protects the roots," said Demain. "As the permafrost melts, we're seeing trees grow where there have never been trees."

Though Alaska's allergy predicament is relatively unusual in the United States, there are analogues in other parts of the world, according to Demain. "I think our allergy-related issues are correlated more with what you'd see in Sweden, just based on the latitude," he said.

Researchers in Europe have also observed allergy changes from the climate. Tim Sparks at the Institute for Advanced Study at the Technical University of Munich co-authored a paper earlier this month in the journal PLoS ONE that showed that increasing carbon dioxide is a bigger allergen driver than rising temperatures.

However, on shorter time frames, changes in weather patterns can alter allergic risks. "Heavy rainfall would tend to ground pollen," said Sparks. "High winds will transmit it further distances." Over the long term, Sparks expects pollen levels to continue to rise.

Fewer places to hide
Human vulnerability is the other side of the allergy problem. Asthma and associated allergy rates have risen all over the world, and scientists have yet to pin down a cause. "Everybody is scratching their heads," said Stephen Apaliski, an allergist and author of "Beating Asthma: 7 Simple Principles." "We're definitely seeing more cases of asthma. We seem to be having some worse cases of asthma, as well. We certainly know that the prevalence has risen over the past 20 years."

In addition, allergens are now so ubiquitous, it's hard to find a safe place for sensitive eyes, skin and throats. "There is almost nowhere you can really go to get away from this," said Apaliski. He noted that physicians in the past recommended that people with allergies move to drier climates, but even those areas are increasingly dusted with pollen.

Allergies can be especially troublesome in urban areas, where allergens coupled with pollution can form a potent health threat. "That synergy is really worrisome because of how many people in this country have asthma and rising rates of asthma," said the Natural Resources Defense Council's Rotkin-Ellman. "Ozone and pollen together are a very dangerous mixture." This will lead to more severe allergic reactions and more hospital visits.

As average temperatures rise, allergies will continue to rise, but only up to a certain point, according to Rutgers' Bielory. Eventually, pollen counts will hit a plateau and may even decline. "It cannot continue on a linear scale," he said. "If heat goes up to a certain temperature, plants will die. It will hit a breaking point."

USDA's Ziska said increased carbon dioxide levels will make allergenic weeds more difficult to control with herbicides. The solution is instead to make the environment more hospitable to native plant species and less prone to weed infestations, according to Steven Apfelbaum, a senior ecologist with Applied Ecological Services Inc., an environmental restoration firm. "Plan A would be to restore the land and the ecosystems so they are healthy and they can tolerate and are not as vulnerable to the unpredictable weather that has been tossed at them," he said.

For people with allergies, the best way to prevent reactions is to stay informed. Bielory is developing iPollenCount, an iPhone app to track pollen. Using this information, people can schedule their outdoor activities to minimize their exposure on high-risk days. More broadly, Bielory said people need to take steps to minimize their emissions, not only to curb short-term pollution, but to slow the long-term climate changes that are driving environmental health risks.

Still, there is no rapid way to reverse these allergy trends, and the risks will continue to increase for the foreseeable future. "My perspective is that we can mitigate all we want but have to learn to adapt and, more so, prepare," said Bielory.



April 03

Spring and Itch Red Eyes



While many Australians think of trips to the beach and weekend picnics at this time of year, those who suffer from seasonal allergic conjunctivitis are more likely to associate spring with other, less pleasurable experiences. For seasonal conjunctivitis sufferers, spring is the time of year when uncomfortable, itchy, red eyes are most common.1



But don't despair! While allergic conjunctivitis causes considerable discomfort, many treatment options are available. They are suitable for both adults and children, and include simple measures as well as medicines.2

Seasonal allergic conjunctivitis

Seasonal allergic conjunctivitis (also called hayfever conjunctivitis) is an allergic eye condition. It is caused by the eye's hypersensitivity reaction to seasonal allergens in the air, such as pollen.1

Itchy, red eyes: The most common symptom

Allergic conjunctivitis is usually not painful, although it causes considerable eye discomfort. The most common symptom is itchy eyes. Other common symptoms include red eyes, swelling of the eye, burning sensations in the eye, puffy eyelids, excessive tears and mucous discharge from the eyes.1,3

People who do not have itchy eyes but have other allergic symptoms are unlikely to be suffering from allergic conjunctivitis, and may have another condition instead. It is very important that these people consult a doctor about their eye symptoms, especially if they experience eye pain or vision loss, as these typically indicate more serious conditions.4

It occurs in warm, windy weather and spring

As the name suggests, seasonal allergic conjunctivitis is a seasonal condition. It is most prevalent in spring when the airborne allergens which cause hypersensitivity or allergic reactions are more common.5 Warm, windy weather also increases the likelihood of allergic conjunctivitis, compared to cool or rainy conditions.6

How the eye responds to allergens

Seasonal allergic conjunctivitis occurs when the conjuctiva (the membrane that covers and protects the eyeball) is exposed to an allergen.5,7 Airborne allergic pathogens enter theeye through the tear film and activate antibodies in the eye.1

Activation of the antibodies disrupts other cells in the eye, in particular mast cells. Mast cells contain and regulate the release of chemicals that respond to allergic or inflammatory conditions, including histamine, serotonin and heparin.1 These chemicals are released to protect the eye from the airborne allergen, but they also cause itching and inflammation.5,7

The most common allergic eye condition

Seasonal allergic conjunctivitis is the most common allergic eye condition.1 Up to 40% of adults experience some type of allergic eye condition,8 and the majority of these (90%) experience seasonal allergic conjunctivitis1 (although the prevalence varies depending on the season9).The number of people with allergic seasonal conjunctivitis (and other allergic conditions) appears to be increasing.2

Children also experience seasonal allergic conjunctivitis. It is estimated that 17% of children aged 12–13 years experience allergic conjunctivitis.10 Children who have other allergic conditions are even more likely to experience allergic conjunctivitis. Almost all children (97%) with hayfever also suffer from allergic conjunctivitis, as do many children with asthma (56%) and eczema (33%).11

How it affects quality of life

The discomfort and vision impairment associated with allergic seasonal conjunctivitis can considerably affect a person's quality of life.

For children, the discomfort can be distressing and may interfere with their day to day activities, including school attendance and performance.12

Adults who experience the condition work less hours and earn less money than those who don't. They also experience greater pain and perceive their health to be poorer than individuals who do not have seasonal allergic conjunctivitis. In addition, there are considerable costs associated with managing and treating the condition, and in some cases these are borne by the individual rather than the health system.13  

Treatment options

There are many treatments that can effectively relieve the symptoms of seasonal allergic conjunctivitis. The treatments are safe and effective for both adults and children.12 The best treatment option depends on the severity of the symptoms,2 and individuals with conjunctivitis should consult their doctor about which treatment is most appropriate for them.

Preventing exposure to allergens

The simplest way of preventing itchy red eyes is to avoid the allergens causing it in the first place. Sometimes this is very difficult. But even in spring when allergen levels are highest, exposure to them can be reduced by wearing sunglasses or using hypoallergenic bedding, which makes it more difficult for allergens to enter the eyes.4

There are also some simple ways to reduce the discomfort of seasonal allergic conjunctivitis. For example, placing a cold compress over the eyes is a good way to reduce itching and inflammation. Avoiding rubbing the eyes is very important, because rubbing the eyes can cause more severe symptoms.3

Over-the-counter medicines to relieve symptoms

A range of medications are available over the counter at pharmacies which can reduce the symptoms of allergic seasonal conjunctivitis. Your doctor or pharmacist will be able to advise which medication is best for you. If your symptoms persist or become worse, seek your doctor's advice immediately.

Ocular lubricants

Ocular lubricants, also known as artificial tears, are eye drops that lubricate the eye's surfaces (e.g.  Genteal eye drops or gel (hypromellose)) and Cellufresh (carmellose)). With additional lubrication, the eyes can often remove allergens from their surfaces, thus preventing the itching and other symptoms of allergic conjunctivitis.

Eye drops known as mucolytics can reduce the excessive mucous discharge sometimes caused by allergic conjunctivitis.2 Mucolytics (such as mucolytic acetylcysteine) are only available fromtertiary centres.

Ocular decongestants

Ocular decongestants such as Zincfrin (pheneylephrine/zinc sulfate) cause vasoconstriction of the eye's blood vessels. In doing so, they reduce blood flow into the eye and reduce the inflammatory symptoms of allergic conjunctivitis.2


Histamine-1 (H1) receptor agonists prevent histamine-induced itching. Histamine is released in response to allergens entering the eye (and other body systems). Histamine binds to cells in the eye and causes them to itch. Antihistamines work by preventing histamine from binding to other cells. Although histamine is still released into the eyes when a person takes antihistamines, the histamine does not cause itching because it is prevented from binding to other eye cells.2

Antihistamines are available in tablet (e.g. Telfast (fexofenadine)) and eye drop (e.g. Livostin (levocabastin)) formulations. They relieve symptoms quickly, although eye drops provide faster symptom relief than tablets.2 They are suitable for short-term symptom relief (2–6 weeks), but do not prevent the symptoms from reappearing in the future.6

Some antihistamines also contain ocular decongestants (e.g. Naphcon A (naphazoline/pheniramine) or Antistine Privine (antazoline/naphazoline)). These combination medications are more effective than either decongestants or antihistamines used alone.2 However, they should not be used for more than 14 days.6

Mast cell inhibitors

Mast cell inhibiting medications (e.g. Alamast (pemirolast), Alocril (nedocromil), Lomide (lodoxamide)) stabilise cells in the eye known as mast cells, and in doing so prevent the release of histamine and other chemicals that cause the eyes to itch and swell. These medications are used to prevent allergic eye reactions. However, they do not provide immediate symptom relief, usually taking 3–7 days to have an effect.6

Combined mast cell inhibitors and antihistamines

Mast cell inhibitors that contain the active ingredient ketotifen fumarate (e.g. Zaditen) are also available over the counter in Australia. Ketotifen fumarate–antihistamine combination medications work in three different ways to reduce the symptoms of allergic eyes. First, they function as antihistamines, preventing histamine from binding to cells in the eyes and causing itching.14Second, they stabilise mast cells, and third, they prevent eosinophils (cells also involved in allergic reactions) from infiltrating the eyes.12 These medications are safe and effective in adults and children aged three years or  older.14 

Mast cell stabilisers combined with antihistamines start working within minutes of use, and the effects of a dose last for 8–12 hours.14 They can be taken by people experiencing periodic episodes of allergic conjunctivitis to prevent recurrence, as well as to treat current syptoms.6

No excuse for putting up with itchy eyes!

There is no excuse for putting up with itchy red eyes this spring. There are many ways to prevent or treat the symptoms of allergic seasonal conjunctivitis, and consulting a doctor will help you find out which treatment option is most suitable for you. People with severe symptoms may be referred to a specialist.15

Find out about your treatment options so you can spend this spring enjoying the great outdoors.


  1. 1.Greiner JV, Mundorf T, Dubiner H, et al. Efficacy and safety of ketotifen fumarate 0.025% in the conjunctival antigen challenge model of ocular allergic conjunctivitis. Am J Ophthalmol. 2003;136(6):1097-105. [Abstract]

  2. 2.Schmid KL, Schmid LM. Occular allergy: Causes and therapeutic options. Clin Exp Optom. 2000; 83(5):257-70. [Abstract]

  3. 3.Griggs PB. Allergic conjunctivitis [online]. Bethesda, MD: MedlinePlus, US National Library of Medicine; 22 August 2008 [cited 2 August 2010]. Available from: URL link

  4. 4.Moloney G, McCluskey PJ. Classifying and managing allergic conjunctivitis. Medicine Today. 2007;8(11):16-21. [Full text]

  5. 5.Khurana AK. Comprehensive Ophthalmology (4th edition). New Delhi: New Age International Publishers; 2007.

  6. 6.Allergic conjunctivitis [online]. Balgowlah, NSW: Australasian Society of Clinical Immunology and Allergy; January 2010 [cited 2 August 2010]. Available from: URL link

  7. 7.Bielory L, Friedlaender MH. Allergic conjunctivitis. Immunol Allergy Clin North Am. 2008;28(1):43-58. [Abstract]

  8. 8.Singh K, Bielory L. Ocular allergy: A national epidemiologic study. J Allergy Clin Immunol. 2007; 119(1 Suppl): S154. [Abstract]

  9. 9.Ono SJ, Abelson MB. Allergic conjunctivitis: Update on pathophysiology and prospects for future treatment. J Allergy Clin Immunol. 2005;115(1):118-22. [Abstract | Full text]

  10. 10.Hesselmar B, Åberg B, Eriksson B, Åberg N. Allergic rhinoconjunctivitis, eczema, and sensitization in two areas with differing climates. Pediatr Allergy Immunol. 2001;12(4):208-15. [Abstract]

  11. 11.Gradman J, Wolthers OD. Allergic conjunctivitis in children with asthma, rhinitis and eczema in a secondary outpatient clinic. Pediatr Allergy Immunol. 2006;17(7):524-6. [Abstract]

  12. 12.Abelson MB, Farzola NJ, McWhirter MC, Cramptom HJ. Efficacy and safety of single- and multiple-dose ketotifen fumarate 0.025% ophthalmic solution in a pediatric population.Pediatr Allergy Immunol. 2004:15(6):551-7. [Abstract]

  13. 13.Pitt AD, Smith AF, Lindsell L, et al. Economic and quality of life impact of seasonal allergic conjunctivitis in Oxfordshire. Ophthalmic Epidemiol. 2004;11(1):17-33. [Abstract]

  14. 14.Product Information: Zaditen. North Ryde, NSW: Novartis Pharmaceuti

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Location: Springfield, NJ
Today's Date: July 04, 2020
Station Director: Leonard Bielory, M.D
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