Crippled by hay fever? Get your car serviced!

Don’t drink grapefruit juice and keep changing your clothes

The very high pollen levels we’ve had for days on end mean that, for many, this is proving a summer to remember for all the wrong reasons. That’s because at this time of year we split into two camps: those who enjoy getting outside in the warm weather and those who have hay fever.

The streaming nose, sneezing and raw red eyes that hay fever causes are a fact of life for about 18 million people in the UK, but cases are rising so fast that some experts estimate it will affect more than 30 million by 2030.

One theory is that this is partly due to increased pollution, which both primes the body to develop allergies and makes pollen stickier and heavier so it is more likely to trigger allergies.

hay fever is caused by an allergic reaction to one or more of about 30 pollens, from grasses to weeds and trees. about 95 per cent of sufferers have an allergy to grass pollen.

‘Timothy grass is the predominant one — but if you have an allergy to tree pollen, the most common cause is silver birch,’ says Dr adam fox, a consultant paediatric allergy specialist at Guy’s and St Thomas’ hospital, in london.

Some unlucky souls react to a variety of pollens and sneeze from the start of the tree pollen season in March to the end of the weed pollen season in September (the grass pollen season falls between the two).

hay fever typically starts in the lining of the nose. There, pollen sticks to antibodies called Ige that are found on mast cells, a type of immune cell.

In someone with hay fever, the mast cells perceive the pollen as an invader and try to get rid of it, releasing histamine and other inflammatory chemicals that work on blood vessels and mucus glands, causing a runny nose, itchy eyes and sneezing.

hay fever is one of the few conditions you can grow out of, it’s thought because the immune system reaction lessens with age. But while it lasts it can have a severe effect.

AReCeNT study published in the journal Brain, Behaviour & Immunity found that hay fever increases feelings of depression. The allergy is most common among 13 to 26-year-olds. about 40 per cent of teenagers have it and it can have a big impact on their education. as amena Warner, head of clinical services at allergy UK, points out: ‘every exam they sit will be in the pollen season.’

In fact, in 2015, Norwegian researchers determined that those with hay fever are less likely to get into top universities because of the impact it has on their grades.

another study published this year found that those with untreated hay fever were slower at processing information and worse at learning words from lists. The researchers, writing in Clinical and experimental allergy, concluded that it has ‘a complex impact on cognitive function’.

Pollen levels this year are likely to remain high, as the wet spring and recent hot weather have encouraged grasses and other plants to grow. So here, experts give their tips on what really helps with the symptoms — and what may make them worse.

STAY IN IF IT’S STORMY

Grass pollen is quite large — each particle measures about 35 microns ( 0.03 mm)— but a thunderstorm can break the pollen into smaller pieces that can penetrate airways and cause inflammation, triggering so-called seasonal asthma in people who already suffer from hay fever.

‘The people who have this don’t normally have asthma but do get hay fever due to a grass pollen allergy,’ says Ian Pavord, a professor of respiratory medicine at Oxford University. ‘It causes the typical asthma symptoms: wheezing, coughing and tightness in the chest.

‘But these attacks can even be life-threatening. During June and July we often have a rush of people admitted to hospital with bad asthma attacks after a thunderstorm — and these are people who don’t get asthma for the rest of the year.’

Professor Pavord says GPs will often prescribe blue reliever inhalers of Ventolin, which dilates the airways. But, he says, ‘these are of little help to those with seasonal asthma. Their symptoms are caused by inflammation, so they need a brown preventor steroid inhaler instead’.

Seasonal asthma can also occur when the pollen count is especially high, typically during late June.

‘Not going out during a thunderstorm might help,’ says Professor Pavord, ‘ but people need to use their brown inhalers during the pollen season. The trouble is, they forget to use what they only need for two months of the year.’

NO GRAPEFRUIT JUICE

OlD- faShIONeD antihistamines such as chlorphenamine (found in Piriton, for example) block the effect of histamine but as they can pass into the brain in large quantities, they may also cause drowsiness. Stephen Durham, a professor of allergy and respiratory medicine at the Royal Brompton hospital and Imperial College london, says the effects are so extreme that it should not be taken before driving.

‘Taking chlorphenamine is as bad as drinking alcohol — it can cause the same level of drowsiness and have effects for six to eight hours,’ he says.

Newer antihistamines such as loratadine and cetirizine are do not cause such severe effects. ‘Cetirizine is more effective but there is a higher risk of drowsiness than with loratadine,’ says Professor Durham. That is because cetirizine does pass the blood- brain barrier, though not in such large quantities as older drugs.

There are prescription- only antihistamines, including Telfast (which contains the active ingredient fexofenadine hydrochloride). This rarely causes drowsiness, which is why Telfast is often prescribed to pilots — though it’s important to note that grapefruit interferes with absorption of the drug. One glass of grapefruit juice is enough to reduce its efficacy.

BE HOME BY TEATIME

Pollen is released in the morning as the temperature starts to rise and levels are peaking by about 11 am, says Dr adrian Morris, an allergy specialist at the Surrey allergy Clinic.

Convection currents then carry the pollen high into the sky — but it sinks again as the temperature falls in the early evening.

‘It’s hard to avoid pollen completely but you can minimise exposure by doing whatever you need to do outside in the middle of the day,’ he says. ‘ Outside, wear wraparound sunglasses, as these will protect the eyes from pollen.’

EAT APPLES STEWED

People who suffer from hay fever may also get tingling in the mouth and throat and swelling around their lips when they eat certain foods.

Some mistakenly believe they have developed a separate food allergy, but in fact they have pollen food syndrome.

‘It’s because the protein in the food is similar to proteins in the allergen that triggers a person’s hay fever,’ says Dr Isabel Skypala, a consultant allergy dietitian at the Royal Brompton and harefield NHS foundation Trust, in london. ‘The body behaves as if you are eating the pollen.’

Those who get hay fever from birch pollen may develop a cross-reaction to apples, hazelnuts or, less commonly, soya.

‘People can get wheezy and if they have had a lot of allergen — for example, a handful of nuts or a glass of freshly squeezed fruit juice — then they may get a massive swelling of the mouth and throat,’ says Dr Skypala. ‘It can be quite scary.’

Other vegetables and fruit such as peaches and tomatoes can also cause the reaction, although this is less common. Dr Skypala says about 2 per cent of the UK population is affected.

Cooking apples — or other fruit or vegetables that are causing an issue — helps, as it alters the nature of the protein.

SIT STILL FOR 15 MINUTES

Pollen can follow you into the home on clothes or pets, or blow in through windows and doors.

‘for respite from symptoms, close your windows and doors and sit still for about 15 minutes to let the pollen settle,’ says Dr Jean emberlin, scientific director of the charity allergy UK. ‘You will be breathing pollen-free air. You can then damp dust surfaces and vacuum up the pollen.’

Protect your pillows from falling pollen by putting a bedspread over them during the day, says Dr emberlin. ‘This will prevent you inhaling pollen and rubbing it into your eyes, which can trigger symptoms that stop you sleeping.’

Washing your hair and showering when you come in will also help, adds Dr fox.

GET THE CAR CHECKED

Since the late eighties, pollen filters have been fitted as standard on most new cars. They remove pollen from the air before it gets into the cabin of the car — but the filters can soon clog up.

Garages are supposed to change them at each service but some experts say they should be replaced after every 10,000 miles of motoring — or 15,000 miles if you travel mainly in rural areas.

If your windscreen doesn’t demist as efficiently as it did or the air from vents is blown with less force than normal, these can be signs that the filter is clogged and needs replacing.

‘filters are absolutely vital,’ says Dr emberlin. ‘When you sneeze, you close your eyes — and this only needs to happen for a second while you are at the wheel to be really dangerous.’

DON’T WEAR PERFUME

‘If YOU have a pollen allergy it causes inflammation in the lining of your nose and that lining consequently becomes more sensitive,’ says Dr fox.

This means strong smells such as perfume will irritate the nose still further.

‘People think they are allergic to their perfume but they’re not,’ says Dr fox. ‘It is just making their hay fever symptoms worse.’