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I am often asked by my patients why it is that their allergy problems seem
to be worse in West Texas than in other regions of the country. The answer
is not a simple one, but understanding what leads to worsening of allergy
symptoms can help a patient understand their disease better, and lead to
better avoidance of allergens.
Many patients who move to a new location will experience a temporary
improvement in their symptoms which lasts between twelve and eighteen
months. This is thought to be due to a decrease in exposure to antigens from
one location to which a patient is sensitive, and a time of lessened
sensitivity while a patient is exposed to antigens in a new area. This is
not proven, but seems plausible.
West Texas has some unique features of the climate and agricultural setting
which leads to year around exposure to antigens, and a perception that
allergy is a more prevalent problem in the area. This has not been formally
studied, to my knowledge, but the contributing factors to this situation are
worth discussing.
Let's begin in January, most of the country is in the middle of winter, and
allergy patients are getting a break. Yet, at times in this area,
temperatures will warm into the low 70's. Trees only need three consecutive
days over 50 degrees to begin pollination. Even if the temperature is cold
in West Texas, Southern Texas may be warm, and the mountain cedar trees will
begin pollination. Depending upon wind direction, patients might become
symptomatic at this time of year.
Most trees begin active pollination by mid March, and continue through May.
There are a variety of species that have been brought to the area, so trees
of all twelve different tree families will be represented in the pollen
counts at one time or another. There are several unique allergenic tree
pollens in the area. Mulberry pollen is common, as the trees were introduced
into the area with the thought of beginning silk production. They have
continued on as a popular ornamental. The indigenous tree of the area is
Mesquite. This April pollinator is highly allergenic, and has a very large
pollen grain. How this large, sticky pollen exposes humans is still not well
understood, but the majority of patients will react to Mesquite.
Grass pollen can begin to show up as early as April, and continue through
October. In most areas of the country, June is grass pollen season, but when
spring comes early in West Texas, and there is ample rain, grass pollen is a
major factor for patients.
This area has much broken ground, so weeds do well here. All nine weed
families are seen in patient sensitivity routinely. Again, this is dependant
on rain, but when there has been ample moisture, and frost is delayed until
November, weed pollen can be a factor for several months.
Finally, just when you would think a patient would get a break, cotton gin
season begins in November, and continues on into January. Cotton gin dust
consists of a combination
of dust, mites, molds, and smuts associated with cotton growth. Many
patients are sensitive to this mix, or experience irritation of their nasal
passage during this timeframe.
Rain in West Texas tends to come all at once in a span of a few days,
followed by weeks or even months without rain. Once pollen is released, it
can remain in the air for an extended period of time, contributing to the
long seasons.
And, we have dirt storms in West Texas. A combination of wind and
agriculture assure that the particulate count in the air is high during much
of the year. Although this isn't a cause of allergy, it is a major cause of
irritation, which can lead to symptoms for many patients. Many patients in
West Texas experience nasal irritation and nosebleeds. I'm told by the sales
representatives who deal in packing to care for nosebleeds that the rate of
this problem is five times as great in Lubbock as it is in Houston.
These factors combine to produce year around exposure for many patients, so
that the typical patient in my practice has some symptoms year around, with
periodic worsening during times of pollination. Their medical needs are
higher, and more patients become immunotherapy candidates because of the
difficulty in controlling their symptoms.
And, that is a good start on the answer to the question of why a patient
might be worse in West Texas. We could all move to the West Coast of Maui,
but we would lose all of the great productivity of the fine people of the
South Plains if that were to happen. Fortunately, allergy is treatable by
avoidance, medication and immunotherapy, so we can stay right here at home
where all the friendly people live.
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