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Allergy in West Texas
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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