Searching for Cedar: Geographic Variation in Single Aeroallergen Shows Dose Response in Internet Search Activity.
OBJECTIVE
To assess the effect of a single aeroallergen on Internet search activity in 3 distinct geographic regions over time.


METHODS
A retrospective time series analysis.


METHODS
Tertiary academic medical center.


METHODS
Mountain Cedar pollen counts spanning the periods from 2011 to 2014 were collected for San Antonio, Dallas-Ft Worth, and Houston metro regions (Texas). Google search data for the corresponding period and regions were also obtained for the search terms pollen and mountain cedar. Data were analyzed through time series plots and autoregressive integrated moving average.


RESULTS
Seasonal maximum pollen counts were greatest in San Antonio, ranging from 5413 to 9982 grains per cubic centimeter. In San Antonio, there was a strong, positive, and statistically significant effect of mountain cedar pollen count on search activity for both pollen (P = .001) and mountain cedar (P < .001) when evaluated by autoregressive integrated moving average.


CONCLUSIONS
Environmental levels of a single allergen-mountain cedar pollen-show a geographic and temporal relationship between Internet searches and mountain cedar pollen, based on Google Trends. These data are useful to understand patients' perceptions of the health risk presented by mountain cedar pollen. In turn, this information affords practitioners the opportunity to offer targeted patient education in a geographically unique region, as well as adjust surveillance of related pathologies.
Department of Otolaryngology-Head and Neck Surgery, San Antonio Military Medical Center, San Antonio, Texas, USA Uniformed Services University of Health Sciences, Bethesda, Maryland, USA S10twillson@gmail.com.
Thomas J
TJ
Willson
Uniformed Services University of Health Sciences, Bethesda, Maryland, USA.
Alexandra
A
Shams
Portia Statistical Consulting, LLC, San Antonio, Texas, USA.
Joshua
J
Lospinoso
Department of Otolaryngology-Head and Neck Surgery, San Antonio Military Medical Center, San Antonio, Texas, USA Uniformed Services University of Health Sciences, Bethesda, Maryland, USA.
Erik
E
Weitzel
Uniformed Services University of Health Sciences, Bethesda, Maryland, USA ENT Section, South Texas Veterans Health Care System, San Antonio, Texas, USA.
Kevin
K
McMains
D000485:Allergens / Q000276:immunology*; D006801:Humans; D015994:Incidence; D020407:Internet / Q000706:statistics & numerical data; D018653:Juniperus; D011058:Pollen / Q000276:immunology*; D012189:Retrospective Studies; D065631:Rhinitis, Allergic / Q000453:epidemiology / Q000276:immunology*; D057386:Search Engine / Q000706:statistics & numerical data*; D013781:Texas / Q000453:epidemiology
D000485:Allergens
Google; Internet; aeroallergen; allergen; juniper; mountain cedar