title: Exposure to Extreme Heat Events Is Associated with Increased Hay Fever Prevalence among Nationally Representative Sample of US Adults: 1997-2013.
abstract: BACKGROUND
  Warmer temperature can alter seasonality of pollen as well as pollen concentration, and may impact allergic diseases such as hay fever. Recent studies suggest that extreme heat events will likely increase in frequency, intensity, and duration in coming decades in response to changing climate.
  
  
  OBJECTIVE
  The overall objective of this study was to investigate if extreme heat events are associated with hay fever.
  
  
  METHODS
  We linked National Health Interview Survey (NHIS) data from 1997 to 2013 (n = 505,386 respondents) with extreme heat event data, defined as days when daily maximum temperature (TMAX) exceeded the 95th percentile values of TMAX for a 30-year reference period (1960-1989). We used logistic regression to investigate the associations between exposure to annual and seasonal extreme heat events and adult hay fever prevalence among the NHIS respondents.
  
  
  RESULTS
  During 1997-2013, hay fever prevalence among adults 18 years and older was 8.43%. Age, race/ethnicity, poverty status, education, and sex were significantly associated with hay fever status. We observed that adults in the highest quartile of exposure to extreme heat events had a 7% increased odds of hay fever compared with those in the lowest quartile of exposure (odds ratios: 1.07, 95% confidence interval: 1.02-1.11). This relationship was more pronounced for extreme heat events that occurred during spring season, with evidence of an exposure-response relationship (Ptrend< .01).
  
  
  CONCLUSIONS
  Our data suggest that exposure to extreme heat events is associated with increased prevalence of hay fever among US adults.
authors.affiliation: Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, Md; Marine Estuarine Environmental Science Program, College of Computer Mathematics and Natural Sciences, University of Maryland, College Park, Md.
authors.forename: Crystal Romeo
authors.initials: CR
authors.lastname: Upperman
authors.affiliation: National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md.
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Parker
authors.affiliation: National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md.
authors.forename: Lara J
authors.initials: LJ
authors.lastname: Akinbami
authors.affiliation: Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, Md.
authors.forename: Chengsheng
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Md.
authors.forename: Xin
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Atmospheric and Oceanic Science, University of Maryland, College Park, Md.
authors.forename: Raghuram
authors.initials: R
authors.lastname: Murtugudde
authors.affiliation: Department of Epidemiology and Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md.
authors.forename: Frank C
authors.initials: FC
authors.lastname: Curriero
authors.affiliation: Crop Systems and Global Change Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, Md.
authors.forename: Lewis
authors.initials: L
authors.lastname: Ziska
authors.affiliation: Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, Md. Electronic address: amirsap@umd.edu.
authors.forename: Amir
authors.initials: A
authors.lastname: Sapkota
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology; D057231:Climate Change; D004781:Environmental Exposure / Q000009:adverse effects; D055874:Extreme Heat; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011058:Pollen / Q000276:immunology; D015995:Prevalence; D006255:Rhinitis, Allergic, Seasonal / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000485:Allergens
keywords: Allergic rhinitis; Allergy; Climate change; Extreme heat events; Extreme weather events; Hay fever