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This paper contains the Final program and the Book of Abstracts of the World Conference of the International Ragweed Society, that was held on 8th-9th September, 2022, in Budapest, Hungary.

International audience; The Poaceae family is composed of 12,000 plant species. Some of these species produce highly allergenic anemophilous pollen grains (PGs). Phleum pratense pollen grains (PPPGs) emerged as a model for studies related to grass allergy. The biochemical composition of allergenic PGs has not yet been fully described despite potential health effects of PG constituents other than allergenic proteins. This review brings together the information available in literature aiming at creating a comprehensive picture of the current knowledge about the chemical composition of allergenic PGs from timothy grass. PPPGs have an average diameter between 30–35 μm and the mass of a single PG was reported between 11 and 26 ng. The pollen cytoplasm is filled with two types of pollen cytoplasmic granules (PCGs): the starch granules and the polysaccharide particles (p-particles). Starch granules have a size between 0.6–2.5 μm with an average diameter of 1.1 μm (estimated number of 1000 granules per PG) while p-particles have a size ranging around 0.3 to 0.4 μm (estimated number between 61,000–230,000 p-particles per PG). The rupture of PG induces the release of PCGs and the dispersion of allergens in the inhalable fraction of atmospheric aerosol. PPPGs are composed of sporopollenin, sugars, polysaccharides, starch, glycoproteins (including allergens), amino-acids, lipids, flavonoids (including isorhamnetin), various elements (the more abundant being Si, Mg and Ca), phenolic compounds, phytoprostanoids, carotenoids (pigments) metals and adsorbed pollutants. PPPG contains about a hundred different proteins with molecular masses ranging from 10 to 94 kDa, with isoelectric points from 3.5–10.6. Among these proteins, allergens are classified in eleven groups from 1 to 13 with allergens from groups 1 and 5 being the major contributors to Phl p pollen allergy. Major allergen Phl p 5 was quantified in PPPGs by several studies with concentration ranging from 2.7 and 3.5 μg.mg−1 in unpolluted environment. Values for other allergens are scarce in literature; only one quantitative assessment exists for allergen groups Phl p 1, 2 and 4. The extractible lipid fraction of PPPGs is estimated between 1.7–2.2% of the total PG mass. The main chemical families of lipids reported in PPPGs are: alkanes, alkenes, alcohols, saturated and unsaturated fatty acids, di- and tri-hydroxylated fatty acids, aldehydes and sterols. Several lipid compounds with potential adjuvant effects on allergy have been specifically quantified in PPPGs: E2-like prostaglandin (PGE2), B4-like leukotriene (LTB4), unsaturated fatty acids (linoleic and linolenic acids and their hydroxylated derivatives), adenosine, vitamins and phenolic compounds. Some other biochemical characteristics such as NAD(P)H oxidase, protease activity and pollen microbiome were described in the literature. The bioaccessibility in physiological conditions has not been described for most biochemicals transported by allergenic PPPGs. There is also a considerable lack of knowledge about the potential health effects of pollen constituents other than allergens. The variability of pollen composition remains also largely unknown despite its importance for plant reproduction and allergy in an environment characterized by chemical pollution, climate change and loss of biodiversity.

This study presents the results of a Europe-wide training and Quality Control (QC) exercise carried out within the framework of the European Aerobiology Society’s QC Working Group. The main aim of this exercise was to examine the feasibility of carrying out a QC exercise for fungal spore monitoring in Europe, using a similar methodology to the one previously used for pollen. The QC survey was conducted in two parts: (1) Coordinators of national and regional aerobiological networks in Europe involved in the monitoring of atmospheric fungal spores were invited to complete a questionnaire survey related to their network and asked whether they were interested in taking part in an external inter-laboratory QC exercise; (2) Participating networks performed an inter-laboratory ring test with the same sample slide in order to determine the reproducibility of identifying and counting two fungal spore taxa (Alternaria and Epicoccum) in air samples collected by a Hirst-type volumetric spore trap. Participants were instructed to read five separate longitudinal transects in the “effective collecting area” of the slide. Reproducibility of analysis was determined following the method previously used in the European Aerobiology Society’s QC exercises for pollen. Thirty-two counters from 16 national or regional networks in Europe participated in the QC exercise. Coefficients of Variation (CV%) ranged from 23.0 to 22.5 when reading one transect and from 14.0 to 16.0 when reading five transects for Alternaria and Epicoccum, respectively. Considering a CV% of 30 as the limit for fungal spores, no significant differences were observed between the absolute errors from two, three, four and five transects. The only significant difference was between one and five transects. We recommend that fungal spore analysis should be carried out on about 5% of the slide (two transects in this study) because results were not significantly different to five transects.

Background: Allergic rhinitis (AR) is a major non-communicable disease that affects the health-related quality of life (HRQoL) of patients. AR is significantly related to asthma also affecting HRQoL. However, data on HRQoL and symptom control in AR patients with comorbid asthma are lacking. Objective: To assess the differences of symptom control and HRQoL in AR patients with and without comorbid asthma. Methods: In this multicentre, cross-sectional study, patients with AR were screened and administered questionnaires of demographic characteristics and health conditions (symptoms/diagnosis of AR and asthma, disease severity level, and allergic conditions). HRQoL was assessed using a modified version of the RHINASTHMA questionnaire and symptom control was evaluated by a modified version of the Control of Allergic Rhinitis/Asthma Test (CARAT). Results: Out of 643 patients with AR, 500 (78%) had asthma as a comorbidity, and 54% had moderate-severe intermittent AR, followed by moderate-severe persistent AR (34%). Patients with both AR and asthma had significantly higher RHINASTHMA scores than the patients with AR alone (e.g., median RHINASTHMA-total score 84 vs. 48.5, respectively). Conversely, CARAT scores were significantly lower in AR with comorbid asthma than in the patients with AR alone (median CARAT-total score 16.5 vs. 23, respectively). Upon stratifying asthma based on severity, AR patients with severe persistent asthma had worse HRQoL and control than AR patients with mild persistent asthma. Conclusions: Our observation of poorer HRQoL and symptoms control in AR patients with comorbid asthma supports the importance of a comprehensive approach for the management of AR in case of a comorbid allergic condition.

Background Pollen food allergy syndrome (PFAS) is a frequently underdiagnosed disease due to diverse triggers, clinical presentations, and test results. This is especially relevant in geographic areas with a broad spectrum of pollen sensitization, such as Southern Europe. Objectives To elucidate similarities and differences of PFAS in nine Southern European centers and identify associated characteristics and unique markers of PFAS. Methods As part of the @IT.2020 Multicenter Study, 815 patients with seasonal allergic rhinitis (SAR), aged 10-60 years, were recruited in seven countries. They completed questionnaires regarding SAR, comorbidities, family history, and PFAS, and underwent skin prick testing (SPT) and serum IgE testing. Results Of the 815 patients, 167 (20.5%) reported PFAS reactions. Most commonly, eliciting foods were kiwi (58, 34.7%), peach (43, 25.7%), and melon (26, 15.6%). Reported reactions were mostly local (216/319, 67.7%), occurring within 5 min of contact with elicitors (209/319, 65.5%). Associated characteristics included positive IgE to at least one panallergen (profilin, PR-10, or nsLTP) (p = 0.007), maternal PFAS (OR: 3.716, p = 0.026), and asthma (OR: 1.752, p = 0.073). Between centers, heterogeneity in prevalence (Marseille: 7.5% vs. Rome: 41.4%, p < 0.001) and of clinical characteristics was apparent. Cypress played a limited role, with only 1/22 SPT mono-sensitized patients reporting a food reaction (p < 0.073). Conclusions PFAS is a frequent comorbidity in Southern European SAR patients. Significant heterogeneity of clinical characteristics in PFAS patients among the centers was observed and may be related to the different pollen sensitization patterns in each geographic area. IgE to panallergen(s), maternal PFAS, and asthma could be PFAS-associated characteristics., EAACI Fellowship Award of the European Academy of Allergology and Clinical Immunology; Euroimmun [118583], SA was supported by the EAACI Fellowship Award of the European Academy of Allergology and Clinical Immunology. The study has been supported by an unrestricted grant from Euroimmun (grant number 118583). The ESEP assay has been provided by Euroimmun. The Informatics Platform AllergyCARD (TM) and the app AllergyMonitor (R) have been provided by TPS Production.

Ambrosia artemisiifolia (ragweed) is an invasive weed with rapid spread during the last decades in many European countries, representing an important problem for environment and for public health, due to its highly allergenic pollen. Data from the European Aeroallergen Network (EAN) confirm the continuous increase of infested areas and of the amospheric ragweed pollen load. Ambrosia is responsible for significant health and economic impact in the most infested areas from Central Europe, mainly Hungary and neighbouring countries, including Romania. Despite generally occurring in dry and abandoned fields, along railways and roadsides, Ambrosia is now recognized as part of urban vegetation in some big cities, contributing to increase risk of air pollution and of respiratory diseases. The aim of our paper is to review the data regarding spread and problematic of Ambrosia in some big cities of Romania, mainly the capital and the actual public activities undertaken to reduce its consequences. Our data showed that Ambrosia is a real and increasing danger for human health in Romania, mainly due to its rapid spread in urban environment and increasing number of affected persons. There is an urgent need for more coordinated efforts and sustainable management of this problem, to reduce impact of Ambrosia in urban environment, to establish a national aerobiology network and to continue collaboration with European institutions and specialists in this field.

Summary Background Ongoing climate change might, through rising temperatures, alter allergenic pollen biology across the northern hemisphere. We aimed to analyse trends in pollen seasonality and pollen load and to establish whether there are specific climate-related links to any observed changes. Methods For this retrospective data analysis, we did an extensive search for global datasets with 20 years or more of airborne pollen data that consistently recorded pollen season indices (eg, duration and intensity). 17 locations across three continents with long-term (approximately 26 years on average) quantitative records of seasonal concentrations of multiple pollen (aeroallergen) taxa met the selection criteria. These datasets were analysed in the context of recent annual changes in maximum temperature (T max ) and minimum temperature (T min ) associated with anthropogenic climate change. Seasonal regressions (slopes) of variation in pollen load and pollen season duration over time were compared to T max , cumulative degree day T max , T min , cumulative degree day T min , and frost-free days among all 17 locations to ascertain significant correlations. Findings 12 (71%) of the 17 locations showed significant increases in seasonal cumulative pollen or annual pollen load. Similarly, 11 (65%) of the 17 locations showed a significant increase in pollen season duration over time, increasing, on average, 0·9 days per year. Across the northern hemisphere locations analysed, annual cumulative increases in T max over time were significantly associated with percentage increases in seasonal pollen load (r=0·52, p=0·034) as were annual cumulative increases in T min (r=0·61, p=0·010). Similar results were observed for pollen season duration, but only for cumulative degree days (higher than the freezing point [0°C or 32°F]) for T max (r=0·53, p=0·030) and T min (r=0·48, p=0·05). Additionally, temporal increases in frost-free days per year were significantly correlated with increases in both pollen load (r=0·62, p=0·008) and pollen season duration (r=0·68, p=0·003) when averaged for all 17 locations. Interpretation Our findings reveal that the ongoing increase in temperature extremes (T min and T max ) might already be contributing to extended seasonal duration and increased pollen load for multiple aeroallergenic pollen taxa in diverse locations across the northern hemisphere. This study, done across multiple continents, highlights an important link between ongoing global warming and public health—one that could be exacerbated as temperatures continue to increase. Funding None.

Objective: The objective of this panel study was to document the relationship between exposure to cypress pollen and allergic symptoms. Methods: The study group included 47 patients with allergy to cypress pollen who completed a daily diary and a weekly evaluation of quality of life (QoL) during the cypress pollen season. Different patients were included in three consecutive pollen seasons: 2014–2015, 2015–2016, and 2016–2017. Daily cypress pollen counts were obtained from the National Aerobiological Network. Air pollution and meteorological data were recorded on a daily basis. The pollen-symptoms relationship was quantified by calculating odds ratios for an increase of 1 log of grains of pollen/m3, taking into account potential confounding factors. The QoL score was expressed with a beta coefficient that increased with 1 grain of pollen/m3. Results: There was a marked increase in rhinitis and ocular symptoms during the pollen season, with a plateau effect at high levels of exposure, but no relationship with bronchial symptoms. The QoL score had a linear and significant relationship with the cypress pollen count. We did not detect any threshold level. Conclusion: This panel study demonstrated a significant association between exposure to cypress pollens and allergic symptoms, with a plateau effect for high exposures.

Knowledge:Rising CO2 levels and climate change may be resulting in some shift in the geographical range of certain plant species, as well as in increased rate of photosynthesis. Many plants respond accordingly with increased growth and reproduction and possibly greater pollen yields, that could affect allergic diseases among other things.The aim of this study is the evolution of aerobiological measurements in France for 25-30 years. This allows to follow the main phenological parameters in connection with the pollination and the ensuing allergy risk.Material and method:The RNSA (French Aerobiology Network) has pollen background-traps located in more than 60 towns throughout France. These traps are volumetric Hirst models making it possible to obtain impacted strips for microscopic analysis by trained operators. The main taxa studied here are birch, grasses and ragweed for a long period of more than 25 years over some cities of France.Results:Concerning birch but also other catkins or buds’ trees pollinating in late winter or spring, it can be seen an overall advance of the pollen season start date until 2004 and then a progressive delay, the current date being nearly the same as it was 20 years ago, and an increasing trend in the quantities of pollen emitted.For grasses and ragweed, we only found a few minor changes in the start date but a longer duration of the pollen season.Discussion:As regards the trees, the start date of the new production of catkins or buds is never the 1st of January but depends on the species. For example, it is early July for birch. For breaking dormancy, flowering, and pollinating, the trees and other perennial species need a period of accumulation of cold degrees (Chilling) and later an accumulation of warm degrees (Forcing). With climate change these periods may be shorter or longer depending of the autumn and winter temperature. Therefore, a change in the annual temperature may have a direct effect on the vegetal physiology and hence on pollen release. It may also explain why the quantities of pollen produced are increasing.The Poaceae reserve, from one place to another and without any spatial structuring, very contrasted patterns which make it impossible to identify a general tendency. This is probably due to the great diversity of taxa grouped under the generic term Poaceae, which are clearly not equally sensitive to climate change.Conclusion:Trees with allergenic pollen blowing late winter or early spring pollinate since 2004 later and produce amounts of pollen constantly increasing. Grasses and ragweed have longer periods of pollination with either slightly higher or most often lower pollen production.

International audience; Forest disease management relies principally on a preventive approach in which epidemiological surveillance plays a crucial role. However, efficient and cost‐effective surveillance methods are not currently available for large spatial scales. Nevertheless, aerobiological networks have been set up for several decades in many countries to monitor pollen dispersal and provide real‐time assessments of allergenic risk. Here, we suggest that the same approach could be used for the surveillance of forest pathogens. Using molecular methods, we analysed samples from 12 sites of the French aerobiological network, at different dates. Both metabarcoding by high‐throughput sequencing (using two markers and two different bioinformatics approaches) and real‐time PCR targeting eight important forest pathogens were conducted. To validate the approach, temporal and spatial trends of spore detection were compared with field disease data. The metabarcoding approach demonstrated that many fungal plant pathogens could be found in aerobiological samples. Moreover, five of the eight targeted forest pathogens were detected by real‐time PCR, with temporal and spatial trends of spore capture consistent with field data. In particular, Hymenoscyphus fraxineus was detected at high frequency in aerobiological samples in the areas where ash dieback has been present for the longest period of time, and at lower frequency in areas with more recent invasion. Spore detection of seasonal pathogens showed a temporal pattern similar to that of disease reports. Overall, our study provides a proof of concept that permanent aerobiological networks combined with molecular methods may provide a useful tool for large‐scale surveillance of forest pathogens.

Background The analysis of mobile health (mHealth) data has generated innovative insights into improving allergic rhinitis control, but additive information is needed. A cross-sectional real-world observational study was undertaken in 17 European countries during and outside the estimated pollen season. The aim was to collect novel information including the phenotypic characteristics of the users. Methods The Allergy Diary–MASK-air–mobile phone app, freely available via Google Play and App, was used to collect the data of daily visual analogue scales (VASs) for overall allergic symptoms and medication use. Fluticasone Furoate (FF), Mometasone Furoate (MF), Azelastine Fluticasone Proprionate combination (MPAzeFlu) and eight oral H1-antihistamines were studied. Phenotypic characteristics were recorded at entry. The ARIA severity score was derived from entry data. This was an a priori planned analysis. Results 9037 users filled in 70,286 days of VAS in 2016, 2017 and 2018. The ARIA severity score was lower outside than during the pollen season. Severity was similar for all treatment groups during the pollen season, and lower in the MPAzeFlu group outside the pollen season. Days with MPAzeFlu had lower VAS levels and a higher frequency of monotherapy than the other treatments during the season. Outside the season, days with MPAzeFlu also had a higher frequency of monotherapy. The number of reported days was significantly higher with MPAzeFlu during and outside the season than with MF, FF or oral H1-antihistamines. Conclusions This study shows that the overall efficacy of treatments is similar during and outside the pollen season and indicates that medications are similarly effective during the year.

Background: Google Trends (GT) searches trends of specific queries in Google, which potentially reflect the real-life epidemiology of allergic rhinitis. We compared GT terms related to ragweed pollen allergy in American and European Union countries with a known ragweed pollen season. Our aim was to assess seasonality and the terms needed to perform the GT searches and to compare these during the spring and summer pollen seasons. Methods: We examined GT queries from January 1, 2011, to January 4, 2017. We included 15 countries with a known ragweed pollen season and used the standard 5-year GT graphs. We used the GT translation for all countries and the untranslated native terms for each country. Results: The results of “pollen,” “ragweed,” and “allergy” searches differed between countries, but “ragweed” was clearly identified in 12 of the 15 countries. There was considerable heterogeneity of findings when the GT translation was used. For Croatia, Hungary, Romania, Serbia, and Slovenia, the GT translation was inappropriate. The country patterns of “pollen,” “hay fever,” and “allergy” differed in 8 of the 11 countries with identified “ragweed” queries during the spring and the summer, indicating that the perception of tree and grass pollen allergy differs from that of ragweed pollen. Conclusions: To investigate ragweed pollen allergy using GT, the term “ragweed” as a plant is required and the translation of “ragweed” in the native language needed.

Pollens are responsible for allergic rhinitis, conjunctivitis, and asthma. The incidence of these diseases, which have adversely impacted the social and professional lives of people who are allergic to pollen, has tripled in the past 25 years. Official institutes, health care institutions, public interest groups, and mainstream news media provide people who are allergic to pollen with advice aimed at reducing their symptoms. The aim of this work was to provide an inventory of the prevention guidelines in the world and to evaluate their scientific relevance. A PubMed search was carried out using specific keywords. The scientific relevance of the recommendations was evaluated based on the publications disproving or confirming their merit. The guidelines issued by 12 countries in Europe, North America, and Australia were inventoried. The recommendations for avoidance were most often based on scientific data regarding their impact on pollen exposures, but they have not been clinically validated. Several studies provided additional details, however, that allowed the guidelines to be further substantiated. These guidelines have been adopted in numerous industrialized countries in the world, and they generally appear to be of relevance.

Background: The monitoring of bioaerosol concentrations in the air is a relevant endeavor due to potential health risks associated with exposure to such particles and in the understanding of their role in climate. In this context, the atmospheric concentrations of bacteria were measured from January 2018 to May 2020 at Saclay, France. The aim of the study was to understand the seasonality, the daily variability, and to identify the geographical origin of airborne bacteria. Methods: 880 samples were collected daily on polycarbonate filters, extracted with purified water, and analyzed using the cultivable method and flow cytometry. A source receptor model was used to identify the origin of bacteria. Results: A tri-modal seasonality was identified with the highest concentrations early in spring and over the summer season with the lowest during the winter season. Extreme changes occurred daily due to rapid changes in meteorological conditions and shifts from clean air masses to polluted ones. Conclusion: Our work points toward bacterial concentrations originating from specific seasonal-geographical ecosystems. During pollution events, bacteria appear to rise from dense urban areas or are transported long distances from their sources. This key finding should drive future actions to better control the dispersion of potential pathogens in the air, like persistent microorganisms originating from contaminated areas.

BackgroundDaily levels of ambient air pollution and pollen may affect lung function but have rarely been studied together. We investigated short-term exposure to pollen and air pollution in relation to lung function in school-age children from a French population-based birth cohort.MethodsThis study included 1063 children from the PARIS (Pollution and Asthma Risk: an Infant Study) cohort whose lung function and FeNO measurements were performed at age 8 years old. Exposure data were collected up to 4 days before testing. We estimated daily total pollen concentration, daily allergenic risk indices for nine pollen taxa, as well as daily concentrations of three air pollutants (particulate matter less than 10 µm (PM10), nitrogen dioxide (NO2), ozone (O3)). Children with similar pollen and air pollution exposure were grouped using multidimensional longitudinal cluster analysis. Associations between clusters of pollen and air pollution exposure and respiratory indices (FEV1, FVC, FeNO) were studied using multivariable linear and logistic regression models adjusted for potential confounders.ResultsFour clusters of exposure were identified: no pollen and low air pollution (Cluster 1), grass pollen (Cluster 2), PM10(Cluster 3) and birch/plane-tree pollen with high total pollen count (Cluster 4). Compared with children in Cluster 1, children in Cluster 2 had significantly lower FEV1and FVC levels, and children from Cluster 3 had higher FeNO levels. For FEV1and FVC, the associations appeared stronger in children with current asthma. Additional analysis suggested a joint effect of grass pollen and air pollution on lung function.ConclusionDaily ambient chemical and biological air quality could adversely influence lung function in children.

[No Abstract Available], Euroimmun [118583], This study was supported by a grant from Euroimmun (code 118583).

Background: Clinical efficacy of pollen allergen immunotherapy (AIT) has been broadly documented in randomized controlled trials. The underlying clinical endpoints are analysed in seasonal time periods predefined based on the background pollen concentration. However, any validated or generally accepted definition from academia or regulatory authorities for this relevant pollen exposure intensity or period of time (season) is currently not available. Therefore, this Task Force initiative of the European Academy of Allergy and Clinical Immunology (EAACI) aimed to propose definitions based on expert consensus. Methods: A Task Force of the Immunotherapy and Aerobiology and Pollution Interest Groups of the EAACI reviewed the literature on pollen exposure in the context of defining relevant time intervals for evaluation of efficacy in AIT trials. Underlying principles in measuring pollen exposure and associated methodological problems and limitations were considered to achieve a consensus. Results: The Task Force achieved a comprehensive position in defining pollen exposure times for different pollen types. Definitions are presented for “pollen season”, “high pollen season” (or “peak pollen period”) and “high pollen days”. Conclusion: This EAACI position paper provides definitions of pollen exposures for different pollen types for use in AIT trials. Their validity as standards remains to be tested in future studies.

The development of a simple and automatic pollen measurement methodology is required to manage allergic problems caused by airborne pollen. We developed a device and algorithm to automatically monitor airborne pollen by using basic laser optics technology. The device measures the sideward and forward scattering intensities of laser light from each particle. Because this device provides detailed temporal variation in the pollen concentration, the dispersal dynamics of airborne pollen can be effectively analyzed. We compared the pollen counts obtained with the automated method and standard Hirst-type method. Scatter-plot graphs were constructed of the forward and sideward scattering intensities of the observed particles. An extract window methodology was used to estimate the concentrations of the major allergenic pollens. The extract window parameters were obtained for major types of allergenic pollen. The results suggest the possibility of developing a device for monitoring several types of airborne pollen simultaneously. We determined the standard extract window to be used for estimating the concentration of all types of airborne pollen together. A field experiment was performed to evaluate the automated monitoring system with the standard extract window. The estimated temporal variation pattern of the total airborne pollen concentration agreed well with the observed temporal variation pattern for the whole pollen season. The pollen monitor was able to estimate the overall features of seasonal changes in the total airborne pollen concentration.

Background Temporal ecological studies have shown that outdoor moulds are associated with severe asthma exacerbations, as emergency department visits or hospitalisations. The aim of this was to assess the associations between daily sales of short-acting β2-agonists (SABA), a specific and frequent treatment for control of mild asthma exacerbations in children and young adults, and outdoor mould concentrations in the central France area over a 5 year period. Methods The relationship between daily changes in mould (25 species) concentrations and daily SABA sales within a population of patients aged 6 to 39 years in a middle-size town of central France (approximately 127,000) was obtained from social security database and analysed with generalized additive models, taking into account confounding factors (air pollution, weather conditions, pollen counts and trend). Results Daily SABA sales (mean, SD) rose from 17.3 (9.7) in 2010 to 22.7 (12) in 2015. The relative risk (RR [95% CI]) of SABA sales associated with an interquartile increase in mould concentration was significant in the whole population for Alternaria 1.06 [1.002–1.12]. When the influence of age and sex was accounted for, the relationship was significant only in 6–12 years old males for Alternaria 1.21 [1.04–1.41] and Aspergillus–Penicillium 1.08 [1.04–1.12]. Conclusions Daily SABA sales are positively associated with Alternaria spores in the general population of children and young adults. The association between daily SABA sales and temporal changes to Alternaria and Aspergillus–Penicillium in male children indicate that outdoor moulds contribute to asthma morbidity.

Many research papers have addressed the beneficial qualities of forests in promoting mental and physical health. However, we should also be clear that forest environments could have detrimental effects. Some of them, which are of allergic nature, have hitherto been largely neglected.A comprehensive literature search has allowed us to achieve an initial synthesis on this matter. The emphasis was on temperate forests, especially on French forests.Anemophilous pollen from deciduous trees is the major factor causing respiratory allergies in connection with forests. The risks are focused between mid-winter and late spring. Ash, hornbeam and birch pollen and, more incidentally, oak and beech pollen induce allergic reactions not only in the forests, but also at great distances. As a result of its high humidity and because decaying organic matter is very abundant, the forest environment presents also a breeding ground for mould growth. Accordingly, fungal spores can lead to allergic manifestations recalling pollinosis. Lastly, the "other" allergies mainly include contact dermatitis symptoms, which affect wood workers first and foremost. However, the pine processionary moth, whose zone of infestation is rapidly spreading northwards and whose setae contain several relevant allergens, represents one particular case.Allergic reactions observed in forests or originating in forests are sufficiently frequent to justify to set up a wide-reaching system for aerobiological and epidemiological monitoring.

Background and objectives: Respiratory allergies induced by allergenic pollen represent an important public health problem with increasing prevalence and severity in Europe. Romania has no aerobiology network and pollen measurements have been done for about ten years in the west region only. Materials and Methods: We established the first pollen monitoring center in the capital of Bucharest in 2013, based on collaboration with the R&eacute, seau National de Surveillance A&eacute, robiologique (RNSA) from France. The aim of our paper is to present results from five years of pollen monitoring in the city center of Bucharest and preliminary data on distribution and health impact of some allergenic plants, mainly Ambrosia artemisiifolia, which is considered a real danger for the public health. Results: Our data show a significant atmospheric amount and a longer season than previously considered of grass (Gramineae) pollen and short period with a high level of Ambrosia pollen, while tree pollen looks less important in this area. The plant distribution data provided by specialists and information from affected persons showed the wide and increasing spread of Ambrosia in Bucharest and other cities from the south region. Preliminary health data from allergists confirmed that the number of patients with allergies to Ambrosia pollen is increasing from one year to another and almost all patients describe a high urban exposure from their living or working place. Conclusions: We consider that the recently implemented Law 62/2018 against Ambrosia may help reduce weed distribution and the atmospheric pollen load, but a more complex and coordinated strategy for controlling urban vegetation and reducing biologic pollution is needed.

Background Google Trends (GTs) is a web-based surveillance tool that explores the searching trends of specific queries via Google. This tool proposes to reflect the real-life epidemiology of allergic rhinitis and asthma. However, the validation of GTs against pollen concentrations is missing at the country level. Objectives In the present study, we used GTs (a) to compare the terms related to allergy in France, (b) to assess seasonal variations across the country for 5 years and (c) to compare GTs and pollen concentrations for 2016. Methods Google Trends queries were initially searched to investigate the terms reflecting pollen and allergic diseases. 13- and 5-year GTs were used in France. Then, 5-year GTs were assessed in all metropolitan French regions to assess the seasonality of GTs. Finally, GTs were compared with pollen concentrations (Reseau National de Surveillance en Aerobiology) for 2016 in seven regions (GTs) and corresponding cities (pollen concentrations). Results The combination of searches for "allergy" as a disease, "pollen" as a disease cause and "ragweed" as a plant was needed to fully assess the pollen season in France. "Asthma" did not show any seasonality. Using the 5-year GTs, an annual and clear seasonality of queries was found in all regions depending on the predicted pollen exposure for spring and a summer peak but not for winter peaks. The agreement between GT queries and pollen concentrations is usually poor except for spring trees and grasses. Moreover, cypress pollens are insufficiently reported by GTs. Conclusions Google Trends cannot predict the pollen season in France.

Pollen allergy is a growing health problem with an increase of sensitized subjects enhanced by plants response adaptation to climate change and by exposure to high concentrations of air pollutants. Linking air quality forecast and pollen estimate is therefore fundamental to assess and reduce allergy risks related to the cocktail effect. Here we present an integrated modelling strategy designed for operational forecasts. The forecast chain is based on the coupling between the ORCHIDEE land surface model and the multi-scale chemistry-transport model CHIMERE. The coupled model allows a full description of pollen production based on plant phenology and climatic conditions and its emission and transport through the atmosphere. The forecast system contains a calibration and evaluation process using 15 years of ground station data of the French aerobiology network (RNSA). The development of such approach is done within the project PREVIPOL with the objective to strengthen the French air quality system PREV’AIR (www.prevair.org) including pollen forecasts. Finally, the outcomes of the modelling system are combained with clinical database to assess the health risk.

Çalışmada 50 yazar bulunmaktadır. Bu yazarlardan sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır. The effect of height on pollen concentration is not well documented and little is known about the near-ground vertical profile of airborne pollen. This is important as most measuring stations are on roofs, but patient exposure is at ground level. Our study used a big data approach to estimate the near-ground vertical profile of pollen concentrations based on a global study of paired stations located at different heights. We analyzed paired sampling stations located at different heights between 1.5 and 50 m above ground level (AGL). This provided pollen data from 59 Hirst-type volumetric traps from 25 different areas, mainly in Europe, but also covering North America and Australia, resulting in about 2,000,000 daily pollen concentrations analyzed. The daily ratio of the amounts of pollen from different heights per location was used, and the values of the lower station were divided by the higher station. The lower station of paired traps recorded more pollen than the higher trap. However, while the effect of height on pollen concentration was clear, it was also limited (average ratio 1.3, range 0.7-2.2). The standard deviation of the pollen ratio was highly variable when the lower station was located close to the ground level (below 10 m AGL). We show that pollen concentrations measured at > 10 m are representative for background near-ground levels. ZAUM- Center of Allergy & Environment of the Technical University Munich/Helmholtzzentrum Munich Bavarian State Ministry of Health and Care grant

International audience; The North American common ragweed, Ambrosia artemisiifolia, which produces highly allergenic pollen, is invasive in different parts of the world, including Europe. In 2013, common ragweed in northern Italy was found attacked by another accidentally introduced species, the North American leaf beetle Ophraella communa, which is used for biological control of common ragweed in China. Since the establishment of O. communa, ragweed pollen concentrations in northern Italy have significantly dropped. Here we set out to estimate the potential economic benefits of establishment of O. communa in the Rhône-Alpes region in south-eastern France, where detailed data on the economic impact of common ragweed are available. Extrapolating from the change in airborne ragweed pollen concentrations in the Milan area, we estimated that establishment of O. communa in the Rhône-Alpes region will reduce the number of days with ragweed pollen concentrations at which sensitive people express symptoms by 50% and the medical costs due to common ragweed by 5.2–6.8M € annually. Our findings suggest that investments of public funds are justified to conduct a complete assessment of the potential risks and benefits associated with the accidental establishment of O. communa in Europe.

The level of symptoms in pollen allergy sufferers and users of the Patient's Hayfever Diary (PHD), does not directly reflect the total amount of pollen in the air. It is necessary to explain the symptom load and thus the development of allergic symptoms and to determine which environmental factors, besides the pollen load, influence variables. It seems reasonable to suspect allergen content because the amount of allergen varies throughout seasons and regions and is not always correlated with the total pollen amount.Data on the allergen content of ambient air (Bet v 1 and Phl p 5) from 2009 until 2011 was used to compare the respective pollen and symptom loads for study regions in Austria, Germany, France and Finland.Our findings suggest that allergen amount (Bet v 1/Phl p 5) has a strong but regionally dependent impact on the symptom load of pollen allergy sufferers. Peak symptom loads can be traced with peak allergen loads. The influence of other important aeroallergens should also be assessed during the pollen season.Allergen concentrations have an impact on pollen allergy sufferers although not as clear as assumed previously. The pattern of pollen load and major allergen content distribution does not directly explain the symptom load pattern, although significant positive correlations were found. Thus, monitoring of symptoms via voluntary crowdsourcing should be considered for future pollen and symptom forecasts in order to support pollen allergy sufferers.

Fungal spores are among the most commonly encountered airborne biological particles, and it is widely proved that they represent a potential source of allergens involved in rhinitis and asthma. A change in temperature may influence the colonisation and growth of fungi directly through the physiology of individual organisms, or indirectly through physiological effects on their host plants or substrates and any competitors or enemies. In order to detect and monitor the evolution of the spore counts, air sampling was carried out using standard equipment (Hirst-type volumetric traps) and an identical method in several stations across France. Cladosporium has been here emphasised because of its very large contribution to the total fungal spectrum. Moreover, this taxon is of particular clinical importance because it possesses a high allergenic potential. The data from the oldest traps (Aix-en-Provence, Bordeaux, Lyon, Paris and Toulouse) were analysed on an annual base. Located at different latitudes and in different climatic areas, these five cities showed fundamentally different trends for the concentrations of Cladosporium spores: downward trend at the southernmost locations and upward trend at the other locations, whereas temperature was everywhere continuously rising over the study period. However, longer data sets are needed to be able to draw more definitive conclusions about quantitative trends in airborne fungal spore concentrations.

Aerobiology is an interdisciplinary science where researchers with different backgrounds are involved in different topics related to microorganism, airborne biological particles, e.g. pollen and spores, and phenology. Some concepts, words or expressions used in aerobiology have a clear definition, but are however frequently misused. Therefore, the working group “Quality Control” of the European Aerobiology Society (EAS) and the International Association of Aerobiology (IAA) would like to clarify some of them, their use and presentation.

En France, depuis plus de trente-cinq ans, l’information sur le risque d’allergie lie a l’exposition au pollen fait appel a l’utilisation de capteurs specifiques. Le reseau de surveillance aerobiologique, aujourd’hui connu sous le sigle RNSA, s’est progressivement constitue a partir de 1984 et il compte a present environ 80 capteurs « de fond » de type Hirst. Initialement, le choix des emplacements devait beaucoup a des contingences locales. Mais la representativite spatiale des sites a ensuite fait l’objet de nombreuses etudes, qui ont permis une certaine optimisation du maillage. Le denombrement et l’identification des grains de pollen sont realises en microscopie optique, selon une methode robuste mais chronophage, necessitant un personnel hautement qualifie et ne fournissant que des donnees depassees au moment ou elles sont diffusees. C’est pourquoi le RNSA participe activement a divers programmes de recherche orientes, soit vers la detection automatique des particules biologiques en suspension dans l’air, soit vers des technologies telles que la surveillance de la teneur en allergenes, l’analyse de l’ADN ou la reconnaissance d’image. Dans le domaine clinique, les indications de la desensibilisation specifique sont devenues beaucoup plus precises grâce a l’utilisation, d’une part de “journaux” numeriques remplis au fil de la saison pollinique par le patient, permettant d’avoir une indication precise sur les dates de debut et de fin de la periode symptomatique et des donnees sur la severite des symptomes ; d’autre part du dosage des anticorps IgE diriges vis-a-vis des allergenes moleculaires caracteristiques de chaque espece vegetale. Cette strategie permet, notamment chez le patient polysensibilise, d’identifier le ou les taxons dont le role clinique est patent et de prescrire une desensibilisation beaucoup mieux ciblee.