Spatial variability in the pollen count in Sydney, Australia: can one sampling site accurately reflect the pollen count for a region?

BACKGROUND: There is increasing interest in the daily pollen count, with pollen-sensitive individuals using it to determine medication use and researchers relying on it for commencing clinical drug trials and assessing drug efficacy according to allergen exposure. Counts are often expressed qualitatively as low, medium, and high, and often only 1 pollen trap is used for an entire region. OBJECTIVES: To examine the spatial variability in the pollen count in Sydney, Australia, and to compare discrepancies among low-, medium-, and high-count days at 3 sites separated by a maximum of 30 km. METHODS: Three sites in western Sydney were sampled using Burkard traps. Data from the 3 sites were used to compare vegetation differences, possible effects of some meteorological parameters, and discrepancies among sites in low-, medium-, and high-count days. RESULTS: Total pollen counts during the spring months were 14,382 grains/m3 at Homebush, 11,584 grains/m3 at Eastern Creek, and 9,269 grains/m3 at Nepean. The only significant correlation between differences in meteorological parameters and differences in pollen counts was the Homebush-Nepean differences in rainfall and pollen counts. Comparison between low- and high-count days among the 3 sites revealed a discordance rate of 8% to 17%. CONCLUSIONS: For informing the public about pollen counts, the count from 1 trap is a reasonable estimation in a 30-km region; however, the discrepancies among 3 trap sites would have a significant impact on the performance of a clinical trial where enrollment was determined by a low or high count. Therefore, for clinical studies, data collection must be local and applicable to the study population.

Allergic rhinoconjunctivitis in elite athletes: optimal management for quality of life and performance.

Allergic rhinoconjunctivitis is a common condition with a peak incidence in the age range of the majority of elite athletes. The condition has been shown to have a significant impact on the quality of life of those affected and poses particular challenges when present in the elite athlete. When an athlete is looking for exceptional performance at events such as the Olympic Games, any factor which affects quality of life by interfering with sleep, decreasing the ability to concentrate, or reducing peak physical fitness, may have a significant impact on the ability to perform at one's best. Optimal management begins with correct diagnosis and identification of triggering factors. There are a number of therapeutic options available to the treating physician. When formulating a management plan for the elite athlete, the physician must consider "doping" rules and the possible effect of medication on athletic performance. Medication choices include the newer, non-sedating antihistamines, used either orally or topically, and the prophylactic use of intranasal corticosteroids. When allergic conjunctivitis is the principal problem, the newer, topical antihistamines are highly effective and have a rapid onset of action. Since avoidance strategies are rarely practical for the athlete, consideration should be given to strategies such as immunotherapy, where long-term benefit is possible.

Effects of intranasal budesonide on symptoms, quality of life, and performance in elite athletes with allergic rhinoconjunctivitis.

OBJECTIVE: To assess change in symptoms, quality of life (QOL), and performance ability before, during, and after treatment with budesonide in a group of Olympic and Paralympic athletes with seasonal allergic rhinoconjunctivitis (SAR/C). DESIGN: Because budesonide has already been proven to be an effective and well-tolerated treatment of SAR/C(1), an open-label treatment format was used. SETTING: The study was community-based with participating athletes preparing for Olympic competition. PARTICIPANTS: Olympic and Paralympic athletes were screened for the presence of SAR/C using history and positive skin test results for pollen allergens. INTERVENTIONS: All were offered treatment with intranasal budesonide, applied to each nostril, once daily for eight weeks. OUTCOME MEASUREMENTS: Symptom and medication diaries were completed before treatment and after 4 and 8 weeks of treatment. Similarly, Quality of Life (QOL) was measured with the Rhinoconjunctivitis Quality of Life Questionnaire. As a secondary outcome measure, the ability to train and compete was assessed using a performance diary. RESULTS: Of the 236 athletes eligible for the study, 145 (61%) agreed to participate. Forty-six percent of the athletes who were dispensed treatment did not return questionnaires. For those returning questionnaires, scores between baseline (week 0) and weeks 4 and 8 were calculated for total symptoms, QOL, and performance scores. There were statistically significant improvements in symptoms, QOL, and performance scores in athletes who used intranasal budesonide. CONCLUSION: SAR/C is a common condition and has demonstrable negative effects on athletes. Better education of coaches and athletes is necessary to ensure that the condition is correctly diagnosed and treated, with safe, effective, permitted medication.