ARZU DIDEM YALCIN, MD. Department of Internal Medicine, Allergy and Clinical Immunology Unit

1. THE CLIMATE AANNDD AAEERROO AALLLLEERRGGEENNSS IINN
MMEEDDIITTEERRRRAANNEEAANN RREEGGIIOONN AANNDD AALLLLEERRGGEENN
SSEENNSSIITTIIVVIITTYY IINN AALLLLEERRGGIICC
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MMEEDD SSCCII MMOONNIITT 22001133((22))
ARZU DIDEM YALCIN, MD.
Department of Internal Medicine, Allergy and
Clinical Immunology Unit.
XXI World Congress of Asthma
Interasma Global Assosiation
Sunday, August 19, Room B, 16.00-17.30
Oral presentation 38
QUEBEC/CANADA

2. Background: In this study, we evaluated
the profiles of allergic rhino-conjunctivitis
and asthma patients annually in a
mediterranean coastal city Antalya in Turkey
Methods: As well as evaluating patients’
allergic clinical status, we also recorded the
climate and pollens in the air of city center if
any correlation between pollination, climatic
conditions and allergic disorders. Total and
specific IgE levels and skin prick tests (SPT)
were evaluated. The meteorological
conditions and the pollen count/cm2 in each
month of whole year and the concordance of
this with the patient’s clinical status were
evaluated.

3.  Results:
 The major causes of allergic rhinoconjunctivitis symptoms
were air pollens and house dust. SPT positivity for
corylusavellana was significant in the age group of >40
years old. SPT positivity for plantagolanceolata, aspergillus
fumigatus and d. pteronyssinus was significant in patients
younger than 40 years old Pollination levels are consistent
from March 2010 to February 2011 and in Antalya high
levels occur mostly from April to June. Thus skin prick test
were performed mostly in May/June (~30%). During these
months, the meteorological conditions of the city were
windy with low humidity without rain and lukewarm
temperatures, all of which contribute to high risk
conditions for seasonal allergies.


4. Results:
 Of the 866 patients studied, 92.8 % of
whom lived in the city center, 66.1 % were
females. 61.21 % of these 866 patients had
allergic rhinoconjunctivitis and 38.79 % had
asthma and allergic rhinoconjunctivitis. 16.3 %
of all cases were active smokers, and among all
cases ~40% had increased symptoms with
exposure to both active/passive cigarette
smoking. Approximately the same numbers of
patients with higher than 100 kU/L total IgE
levels and who had allergen-specific IgE
positivity, clustered in the age ranges 10-19,
20-29, 30-39 and 40-49, as shown in Table I.

5. Number of patients Percentage %
SEX
Male 294 33.9
Female 572 66.1
AGE
10-19 179 20.7
20-29 192 22.2
30-39 203 23.4
40-49 155 17.9
50-59 83 9.6
60+ 54 6.2
Table I. Demographics for the ppaattiieenntt ggrroouupp ((nn=86666))

6. CLINICAL VISIT NUMBERS PER MONTH
January 59 6.8
February 92 10.6
March 86 9.9
April 104 12.0
May 152 17.6
June 127 14.7
July 55 6.4
August 40 4.6
September 48 5.5
October 24 2.8
November 40 4.6
December 39 4.5

7. Table II. Skin prick test results for patients (nn==886666)) aanndd %% ppoossiittiivviittyy
ttoo ddiiffffeerreenntt aalllleerrggeennss..
Test x ± SD (mm) Minimum maximum size(mm)
Positive Result
Number of patients Percentage of patients
Positive control 11,15±3,79 1 - 24 863 99.6
Negative control 0,17±1,03 2 - 10 23 2.6
GRASS MIX 5,86±4,03 1 - 30 703 81.2
holcuslanatus 4,14±4,08 3 - 23 512 59.1
dactylisglomerata 4,75±4,40 3 – 26 594 68.6
loliumperenne 4,56±4,29 1 - 28 568 65.6
phleumpratense 3,46±3,76 3 – 21 452 52.2
poapratensis 3,54±3,92 2 – 24 459 53.0
festucapratensis 3,15±3,74 2 – 19 416 48.0
BARLEY MIX 4,09±4,20 2 - 30 516 59.6
hordeumvulgare 2,78±3,65 3 – 20 366 42.3
triticumsativum 2,61±3,54 2 – 20 351 40.5
secalecereale 2,32±3,63 2 – 22 316 36.5
avenasativa 2,32±3,35 2 – 18 319 36.8
WEED MIX 3,35±3,39 1 – 21 471 54.4
artemissiavulgaris 3,26±3,21 3 – 14 477 55.1
urticadioica 2,45±2,99 2 – 12 372 42.9
plantagolanceolata 2,65±3,15 3 – 18 396 45.7
taraxacumofficianele 2,46±3,33 3 – 20 353 40.8

8. Table II. Skin prick test results for patients (nn==886666)) aanndd %% ppoossiittiivviittyy
ttoo ddiiffffeerreenntt aalllleerrggeennss..
TREE MIX 3,22±3,46 3 - 21 433 50.0
alnusglutinosa 2,40±3,19 3 – 18 337 38.9
corylusavellana 2,42±3,50 3 – 44 326 37.6
populusalba 2,52±3,12 3 – 13 366 42.3
salixcaprea 2,69±3,08 2 – 11 397 45.8
betulaverricosa 2,12±2.99 3 – 10 307 35.4
pinussilvestris 1,45±2,68 3 – 10 207 23.9
quereusrobur 2,58±3,03 3 – 10 386 44.6
robininapseudoacacia 0,17±1,03 2 – 10 23 2.6
oleaauropeae 3,57±3,48 3 – 18 491 56.7
EPITHELIAL ALLERGENS
dog 3,30±3,14 2 – 10 486 56.1
cat 2,91±3,26 3 – 15 415 47.9
horse 0,08±0,71 4 – 9 10 1.1
FUNGAL ALLERGENS
alternaria 3,38±3,18 2 – 18 496 57.3
aspergillusfumigatus 3,36±3,17 3 – 19 493 56.9
MITE MIX
D. pteronyssinus 3,88±3,69 3 – 36 532 61.4
D. farinae 3,95±4,54 3 – 45 517 59.7
P. germanica 0,07±0,70 4 – 11 9 1.0
P. america 0,03±0,39 3 – 8 4 0.5
Blatella germanica 2,73±3,32 3 - 35 457 52.8

9. Table III. Age distribution (n=886666)) aanndd mmeeaann SSPPTT ppoossiittiivviittyy
AGE Corylusavellana
X±Sd (mm)
Aspergillus fumigatus
X±Sd (mm)
Dpteronyssinus
X±Sd (mm)
Plantagolanceolata
X±Sd (mm)
<40
2.21±3.14 3.59±3.12 4.12±3.78 3.00±3.49
40+
2.82±4.09 2.93±3.23 3.42±3.47 2.19±2.90
Independent-samples t-test
p=0.02 p=0.004 p=0.008 p=0.001

10. Table IV: The most commonly detected mmoonntthhss ooff tthhee aalllleerrggeennss
Allergens Most common on … %
Grass mix (n:703) May (n:115), June(n:97) 30,2
Barley mix (n:516) May (n:94), June (n:89) 35,5
Weed mix (n:471) May (n:71), June (n:71) 30,1
Tree mix (n:433) May (n:77), June (n:77) 35,6

11. Table V: Monthly pollination ratios

19. What is already known on this
subject?
 Allergic rhinoconjunctivitis-asthma is
a common health problem that its
prevalence and varies from region to
region. Several studies have investigated
the association between pollen exposure
and asthma emergency admissions, but
only two have investigated the effect of
airborne allergens on consultations for
rhinitis.

20. What this study adds?
 In this study, we evaluated the
climate and pollens in the air and the
correlation between pollination,
climatic conditions and clinical status
of the allergic patients. The results
suggesting that the pollination is
correlated with allergic conditions and
thus skin prick test might be best
performed according to the pollen
population.


21. Conclusion: The major allergen between
April and June was derived from
Graminae; between February and March
was Cupressus sp; and between March
and June was Pinus sp. These results
suggest that the pollination is correlated
with allergic conditions and thus SPT
might be best performed according to the
pollen population.

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Arzu Didem Yalcin ,MD adidyal@yahoo.com

23. AAttiill ,,HHaassaann,, SSaaiimmee,, RReegg,, ÖÖzzlleemm,, IIbbrraahhiimm,, RReeyyhhaann,, RRaahhiimmee,, BBuulleenntt,, HHaallee..
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