Mar 28, 2019

Associations between alteration in plant phenology and hay fever prevalence among US adults: Implication for changing climate

Amir Sapkota, Raghu Murtugudde, Frank C. Curriero, Crystal R. Upperman, Lewis Ziska, Chengsheng Jiang

Study key findings & significance

  • The study, based on over 300,000 respondents between 2002 and 2013, shows that hay fever allergies increase when the timing of spring 'greenup' changes.
  • The study provides the first national-level quantitative data showing how ongoing climate change is increasing the allergic disease burden in the United States.

Author quotes

We found that areas where the onset of spring was earlier than normal had 14% higher prevalence of hay fever. Surprisingly, we also found similar risk in areas where the onset of spring was much later than what is typical for that geographic location.

Amir Sapkota, lead author and Associate Professor at the Maryland Institute for Applied Environmental Health

Previous studies have shown that plant phenology is highly dependent on temperature. As such, it is one of the most sensitive indicators of how our ecosystem is responding to climate change. We show that such climate change-driven ecological changes are directly linked to allergic disease burden in the United States. Even a relatively small change in the timing of tree flowering can have a significant economic impact given that 25 million American adults already suffer from hay fever each year.

Chengsheng Jiang, co-author of the paper


Plant phenology (e.g. timing of spring green-up, flowering) is among the most sensitive indicator of ecological response to ongoing climate variability and change. While previous studies have documented changes in the timing of spring green-up and flowering across different parts of the world, empirical evidence regarding how such ongoing ecological changes impact allergic disease burden at population level is lacking. Because earlier spring green-up may increase season length for tree pollen, we hypothesized that early onset of spring (negative anomaly in start of season (SOS)) will be associated with increased hay fever burden. To test this, we first calculated a median cardinal date for SOS for each county within the contiguous US for the years 2001–2013 using phenology data from the National Aeronautics and Space Administration’s Moderate Resolution Imaging Spectroradiometer (MODIS). We categorized yearly deviations in SOS for each county from their respective long-term averages as: very early (>3 wks early), early (1–3 wks early), average (within 1 wk), late (1–3 wks late) and very late (> 3 wks late). We linked these data to 2002–2013 National Health Interview Survey data, and investigated the association between changes in SOS and hay fever prevalence using logistic regression. We observed that adults living in counties with a very early onset of SOS had a 14% higher odds of hay fever compared to the reference group, i.e. those living in counties where onset of spring was within the normal range (Odds Ratios (OR): 1.14. 95% Confidence Interval (CI): 1.03–1.27). Likewise, adults living in counties with very late onset of SOS had a 18% higher odds hay fever compared to the reference group (OR: 1.18, CI: 1.05–1.32). Our data provides the first-ever national scale assessment of the impact of changing plant phenology–linked to ongoing climate variability and change–on hay fever prevalence. Our findings are likely tied to changes in pollen dynamics, i.e early onset of spring increases the duration of exposure to tree pollen, while very late onset of spring increases the propensity of exposure because of simultaneous blooming.