Medical consultation dynamics in Japanese cedar pollinosis patients at an office building clinic in central Tokyo

Abstract

To clarify medical consultation dynamics in Japanese cedar pollinosis patients visiting an office building clinic in an office block in central Tokyo, we surveyed number of patient at a private ENT clinic in Chiyoda-ku, Tokyo, during the Japanese cedar pollen season from 1990 to 1999. Based on questionnaires and CAP RAST tests in 1995, we studied the profiles of Japanese cedar pollinosis patients and determined positive rates of noncedar antigens. The gender ratio in 1995 was 674 men versus 501 women, most frequently men in their 40s and women in their 20s. Of these, 79.2% worked in Chiyoda-ku and Chuo-ku, but only 1.9% lived in these districts. Positive rates of noncedar antigens in 232 who received simultaneous CAP RAST tests were 64.7% for Japanese cypress, 38.3% for house dust, 35.3% for Dermatophagoides pteronyssinus, 34.4% for Epidermoptidae spp, 19.8% for mixed grasses, and 10.3% for mixed weeds (asteraceous plants). Patients positive for cedar alone were 19.0% and positive for both cedar and cypress but negative for other antigens were 23.3%; about 60% of these were suspected of multiple sensitization to antigens other than cedar and cypress. The number of pollens and patients were summarized weekly and compared. Those paying a first visit were peaked with an increase in pollen in the first week of March almost every year; second visits peaked 1 or 2 weeks later than the first visit. Little increase in first visit was noted even with increasing pollen dissemination from the latter half of March. The relationship between the number of pollen and patients each year from 1990 to 1999 correlated highly with the linear regression equation y = 0.1005x + 547.07 with R2 = 0.7562. The relationship between square roots of the number of pollen and patients each year for 5 year from 1995 to 1999 correlated very highly with the linear regression equation y = 11.167x + 376.72 with R2 = 0.9941. We concluded that the number of patients may be predicted with substantially higher accuracy based on the estimated amount of pollen in a given year.