Abstract
Pollen allergies are responsible for a considerable global public health burden, and understanding exposure is critical to addressing the health impacts. Atmospheric pollen counts are routinely used as a predictor of risk; however, immune responses are triggered by specific proteins known as allergens, which occur both within and on the surface of the pollen grain. The ratio between atmospheric pollen counts and allergen concentrations (‘pollen potency’) has been shown to be inconsistent, with potentially important implications for pollen monitoring practice. Despite this, there has been no previous synthesis of the literature and our understanding of the factors that influence pollen potency remains poor. We conducted a scoping review with the aim of deriving a current understanding of: (a) the factors that influence pollen potency; (b) its variation through time, between taxa and by location; and (c) the implications for pollen monitoring practice. Our synthesis found that pollen potency is highly variable within and between seasons, and between locations; however, much of this variability remains unexplained and has not been deeply investigated. We found no predictable pollen potency patterns relating to taxon, geography or time, and inconclusive evidence regarding possible driving factors. With respect to human health, the studies in our synthesis generally reported larger associations between atmospheric allergen loads and allergy symptoms than whole pollen counts. This suggests that pollen potency influences public health risk; however, the evidence base remains limited. Further research is needed to better understand both pollen potency variability and its implications for health.
Highlights
Allergic sensitisation to pollen poses a considerable individual and public health burden because it is a major cause of two common conditions: allergic rhinitis (AR, commonly referred to as hay fever) and allergic asthma
Pollen potency varies within a single season as a dynamic decoupling of atmospheric pollen and allergen concentrations
Pollen potency varies between seasons, both in terms of season-average potency and within-season potency dynamics
Summary
Allergic sensitisation to pollen poses a considerable individual and public health burden because it is a major cause of two common conditions: allergic rhinitis (AR, commonly referred to as hay fever) and allergic asthma These conditions are common and globally pervasive. Asthma alone affects approximately 339 million individuals worldwide (Global Asthma Network, 2018), while it is estimated that AR affects 10–30% of the global adult population (Pawankar et al, 2013) The burden of both diseases is notable: allergic asthma can have serious health consequences including mortality (Thien et al, 2018), while AR symptoms result in reduced productivity, increased absenteeism from work and decreased quality of life (Katelaris et al, 2012). Effective management and treatment of pollen allergy are a global health priority
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