The Asthma and Allergy Foundation of America (AAFA) 2018 Spring Allergy Capitals Report ranks the most challenging places in the U.S. to have allergies. We're counting down the 15 worst cities for allergies this year.
Here, women browse for flowers at the Crescent City Farmers Market in New Orleans, the city that ranked 15th on the list.
14. Toledo, Ohio
The AAFA used three factors to determine the most challenging places to have allergies in the U.S.: pollen score, the medicine utilization per patient, and the availability of board certified allergists per capita.
Toledo, Ohio, is ranked as the 14th worst place to have allergies in 2018.
13. El Paso, Texas
"Allergies are a major public health concern, with more than 50 million Americans suffering from allergies every year," AAFA writes in their report. "More Americans than ever say they manage allergies." El Paso, Texas, on the border with Mexico, ranks as the 13th most challenging place for spring allergies in 2018.
12. Baton Rouge, Louisiana
Louisiana is prone to flooding and the capital city, Baton Rouge, ranks number 12 on AAFA's list of most challenging places for allergies. The spring allergy season begins with pollen released by trees, and then grasses follow later in spring, AAFA says.
11. Springfield, Massachusetts
On days that the pollens are high for the trees or grasses, people can take several actions to lessen exposure. AAFA suggests limiting outdoor activities, keeping windows closed and wearing sunglasses outdoors. Springfield, Mass., pictured here, ranks 11th worst for 2018 spring allergies.
10. Knoxville, Tennessee
AAFA also recommends changing and washing clothes worn during outdoor activities, drying laundry in a clothes dryer, not on an outdoor line and limiting close contact with pets that spend a lot of time outdoors. Knoxville placed tenth in the 2018 spring allergy rankings.
9. Oklahoma City, Oklahoma
Although many assume allergies are only an issue in the spring, AAFA says if you have a mold allergy, you may experience symptoms year-round. Oklahoma city ranks as ninth-worst on the list.
8. Syracuse, New York
To reduce your exposure to outdoor molds, AAFA recommends limiting your outdoor activities and wearing a mask and sunglasses or goggles when cutting grass, digging around plants, picking up leaves and disturbing other plant materials. Syracuse, in upstate New York, is eighth in the rankings.
7. Dayton, Ohio
Dayton ranks seventh for 2018 spring allergies, according to AFAA. The ranking is based on analysis of data from the 100 most-populated Metropolitan Statistical Areas (MSAs) in the contiguous 48 states.
6. Providence, Rhode Island
One of the factors AAFA used to determine the ranking was an index of "the population at risk of being affected by airborne allergenic pollen, derived from actual pollen counts, allergy prevalence for each pollen type, and related factors, for the most recent spring allergy season (spring 2017)." Providence ranks at No. 6.
5. San Antonio, Texas
Another factor used to determine this list was "the number of allergy medication prescriptions per patient prevalence, for the most recent spring allergy season (spring 2017)," including over-the-counter and behind-the-counter allergy medication sales. San Antonio ranks fifth.
4. Memphis, Tennessee
The final factor AAFA used was the number of board-certified allergists/immunologists per patient prevalence in each city. Memphis placed fourth-worst on the list.
3. Jackson, Mississippi
AAFA ranked 100 cities and found Denver, Colorado, was the least challenged when it came to allergies. The worst five cities -- including Jackson at No. 3 -- all belong in the South.
2. Louisville, Kentucky
Louisville comes in second on the list. AAFA has published their annual report since 2003 to help patients recognize, prevent and manage allergy symptoms.
1. McAllen, Texas
McAllen, Texas, is the worst place to have spring allergies in 2018, AAFA determined.