<scp>EAACI</scp> Guidelines on Environmental Science for Allergy and Asthma—Evidence‐Based Recommendations for Prevention and Public Health Action to Mitigate the Impact of Pollen Exposure on Respiratory Allergy

Developed using the GRADE methodology, these EAACI guidelines provide evidence-based recommendations on the effectiveness of pollen reduction/avoidance strategies for allergic rhinitis (AR) and asthma, the utility of biomarkers for monitoring pollen-induced asthma and the efficiency of mitigation measures and of public health strategies. Systematic and narrative reviews and health economic analysis support the recommendations. According to GRADE, the certainty of evidence was moderate to very low, therefore conditional recommendations are provided to guide healthcare professionals, patients, and policymakers in developing personalized, preventive, and scalable interventions. Reducing/avoiding exposure to pollen should be recommended to reduce the risk of severe asthma exacerbations. Lung function decrease and exhaled nitric oxide increase may be predictive for pollen-induced asthma exacerbations. Real-time pollen monitoring and pollen concentration-based forecast may be recommended for managing pollen-induced AR and/or asthma. Pollutant information should be included in pollen information systems. Combined forecast (weather, pollen, pollutants) and warning systems might reduce the impact of thunderstorm asthma (TA). Emergency department/asthma-related services should be strengthened during pollen season and in TA. Personalized frameworks covering the types and allergenic potential of pollen, the coaggressors and the vulnerability of each patient are needed in daily practice. The fundamental role of prevention should be further prioritized.

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Publication Details

Journal
Allergy
Published
2026-06-26
DOI
https://doi.org/10.1111/all.70423
Primary Topic
Allergic Rhinitis and Sensitization
Type
article
Field-Weighted Citation Impact
0.00

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article

EAACI Guidelines on Environmental Science for Allergy and Asthma—Evidence‐Based Recommendations for Prevention and Public Health Action to Mitigate the Impact of Pollen Exposure on Respiratory Allergy

Claudia Traidl‐Hoffmann, Santiago Quirce, Kari Christine Nadeau, Ioana Agache et al.
Allergy
Allergic Rhinitis and Sensitization
article

EAACI Guidelines on Environmental Science for Allergy and Asthma—Evidence‐Based Recommendations for Prevention and Public Health Action to Mitigate the Impact of Pollen Exposure on Respiratory Allergy

Claudia Traidl‐Hoffmann, Santiago Quirce, Kari Christine Nadeau, Ioana Agache, Lorenzo Cecchi, Carmen Galán, Fiona Tummon, Kian Fan Chung, Bernard Clot, Jolanta Walusiak‐Skorupa, Magdalena Zemelka‐Wiącek, Isabella Annesi‐Maesano, Benedetta Biagioni, Mohamed F. Jeebhay, Stefanie Gilles, Cezmi A. Akdiş, Marek Jutel, Gennaro D’Amato, Javier Domínguez‐Ortega, Stefano R. Del Giacco, Athanasios Damialis, Stephen T. Holgate, J. Sastre, Stelios Kazadzis, Nikolaos G. Papadopoulos
article en

Abstract

Developed using the GRADE methodology, these EAACI guidelines provide evidence-based recommendations on the effectiveness of pollen reduction/avoidance strategies for allergic rhinitis (AR) and asthma, the utility of biomarkers for monitoring pollen-induced asthma and the efficiency of mitigation measures and of public health strategies. Systematic and narrative reviews and health economic analysis support the recommendations. According to GRADE, the certainty of evidence was moderate to very low, therefore conditional recommendations are provided to guide healthcare professionals, patients, and policymakers in developing personalized, preventive, and scalable interventions. Reducing/avoiding exposure to pollen should be recommended to reduce the risk of severe asthma exacerbations. Lung function decrease and exhaled nitric oxide increase may be predictive for pollen-induced asthma exacerbations. Real-time pollen monitoring and pollen concentration-based forecast may be recommended for managing pollen-induced AR and/or asthma. Pollutant information should be included in pollen information systems. Combined forecast (weather, pollen, pollutants) and warning systems might reduce the impact of thunderstorm asthma (TA). Emergency department/asthma-related services should be strengthened during pollen season and in TA. Personalized frameworks covering the types and allergenic potential of pollen, the coaggressors and the vulnerability of each patient are needed in daily practice. The fundamental role of prevention should be further prioritized.

Allergy
Federal Office of Meteorology and Climatology MeteoSwiss (CH), Harvard University (US), University of Cape Town (ZA), University of Cagliari (IT), Guy's and St Thomas' NHS Foundation Trust (GB), National and Kapodistrian University of Athens (GR), University of Ferrara (IT), Nofer Institute of Occupational Medicine (PL), Aristotle University of Thessaloniki (GR), Royal Brompton & Harefield NHS Foundation Trust (GB), University Hospital Augsburg (DE), Harefield Hospital (GB), Center for Environmental Health (US), University of Manchester (GB), Helmholtz Zentrum München (DE), Transylvania University of Brașov (RO), Wroclaw Medical University (PL), Nuovo Ospedale San Giovanni di Dio (IT), Fatebenefratelli Hospital (IT), Centro de Investigación Biomédica en Red (ES), CK-CARE (CH), Physikalisch-Meteorologisches Observatorium Davos (CH), Hospital Universitario Fundación Jiménez Díaz (ES), Centre for Inflammation Research (GB), Czech Academy of Sciences, Institute of Physiology (CZ), Royal College of Physicians (GB), University of Córdoba (ES), Universidad Autónoma de Madrid (ES), University of Naples Federico II (IT)
European Academy of Allergy and Clinical Immunology
Partnerships for the goals
Openalex Percentile: Top 8%
Allergic Rhinitis and Sensitization
DOISourceOpenAlex
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