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) -- If you're a spring allergy sufferer who finds that poplar isn't very popular with your sinuses this time of year or hackberry get your hackles up, here's a look at five U.S. cities you might want to avoid moving to.

"Allergies can be a problem no matter where you live -- but some places are worse than others," says Mike Tringale of the Asthma and Allergy Foundation of America, which recently released its 11th annual

Spring Allergy Capitals


The study ranks the continental United States' 100 largest metro areas on a weighted scale of allergy-related factors.



gave each community a score between zero and 100 based on springtime pollen counts, how much prescription and over-the-counter medicine the average spring allergy patient buys and how many allergists each community has relative to patient levels.

Tringale says his group has found during more than a decade of compiling its annual rankings that Southern noncoastal communities tend to dominate the top 25 spots for worst springtime allergies.

Northeast cities mostly rank in the middle, while Western metro areas and those along the Florida and Gulf coasts come out the best. (A separate autumn allergy study that the AAFA puts out annually tends to rank Northeast and Mid-Atlantic cities poorly and Southern cities well.)

Tringale theorizes areas with the least springtime allergy problems have environments that don't lend themselves to pollen-producing trees.

Low spring allergy areas also sometimes have winds that come off the ocean, carrying little pollen but lots of sea salt that Tringale suspects cleanses the air (not to mention sufferers' sinuses).

Here's a look at the five metro areas that this year's AAFA study found have the worst problems nationwide with springtime allergies.

Each city's pollen score refers to spring 2012 levels of oak, mulberry and other tree pollens, while medicine use reflects a community's average per-patient springtime consumption of drugs such as antihistamines. The level of allergy doctors per city refers to the ratio of allergy patients to board-certified allergists tracked by the

American Board of Medical Specialties


Fifth-worst springtime-allergy city: Louisville, Ky.

Spring allergy score:

91.13 (out of a possible 100)

Kentucky's largest city ranks poorly for springtime allergies thanks partly to above-average levels of tree pollen.

The 1.3-million metro area particularly has problems with pollen from red cedars, elms, willows, poplars and hackberry trees. The Derby City also has higher-than average per-patient use of allergy medications. In fact, it ranked as America's third-worst city for springtime allergies last year.

On the plus side, Louisville has a better-than-average ratio of allergy doctors to allergy patients. Tringale says a high level of allergists means patients don't have to wait as long for appointments, have better odds of getting into experimental-drug trials and often get better access to the latest treatments.

Fourth-worst springtime-allergy city: McAllen, Texas

Spring allergy score:


This South Texas city has perennial problems with springtime allergies, coming in second place in last year's AAFA study.

Located along the U.S.-Mexican border, McAllen has above-average springtime pollen counts, with mountain cedar, Arizona cypress, elm, ash and poplar trees all causing particular problems.

The 775,000-person metro area also has above-average springtime use of allergy medications, plus a low level of board-certified allergists (the American Board of Medical Specialties says there are just two in the city proper).

"McAllen is bad on all three of our indicators," Tringale says.

Third-worst springtime-allergy city: Chattanooga, Tenn.

Spring allergy score:


Move to Chattanooga and you can expect your breathing to sound like a choo-choo this time of year if you have springtime allergies.

That's because the 530,000-person metro area has worse-than-average springtime pollen counts, with lots of allergens from red cedar, hackberry, elm, willow and poplar trees. The south Tennessee city also has higher-than-average allergy-medication consumption this time of year.

"Chattanooga has the exact same story we see in many cities with bad springtime allergies -- very high pollen counts and very high medication usage," Tringale says.

On the upside, the Scenic City does enjoy an above-average ratio of allergists to patients.

Second-worst springtime-allergy city: Knoxville, Tenn.

Spring allergy score:


Knoxville has historically had some of the nation's worst springtime allergy problems, coming in first place in the AAFA's study last year and in many previous years as well.

"Knoxville is no stranger to the No. 1 spot in our rankings," Tringale says. "In fact, I'm always surprised when it's not in first place."

The 848,000-person metro area suffers from above-average pollen counts, with red cedar, hackberry, elm, willow and poplar trees especially causing problems. Located just 110 miles from Chattanooga, K-Town also has above-average spring usage of allergy medicines.

Its only saving grace for allergy sufferers is that Knoxville enjoys an above-average ratio of allergists to patients.

No. 1 worst springtime-allergy city: Jackson, Miss.

Spring allergy score:


Mississippi's state capital is this year's U.S. capital for springtime allergies, too.

Jackson placed fourth in the AAFA's 2012 study, but Tringale says the city moved up to No. 1 this year "due to very high pollen and allergy-medication indices. Both are significantly higher there than in other cities."

Located in southwest Mississippi, Jackson has particularly bad problems with pollen from red cedar, hackberry, elm, willow and poplar trees.

That said, the 539,000-population metro area does enjoy an above-average ratio of board-certified allergists to patients.