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The treatment of the allergic voice patient may be somewhat different than other voice patients. Antihistamines are generally avoided, though decongestants with Guaifenesin may be useful. Steroids are more useful in perennial allergic systems. Steroids may be inhaled nasally, inhaled orally, or given systemically. Systemic steroids are especially useful for a performer who needs quick relief. We strongly feel that vocalists with chronic laryngitis and dysphonia should be allergy tested. A hidden dust mite or cat dander allergy is often found. A clean indoor environment can then be established. Immunotherapy injections can also be initiated. Both of these treatments, desensitization injections and environmental control, are especially useful in vocalists. These treatments are helpful in keeping a vocalist's trachea, larynx, and nasal cavity healthy. A careful search for mild asthma should be considered. Establishing good vocal hygiene and voice training may also be necessary.

Temperature gradients in cities can cause inter-neighborhood differences in the timing of pollen release. However, most epidemiological studies examining allergenic pollen utilize daily measurements from a single pollen monitoring station with the implicit assumption that the measured time series of airborne pollen concentrations applies across the study areas, and that the temporal mismatch between concentrations at the counting station and elsewhere in the study area is negligible. This assumption is tested by quantifying temperature using satellite imagery, observing flowering times of oak (Quercus) and mulberry (Morus) trees at multiple sites, and collecting airborne pollen. Epidemiological studies of allergenic pollen are reviewed and temperatures within their study areas are quantified. In this one-year study, peak oak flowering time was well explained by average February nighttime temperature (R 2 = 0.94), which varied by 6° C across Detroit. This relationship was used to predict flowering phenology across the study region. Peak flowering ranged from April 20-May 13 and predicted a substantial portion of relative airborne oak pollen concentrations in Detroit (R 2 = 0.46) and at the regional pollen monitoring station (R 2 = 0.61). The regional pollen monitoring station was located in a cooler outlying area where peak flowering occurred around May 12 and peak pollen concentrations were measured on May 15. This provides evidence that the timing of pollen release varies substantially within a metropolitan area and challenges the assumption that pollen measurements at a single location are representative of an entire city. Across the epidemiological studies, 50% of study areas were not within 1° C (equal to a lag or lead of 4 days in flowering time) of temperatures at the pollen measurement location. Epidemiological studies using a single pollen station as a proxy for pollen concentrations are prone to significant measurement error if the study area is climatically variable.

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