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This 30-year study conducted in an urbanized area provided evidence that Betulaceae sensitization significantly increased, pollen load significantly augmented, and climate and air pollution changed with a possible influence on pollen release.

The authors have mapped the occurrence of allergenic pollens throughout Italy and defined their most common clinical symptoms. To obtain an accurate aerobiological and clinical picture of such a geographically complex country as Italy, a detailed investigation was carried out involving 80 data-gathering stations and 40 clinical centers nationwide. Three main pollination periods can be distinguished: winter-pre-spring (January to March) for Betulaceae, Corylaceae, Cupressaceae, Salicaceae and Ulmaceae: spring-summer (April to June) for Gramineae, Urticaceae, Oleaceae, Plantago, Fagaceae, Pinaceae and Polygonaceae, and summer-autumn (August to September) for Urticaceae, Compositae and Chenopodiaceae. Examination of 49,660 patients affected by pollinosis (conjunctivitis, rhinitis, asthma, with positive skin tests or IgE-specific serum determination: RAST, ELISA) throughout Italy revealed sensitivity to Gramineae in 64.6%, to Parietaria in 36.7% to Olea in 15.8%, to Compositae in 13.2%, to Betulaceae-Corylaceae in 7% and to Fagaceae-Cupressaceae-Plantago in 4%-10%; marked regional variations were observed. The patients suffered from rhino-conjunctivitis (55.7%), rhino-conjunctivitis plus asthma (31.6%) and asthma (12.7%). In monosensitised individuals, Parietaria was seen to be the main cause of the asthmatic syndrome (though our preliminary data also implicate Olea) followed by Gramineae.