Page - 53 - in Biodiversity and Health in the Face of Climate Change

53 Jugendlichen in Deutschland, (KiGGS initial survey, 2003–2006 of the Robert Koch Institute)) was shown to be 4.7% (95% CI) for allergic bronchial asthma and 10.7% (95% CI) for allergic rhinitis (Bergmann et  al. 2016). Allergic rhinitis was shown to have a negative impact on quality of life, by using validated questionnaires like the five-dimension EuroQol QOL survey (EQ-5D, the Sino-Nasal Outcome Test (SNOT-22) or the Nasal Obstruction Severity Evaluation (NOSE) scale (e.g. Höhle et  al. 2017). In addition to respiratory symptoms, a number of pollen-allergic patients, espe- cially those with birch allergy, suffer from concomitant pollen-related food aller- gies, which means that they develop allergy symptoms after ingestion of certain foods. Symptoms may manifest as oral itching, swelling of the lips, itchy exan- thema, shortness of breath, diarrhoea or even circulation problems (Treudler et  al. 2017). Overall, the majority of IgE-mediated food allergies in adults are based on sensitisation to aeroallergens (in particular pollen), followed by (cross-) reactions to structurally related, often unstable, allergens, especially in (plant) foods such as fruit, vegetables and spices (Treudler et  al. 2017). This type of food allergy has been referred to as a secondary food allergy, as distinct from the primary form, which is presumed to involve sensitisation via the gastrointestinal tract. The types of fruit most commonly involved in pollen-related food allergy belong to the Rosaceae plant family (e.g. apples) and to the Corylaceae family (e.g. hazel) (Treudler and Simon 2017). Recently, birch-related soy allergy has gained much attention as soy Table 3.1 (continued) Pollen taxon Studied species or genus (according to the authors) Country Number of atopic patients Positive skin prick tests (%) Citation Rumex R. crispus Australia 1000 26.5 Mueller et  al. (2000) Ulmaceae Ulmus pumila Australia 1000 11.6 Mueller et  al. (2000) Ulmaceae Ulmus Hungary 1139 6.0–17.9 Kadocsa and Juhasz (2002) Ulmaceae Trema orientalis India 2568 13.8 Mandal et  al. (2008) Ulmaceae Ulmus americana USA 371 24.6 Lin et  al. (2002) Urticaceae Parietaria Greece 150 27.5–28.0 Kaleyias et  al. (2001) Urticaceae Parietaria Italy 507 23.0 Verini et  al. (2001) Urticaceae Parietaria Portugal 371 23.4 Loureiro et  al. (2005) For each study, the taxon whose properties were studied, the country where the research was con- ducted, the sample size of atopic patients examined and the percentage of positive reactions to skin prick tests are given. Taxa are presented in alphabetical order. Empty cells signify lack of informa- tion Sources: Scopus and Web of Science; references without an abstract in English are not included 3 Climate Change and  Pollen Allergies