'Hay fever' symptomatology in Glasgow : a general practice view
General practice appears to provide an ideal setting for the study of a common condition such as hay-fever. The study which forms the main part of this thesis was carried out during the hay-fever season of 1983 in Glasgow. The observations, comments, ,and discussion are those of one general practitioner, the author, who has developed a keen interest in the subject over a number of years and are based both on day-to-day contact with patients who suffer from this condition and from scientific study of the subject and its literature. Details of the study are preceded by a historical review of hay-fever from "Rose Fever" to the discovery, in relatively recent years, of 1gE. The next section deals with basic mechanisms from botany through aerobiology, pollen characteristics and chemistry to allergen exposure, the Type I allergic reaction and the symptoms thus produced. Details relating to sources of grass pollen in the Greater Glasgow area are included and much of this information is based on data obtained at the West of Scotland Agricultural College, Auchencruive, Ayr. The thesis, which is the culmination of over four years interest in hay-fever in general practice, attempts to compare the symptom severity of eighty-two hay-fever sufferers with daily pollen counts during the hay-fever season of 1983 in Glasgow. Mean daily valu'7s for symptom severity were obtained from diary cards kept by the patients and are compared not only with the daily grass pollen count but with other elements of the total atmospheric pollen count and fungal spore counts. It has been suggested that grass pollen is indeed not the solely relevant antigen in causing hay-fever. Information was gathered about each patient's personal hay-fever symptom profile from a questionnaire incorporated into the diary cards. The study was carried out in a general practice setting and pollen counting was carried out on the roof of the Environmental Health Department, Glasgow District Council, 23, Montrose Street, Glasgow. A representative selection of photomicrographs are presented in relation to the different types of atmospheric pollen isolated from the air over Glasgow during the hayfever season of 1983. The thesis concludes by making recommendations regarding the management of hay-fever in general practice and regarding the design of clinical trials of new forms of therapy for hay-fever. It also raises questions regarding incomplete correlation between patients' symptoms and information available on atmospheric pollen. Suggestions are made for further work, including, in particular, continued efforts to relate specific grass varieties in West Scotland to patients' symptom severity. This thesis does not itself attempt to cover the wide areas of investigation and management of hay-fever in general practice but may inevitably have relevance in both of these areas. Considerable further study seems to be indicated in an attempt to improve our understanding of this common troublesome condition and thereby, hopefully, to help our patients by improved management and by more effective treatment.