Strategies for prevention and mitigation of hay fever

Seasonal allergic rhinitis is a widespread disorder in westernized countries. It has a strong negative impact on the patient's health-related quality of life and is accompanied by considerable medical and economic costs. Currently, the socioeconomic interest in prevention is growing. Reducing or avoiding allergen exposure may result in a significant reduction of sensitization and mitigation of allergic complaints, and this reduction is in addition to existing medical prevention strategies. It will require good communication to (potential) patients on the importance and possibilities for reducing the contact with allergenic pollen. Longterm pollen monitoring and forecasts of the flowering period of allergenic plants are important tools in this respect. Reducing the allergenic load may prove an alternative prevention strategy. Pollen sources are heterogeneously distributed throughout the landscape and may be avoided or selectively removed. The use of selection, conventional breeding strategies or genetic modification may reduce the allergenicity of the pollen sources. Strategies that involve genetic modification are, however, likely to raise some public concern and acceptability of these strategies has to be considered.