{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:39:15Z","timestamp":1793194755456,"version":"4.5.0"},"reference-count":45,"publisher":"American Geophysical Union (AGU)","issue":"10","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["agupubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["GeoHealth"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This study quantifies the lagged association between grass pollen exposure and the onset of allergic rhinitis (AR) symptoms, including differences between asthmatic and non\u2010asthmatic subgroups. Data included 114,834 self\u2010reported AR symptoms collected from 25,194 uniquely identified users of a smartphone application. Reports were gathered prospectively for seven consecutive grass pollen seasons (2017\u20132023) in Melbourne. We adjusted for meteorological, air quality, and other time\u2010varying covariates. A quasi\u2010Poisson regression model combined with a distributed lag non\u2010linear model (DLNM) was used, testing 0\u20137\u00a0days lagged effects. An association between grass exposure and daily AR incidence of any severity was observed on \u201clow\u201d exposure days (19 grains\/m\n                    <jats:sup>3<\/jats:sup>\n                    ), when exposure was modeled cumulatively across a 3\u2010day lag period (RR 1.31, 95% CI 1.16\u20131.47). Higher grass concentrations were associated with increased risk at lag\u20101, with risk rising from RR 1.08 (95% CI 0.99\u20131.17) at 19 grains\/m\n                    <jats:sup>3<\/jats:sup>\n                    to RR 1.19 (95% CI 1.09\u20131.29) at 150 grains\/m\n                    <jats:sup>3<\/jats:sup>\n                    . By lag\u20102, risk returned to a non\u2010significant baseline. Asthmatics, users reporting medication use, and users reporting more severe symptoms exhibited elevated risk at later lags. The magnitude and duration of elevated risk varied across stratified models by age and sex. We provide new population\u2010level evidence that grass pollen triggers allergic rhinitis symptoms predominately on the day of exposure, even at concentrations traditionally classified as \u201clow\u201d, with symptom risk persisting longer in asthmatics and other sensitive groups. This study highlights the value of refining communication and early\u2010warning systems to better support individuals who are sensitive to even low levels of exposure.\n                  <\/jats:p>","DOI":"10.1029\/2026gh001946","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:41:33Z","timestamp":1790664093000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hay Fever Symptom Burden From Grass Pollen: Implications for Public Health Warning Thresholds"],"prefix":"10.1029","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7480-3928","authenticated-orcid":false,"given":"Max J.","family":"Tyler","sequence":"first","affiliation":[{"name":"School of Public Health The University of Queensland  Brisbane QLD Australia"},{"name":"Queensland Alliance for Environmental Health Sciences The University of Queensland  Woolloongabba QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7050-9150","authenticated-orcid":false,"given":"Darsy","family":"Darssan","sequence":"additional","affiliation":[{"name":"School of Public Health The University of Queensland  Brisbane QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3666-7240","authenticated-orcid":false,"given":"Edwin R.","family":"Lampugnani","sequence":"additional","affiliation":[{"name":"College of Health and Medicine Menzies Institute for Medical Research University of Tasmania  Hobart TAS Australia"},{"name":"School of Health Sciences University of Melbourne  Parkville VIC Australia"},{"name":"Department of Medicine (RMH) Melbourne Medical School University of Melbourne  Parkville VIC Australia"},{"name":"AirHealth Pty Ltd.  Brunswick VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6700-2284","authenticated-orcid":false,"given":"Nicholas J.","family":"Osborne","sequence":"additional","affiliation":[{"name":"School of Public Health The University of Queensland  Brisbane QLD Australia"},{"name":"Queensland Alliance for Environmental Health Sciences The University of Queensland  Woolloongabba QLD Australia"},{"name":"School of Population Health University of New South Wales  Sydney NSW Australia"},{"name":"European Centre for Environment and Human Health (ECEHH) University of Exeter  Cornwall UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"13","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Melbourne pollen count and forecast","author":"AirHealth Pty Ltd","year":"2025"},{"key":"e_1_2_8_3_1","unstructured":"AirRater. (2025).AirRater. Retrieved fromhttps:\/\/airrater.org\/airrater\u2010readings\u2010accuracy\/index.html"},{"key":"e_1_2_8_4_1","unstructured":"Australian Bureau of Statistics. (2021).2021 Census of Population and Housing: Custom tables generated using TableBuilder. Retrieved fromhttp:\/\/www.abs.gov.au"},{"key":"e_1_2_8_5_1","unstructured":"Australian Bureau of Statistics. (2022).Asthma. Retrieved fromhttps:\/\/www.abs.gov.au\/statistics\/health\/health\u2010conditions\u2010and\u2010risks\/asthma\/latest\u2010release"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.11.022"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1710\u20101492\u20101\u20102\u201081"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2001.118891"},{"key":"e_1_2_8_9_1","volume-title":"Climate data online","author":"Bureau of Meteorology","year":"2025"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.01.049"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12940\u2010022\u201000871\u2010x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000023896"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12317"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/2045\u20107022\u20101\u201018"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13407"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/isj.12179"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature07204"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v043.i08"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3940"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(14)60617\u20106"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jenvman.2020.111111"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12940\u2010015\u20100057\u20100"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10393\u2010009\u20100225\u20101"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2021.111484"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081\u20101206(10)61464\u20100"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00484\u2010013\u20100776\u20102"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2000.110151"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010025\u201026078\u20106"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00484\u2010023\u201002533\u20100"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1039\/d5ea00024f"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102022\u2010066851"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/00173139509429034"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.13775"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00484\u2010017\u20101369\u20102"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10453\u2010009\u20109130\u2010x"},{"key":"e_1_2_8_36_1","unstructured":"QUT Allergy Research Group. (2025).AusPollen Brisbane. Retrieved fromhttps:\/\/auspollen.edu.au\/brisbane\/"},{"key":"e_1_2_8_37_1","volume-title":"R: A Language and environment for statistical computing","author":"R Core Team","year":"2024"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02694592"},{"issue":"2","key":"e_1_2_8_39_1","first-page":"219","article-title":"Interaction between air pollutants and pollen grains: The role on the rising trend in allergy","volume":"6","author":"Sedghy F.","year":"2018","journal-title":"Rep Biochem Mol Biol"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2019.135147"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0194929"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/clt2.12208"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13052\u2010020\u201000870\u2010z"},{"key":"e_1_2_8_44_1","volume-title":"DataVic \u2010 Victoria'S open data platform","author":"Victorian Department of Premier and Cabinet","year":"2012"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1159\/000527481"},{"issue":"29","key":"e_1_2_8_46_1","article-title":"Package \u2018mgcv","volume":"1","author":"Wood S.","year":"2015","journal-title":"R package version"}],"container-title":["GeoHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agupubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1029\/2026GH001946","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agupubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1029\/2026GH001946","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agupubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1029\/2026GH001946","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:30:28Z","timestamp":1793194228000},"score":1,"resource":{"primary":{"URL":"https:\/\/agupubs.onlinelibrary.wiley.com\/doi\/10.1029\/2026GH001946"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":45,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1029\/2026GH001946"],"URL":"https:\/\/doi.org\/10.1029\/2026gh001946","archive":["Portico"],"relation":{},"ISSN":["2471-1403","2471-1403"],"issn-type":[{"value":"2471-1403","type":"print"},{"value":"2471-1403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"assertion":[{"value":"2026-04-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2026GH001946"}}