European ash is a potent allergen source (3) and a common cause of allergic rhinitis, conjunctivitis and asthma (6, 12). The prevalence of ash pollen sensitization in Germany is about 10%, although it may be underestimated because the ash pollination season in Europe overlaps with birch (Betulaceae) (13). In a study of 5416 Austrian patients sensitized to any pollen, 17.6% had a positive skin prick test to ash (14). In northern Iran, 36.7% of 1006 allergic patients showed a positive skin prick test to Fraxinus excelsior; this was significantly associated with asthma and allergic rhinitis, although urticaria and atopic dermatitis were also recorded (6). In a New York study, 27% of 371 allergic patients were sensitized to ash (3), while in Istanbul, 8.1% of 60 allergic patients showed a positive skin prick test to ash, which was the main sensitizer among the woody plants tested (7).
Allergic rhinitis
In a Belgian study comparing pollen exposure and sales of allergic rhinitis medication, positive associations were found between Fraxinus pollen counts and medication sales (10).
Other topics
In nasal provocation tests, 58% of 113 ash-sensitized patients showed symptoms of allergy, while 42% were clinically silent. 94% of sensitized patients and 88% of allergic patients were poly-sensitized to three or more allergens in addition to ash pollen, and 86% of all patients also had a positive skin prick test to birch (Betulaceae) pollen (13).