In a study conducted by the American College of Allergy, Asthma, and Immunology, it is estimated that the pollen issue will double by 2040 and affect up to 30% of adults with respiratory diseases. This is why the Asthma and Allergy Foundation of America (AAFA) releases a yearly list of the country’s worst cities to live in with asthma and allergies to help citizens to get a head start on treatment. Here are seven prime examples:

1. Pittsburgh, PA
Pittsburgh is a beautiful town teeming with stunning bridges and gushing rivers. However, it is also home to many pollen-producing trees like ragweed, box elders, elm, and cedars. Additionally, the increase in particle pollution caused by cars and factories, as well as mold problems exacerbated due to autumn, contribute to the allergies and related symptoms, making Pittsburg the 16th most polluted city in the country.

2. Oklahoma City, OK
Oklahoma contains a high concentration of weed and mold that gets swept down the plains through southward winds, bringing pollens and allergens to your home. Due to its allergy-stimulating conditions, the city ranks ninth in the country. Moreover, Oklahoma has just the right climate for the allergens to reproduce and keep them afloat, affecting the people with asthma and allergies.

3. San Antonio, TX
San Antonio has a warm climate all year round, giving trees and plants like cedar, oak, elm, and mulberry plenty of time to leash out pollen in the environment. So, those suffering from breathing disorders and allergic reactions must be prepared to deal with the irritants if they are moving or traveling to San Antonio.

4. Jackson, Mississippi
Jackson’s rich foliage, high humidity, and pollen count account for why its citizens suffer from allergies and asthma. The AAFA noted that the use of allergy medicines in the city is higher than average. But on the brighter side, Jackson also has more certified allergists that help mitigate the problem and keep it under control.

5. Richmond, VA
Richmond has been awarded as the most allergy-prone city in the country due to its higher than normal pollen count, increased use of allergy medicine, and fewer medical experts than average to mitigate the rising problem. So, it’s important for patients who are sensitive to allergic triggers to stay away from this city.

6. New Haven, CT
New Haven has been rated F by the American Lung Association for its high pollen count, poor air quality, and an increased number of ozone days. All these factors together make it one of the worst U.S. cities to live in with asthma and allergies.

7. McAllen, TX
Dry cold spells from the mountain bring pollen and allergens into town every year. Add to that McAllen’s pollen count with little rainfall, and you get yourself a recipe for disaster that results in massive allergy flares for its citizens.