Louisville comes out on top in a new listing of the 100 most challenging cities to live in with allergies.

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Louisville has sprung to the top of the sneeze list.

Louisville is the worst city for spring allergies this year, according to the Asthma and Allergy Foundation of America (AAFA). The city ranked No. 5 last spring.

The foundation, based in Landover, Md., Monday releases its annual Spring Allergy Capitals report, which ranks the 100 most challenging cities to live in with allergies.

The ranking, based on 2013 data, has some surprises. Dallas leaped from No. 23 in 2013 to No. 7 this year, with a higher pollen score. New York rose from No. 43 last year to No. 13, with more people buying allergy medications.

The not-for-profit organization ranks communities based on pollen, the number of over-the-counter and prescription medications per patient, and the number of board-certified allergists per patient in the 100 most populous cities in the continental USA. A full list of the Top 100 cities as well as resources for patients and doctors are available at AllergyCapitals.com.

"It's the 12th year for this report, and it's a reminder that, no matter where you live or what the outdoor conditions are, people need to take allergies seriously and have a treatment plan," said Mike Tringale, AAFA's senior vice president for external affairs.

With an allergy, the immune system overreacts to a trigger substance, or allergen.

Seasonal allergic rhinitis, or hay fever, occurs when an allergen found outdoors is inhaled. Symptoms include a runny nose, watery or itchy eyes, sneezing and coughing.

Common allergens are tree pollen in the spring, grass pollen in the summer and weed pollen in the fall, as well as mold spores.

In 2012, about 17.6 million adults were diagnosed with hay fever and 6.6 million children were reported to have it, according to the Centers for Disease Control and Prevention's National Center for Health Statistics.

MORE: 10 best tips to ease spring allergies

The blending of winter and spring in some areas may worsen allergy symptoms this spring.

With the prolonged winter and precipitation, the root systems of plants are primed, said Clifford Bassett, medical director of Allergy and Asthma Care of New York. "As soon as the weather gets warmer in some communities, we will see a pollen explosion in April," said Bassett, a board-certified allergist. "I expect to a see a robust pollen season."

"With the proper testing, planning and early treatment, patients can prepare and find relief," Bassett said. "We in the allergy community are very interested in individualizing your care and educating you so that you can enjoy the spring."

Top 10 worst cities for spring allergy sufferers

1. Louisville

2. Memphis

3. Baton Rouge

4. Oklahoma City

5. Jackson, Miss.

6. Chattanooga, Tenn.

7. Dallas

8. Richmond, Va.

9. Birmingham, Ala.

10. McAllen, Texas

For the full list of Top 100 cities, go to AllergyCapitals.com.

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