Fall is quickly approaching: the mornings are brisk, the days are shorter, and ragweed pollen — not love — is in the air. Fall allergies are a great source of dread for people in the twilight of the summer, as their sinuses clog up and daily life becomes more about finding the nearest box of tissues than enjoying the fading summer warmth. The Asthma and Allergy Foundation of America (AAFA) just released its list of the 100 worst cities for allergies in the U.S., and eight of the top 10 land in the South. What gives?

The top 10 worst cities for allergies are:

10. Oklahoma City, Okla.

9. Chattanooga, Tenn.

8. Dayton, Ohio

7. Baton Rouge, La.

6. McAllen, Texas

5. Memphis, Tenn.

4. Louisville, Ky.

3. Knoxville, Tenn.

2. Jackson, Miss.

1. Wichita, Kan.

What’s Going On Down There?

With the exception of Wichita and Dayton, the list comprises entirely southern cities (the AAFA counts Oklahoma City in the South), which raises the inevitable question: why are southern people so susceptible to allergies?

As it turns out, folks down south are not more susceptible to allergies. What’s different is the presence of ragweed, which grows predominantly in the South, Northeast, and Midwest and can travel up to 400 miles by wind. A single plant can produce a billion grains of pollen in one season. Multiply that by fields upon fields of the common fall allergen and you’ve got one sniffly segment of the population.

To carry out its evaluation, the AAFA looked at pollen levels, over-the-counter and prescription allergy medicine purchases, and the number of board certified allergists in the 100 most populated metropolitan areas. New York City and Los Angeles, widely regarded as two of the most polluted cities in the country, fell at 56 and 76, respectively — due in part to the pollen's inability to make its way past the jungle of concrete and into people’s sinuses.

However, ragweed is no stranger to certain urban areas, as it can appear “in cracks in sidewalks, along sides of roads and on roofs of buildings," Mike Tringale, vice president of external affairs at AAFA, told USA Today, possibly explaining why Dallas climbed from 26th to 18th this year, and Detroit moved up nine spots to No. 19.

"This fall could be a perfect storm for allergy sufferers, as global weather conditions boost ragweed levels, and fall storms and tornadoes disperse allergens and outdoor mold,” the AAFA states alongside this year’s list.

The report was sponsored by Dymista (azelastine HCl and fluticasone propionate), a prescription nasal spray intended to relieve the symptoms of seasonal allergies in people 12 years of age and older.

Approximately 40 million Americans suffer from seasonal allergies. People with fall allergies should take caution on windy days, when pollen is most likely to be airborne. Taking frequent showers, closing the windows, and opening the car windows before turning on the air conditioning (so as to let the mold spores disperse), can help reduce the frequency and severity of fall allergies.

“Many [people] can be helped with modern medical treatments,” says Dr. Bruce Gordon, an ear, nose, and throat allergy specialist at Cape Cod Hospital, “if they would only complain to their doctors and get tested to detect possible allergies.”

Alternatively, if you live in a large city or in the South, consider using some leftover vacation days and avoid the problem altogether.