It’s been a long, long winter, but spring is finally here! Along with sunny days and cool breezes, the next few months will trigger good ole spring allergies. Symptoms could be worse for allergy sufferers who live in certain cities in the U.S, according to the Asthma and Allergy Foundation of America (AAFA).

For the past 12 years, the foundation has released a list of top worst cities for allergy sufferers. This year – and for the third time in the report’s history – Louisville, Ky. tops the list as the #1 Spring Allergy Capital. The rankings are based on a variety of factors, including prevalence data, pollen scores, number of allergy medicine used per patient and the number of Board Certified Allergists per patient.

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Below are the top 10 allergy capitals of 2014, with last year's ranking in parenthesis:

  1. Louisville (#5)
  2. Memphis (#8)
  3. Baton Rouge (#10)
  4. Oklahoma City (#9)
  5. Jackson, Miss. (#1)
  6. Chattanooga, Tenn. (#3)
  7. Dallas (#23)
  8. Richmond, Va. (#22)
  9. Birmingham, Ala. (#14)
  10. McAllen, Texas (#4)

You can find the full list at here.

“Allergy and asthma patients already have a chronic sensitivity to things like pollen, mold and other airborne allergens, but they can also be more susceptible to rapid changes in temperature, moisture, and air quality,” Dr. Clifford Bassett, medical director of Allergy and Asthma Care of NY and an ambassador for the AAFA, said in a statement. “A blending of the winter and spring means these patients are at risk of multiple symptoms simultaneously. But with proper planning and early treatment, patients can prepare and find relief.”

If you’re one of the 45 million Americans who suffer from allergies, here are a few tips that can help ease symptoms this spring:

  • Keep your windows closed. Driving with your windows down and feeling the cool spring breeze may be just what you need to start your weekend, but if you have allergies, it may not be a good idea. At home, try using a humidifier to maintain humidity at 30-50%. Don’t forget to change your air filters.
  • Use allergy bedding to keep symptoms at bay. Allergy mattress covers and pillow covers encase your bedding on all sides to keep it free from dust mites and other allergens. The breathable covers not only hypoallergenic, but also allow for airflow so you can get a better night’s sleep.
  • Wear protective gear. On windy and high-pollen days, wear sunglasses to keep pollen out of your eyes. A hat, especially one with wide brims, also helps keep pollen out of your hair as you go about your day. Be sure to thoroughly clean your face and wash your hair before hitting the sheets at night!

“No matter what time of the year it is, and no matter what Mother Nature sends our way, people with allergies need to be prepared and proactive to avoid allergy misery,” Dr. Bassett said. “Now we have the ability to prevent symptoms before they even occur, but patients have to take the first step to visit their doctors and to get ahead of their disease.”