The Asthma and Allergy Foundation of America (AAFA) has named Knoxville, Tenn, the #1 Spring Allergy Capital in its new list of the 100 “Allergy Capitals”—the most challenging places to live with spring allergies. High pollen counts, high use of allergy medications by patients, and too few allergists to treat the allergy population, earned Knoxville the top spot.

Louisville, Ky; Chattanooga, Tenn; Dayton, Ohio; and Charlotte, NC rounded out the top five.