The website of the AAFA calls the cities on its list “the 100 most challenging places to live with allergies” in the United States.

The rankings by the AAFA are based on three major factors: (1) amount of allergy medication used per patient, (2) seasonal pollen scores (airborne grass/tree/wee pollen and mold spores) and prevalence of allergies, and (3) number of allergy specialists per patient.

Get your tissues out because the worst metropolitan city in the United States in 2008 for spring allergies is:

Lexington, Kentucky.

The U.S. cities for the second to tenth worst conditions for spring allergies are:

2. Greensboro, North Carolina
3. Johnson City, Tennessee
4. Augusta, Georgia
5. Jackson, Mississippi
6, Knoxville, Tennessee
7, Birmingham, Alabama
8. New Orleans, Louisian
9. Little Rock, Arkansas
10. San Diego, California

To find your city on the list of top 100 allergy capitals in the United States, please go to the AAFA website “Allergy Capitals ” and click on “2008 Spring Rankings” (under the title “Spring Allergy Capitals 2008”).

You might want to have a tissue handy before looking at the list, especially if you live in the eastern half of the United States, where the number of cities far outdistances the number in the western half of the country.

And, a whole box of tissues might be advisable for those of you in the southeastern part of the United States.

According to the AAFA, over 35 million people in the United States suffer from allergic rhinitis (hay fever) each year, usually during the spring and early summer.

The only place in the United States that looks pretty safe for spring allergy sufferers is the Upper Great Plains states of Wyoming, Montana, Idaho, North Dakota, South Dakota, and Nebraska, in the upper western part of the country.