TAMPA, Fla. (WFLA) — A new report from the Asthma and Allergy Foundation of America ranks the 100 largest cities when it comes to the worst seasonal allergies in the U.S.

The study looks at how challenging it is for residents to manage seasonal pollen allergies. Researchers analyzed the cities’ weed, grass and tree pollen scores, use of over-the-counter allergy medications and availability of immunologists and allergy specialists to determine their placement.

Wichita, Kansas topped the list of cities based on its high pollen count and lack of board-certified allergists. Florida had the most cities in the top 20, with seven. Sixth-place Sarasota ranked highest in the state.

Climate change is making seasonal allergies worse and warmer states like Florida have been feeling the effects for decades, AAFA researchers said. Rising global temperatures means more time for pollen producers to grow, which leads to higher concentration of the allergen.

From 1990-2018, the plant growing season extended an average of 20 days, producing about 21% more pollen, according to the AAFA. Last month’s report on seasonal allergies from Climate Central found allergy seasons grew by as much as 50-99 days in some cities.

“We are experiencing longer and more intense allergy seasons because of climate change. For people with asthma, allergies can trigger an asthma attack,” said Kenneth Mendez, CEO and president of AAFA. “If we don’t take immediate action on the climate crisis, pollen production will only intensify.”

Intense allergy seasons pose a risk to the nearly 26 million Americans with asthma, according to AAFA. The report said the condition is triggered by allergies in 60-80% of patients.

“As pollen counts spike, we often see spikes in emergency room visits for asthma,” Mendez said. “Around 3,600 people per year die from asthma, so it is important to address and manage asthma and allergy triggers where you live.”

The top 20 Allergy Capitals of America, according to the AAFA:

To see where the other 80 metros rank, view the full allergy capitals report here.